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TOWARDS A GLOBAL DIET TOWARDS A GLOBAL DIET AND PHYSICAL ACTIVITY AND PHYSICAL ACTIVITY

STRATEGYSTRATEGY

APPROACH - PROGRESS - CHALLENGES

DEREK YACHEXECUTIVE DIRECTOR

NONCOMMUNICABLE DISEASES AND MENTAL

HEALTH

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THE PROBLEMTHE PROBLEM

• UNHEALTHY DIETS AND PHYSICAL INACTIVITY ARE MAJOR CONSTRIBUTORS TO THE BURDEN OF DISEASE WORLDWIDE

• WHAT’S NEW?

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Global prevalence of Global prevalence of diabetes diabetes

current estimatescurrent estimates• Number of people with diabetes:

– 177 million (154 million projected)

• Top 10 countries (number of people with diabetes):– India, China, USA, Indonesia, Russia, Japan, UAE,

Pakistan, Brazil, Italy

Source: WHO/EIP Global Burden of Disease

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Global prevalence of underweight Global prevalence of underweight and obesity in adults for year 2000and obesity in adults for year 2000

by level of developmentby level of development

0

5

10

15

20

25

Global Least developedcountries (45)

Developingcountries (75)

Economies intransition (27)

Developedmarket economycountries (24)

BMI < 17.00 BMI > 30.00

Prevalence (%)

BMI = Body Mass IndexSource: WHO, SDE/NHD, 2000

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NCD related mortalityNCD related mortality

• In the mid-90s in South Africa 17% of all death were due to CVD, in China 34% and in Russia 55% *

• Between 2000 and 2020 deaths due to cancer will increase from 2.6 to 3.5 million in developed countries and from 3.6 to 6.3 million in developing countries#

*Global Cardiovascular Infobase# WHO National Cancer Control Programmes, 2002

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• The behavioural factors lead to high blood pressure & hypertension, blood glucose intolerance & diabetes, elevated blood cholesterol & hypercholesterol anaemia, overweight and obesity.

NCD risk factorsNCD risk factors

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MAJOR RISKS FOR DEATHMAJOR RISKS FOR DEATH

High BMILow fruit consumption & high cholesterol

Tobacco (men)

High cholesterol

Alcohol abuseHigh blood pressure

High blood pressure

Tobacco(men)

Unsafe sex

TobaccoHigh blood pressure

Underweight

High incomecountries

Middle income countries

Low income countries

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NCDs are to a great extent NCDs are to a great extent preventable diseasespreventable diseases

• Evidence for prevention exists

• Population-based prevention is the most cost-effective and the only affordable option for major public health improvement in NCD rates

• Major changes in population rates can take place in a surprisingly short time

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Diet and risk of NCDDiet and risk of NCD

• Healthy diet, maintaining normal weight and adequate physical activity throughout the life span are the most effective ways of preventing NCD

• Simple changes in lifestyles can powerfully prevent chronic diseases and promote health

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WHO RESPONSEWHO RESPONSE

• Science: WHO/FAO expert report; World Health Report- Risks to Health 2002

• WHA resolutions - WHO Global Strategy

• DG statements

• Advocacy: World Health Day 2002, process for Global Strategy

• Stakeholder involvement

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WHO/FAO expert WHO/FAO expert consultation report - consultation report - example commentsexample comments

• Physical activity is the key to obesity

• Its not the soft drinks• Breastfeeding is bad for breast

cancer in baboons• Reduced salt threatens iodine

programs• What about the nuts, spices…?

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OUR MANDATEOUR MANDATE

World Health Assembly 2002:

Resolution 55.23 on diet, physical activity and

health: calls for preparation of Global Strategy

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“High blood pressure and high blood cholesterol, strongly linked to cardiovascular and cerebrovascular diseases, are also closely related to excessive consumption of fatty, sugary, salty foods. They become even more dangerous when combined with deadly forces of tobacco and excessive alcohol consumption.

Obesity, a result of unhealthy consumption, is itself a serious health risk”

Dr Gro Harlem Brundtland, Director General 55th World Health Assembly, Geneva

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I shall also reinvigorate WHO’s work on diet, food safety and human nutrition – linking basic research with efforts to tackle specific nutrient deficiencies in populations and the promotion of good health through optimal diets.

Dr Gro Harlem Brundtland, Director General 55th World Health Assembly, Geneva

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Consultation Process Consultation Process

Memberstates

Memberstates

Civil SocietyCivil

SocietyPrivate sectorPrivate sector

UN agencies

UN agenciesP

has

e II

WHO Strategy on Diet, Physical Activity and HealthWHO Strategy on Diet, Physical Activity and Health

WHA 2004WHA 2004

EB Jan 2004EB Jan 2004SecretariatSecretariatReference

groupReference

group

Ph

ase

III

Preparation of consultation process and finalization of expert report

Preparation of consultation process and finalization of expert report

Ph

ase

I

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STAKEHOLDER STAKEHOLDER INVOLVEMENTINVOLVEMENT

• CLIMATE TO TALK• DEFINE JOINT ACTIONS FOR GOOD• ACKNOWLEDGE THAT SOME AREAS

WILL TAKE A LONG TIME• ADDRESS GLOBAL DIVERSITY

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CHALLENGESCHALLENGES

• NGO’s AND PRIVATE SECTOR’s AGENDA IS VAGUE

• SCIENCE DISPUTED: MEDIA CONTROVERSY DOMINATES

• COMPLEX TRADE-OFFS• LONG TIME TO SEE RESULTS

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CHALLENGES TO NGOsCHALLENGES TO NGOs

• MORE COHERENT “DEMANDS”• OPEN DECLARATION OF INTERESTS• GLOBALLY APPLICABLE MESSAGES• ACKNOWLEDGE COMPLEXITY AND

TRADE-OFFS• BROADER ALLIANCE OF NGOs