BMJ 2015;350:h331 doi: 10.1136/bmj.h331 (Published 19 January 2015)
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News
NEWS Most countries will fail to meet targets on non-communicable diseases, says WHO Anne Gulland London
Most countries are set to fail to meet global targets on tackling non-communicable diseases, a report by the World Health Organization has said.1 The report looks at progress made on targets set in 2013, two years after world leaders agreed to tackle this growing problem at a United Nations high level meeting.2 In 2013 the World Health Assembly adopted a monitoring framework with 25 indicators and nine voluntary global targets set for 2025. However, in the latest report WHO said that while some countries were making progress, most were off course to meet the global targets on non-communicable disease. Progress remained “uneven and inadequate,” WHO warned, and the report highlighted “missed opportunities to strengthen governance, prevention and reduction of risk factors, health care, and surveillance and monitoring, particularly in low and middle income countries.”
Non-communicable diseases are the leading cause of deaths worldwide and were responsible for 38 million of the world’s 56 million deaths in 2012. Some 16 million of these deaths (40%) occurred in people aged under 70. People living in WHO’s Africa and South East Asian regions were most at risk of dying from a non-communicable disease, and 25% of deaths in South East Asia and 21% in Africa between the ages of 30 and 70 were caused by a non-communicable disease.
The report found that as at December 2013 only 70 countries had at least one operational national plan in line with the global action plan on non-communicable diseases. Just 56 countries had a plan to reduce physical inactivity; only 60 countries had national plans to reduce unhealthy diets; 69 countries had a plan to reduce the burden of tobacco use; 66 countries had a plan to reduce the harmful use of alcohol; and just 42 countries had monitoring systems to report on the nine global targets.
Shanthi Mendis, the report’s author, said that many of WHO’s recommendations were affordable to most countries, even low and middle income countries. “Every country can make good progress, even if they don’t reach the actual target,” she said. “It’s clear that when you look at the set of interventions we have costed, most of these costs can be met by the countries themselves.”
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Mendis said that many countries were spending large amounts on curative interventions while neglecting primary healthcare and early interventions, an approach she described as “trying to mop the floor with the tap open.” She added, “They need to re-channel some of the resources put into curative interventions toward public health approaches, towards the 15 interventions we have highlighted which cost less than one dollar a person.” WHO’s “best buys” include promoting and protecting breast feeding, restricting or banning alcohol advertising and promotion, replacing trans fats with polyunsaturated fats, and introducing hepatitis B immunisation to prevent liver cancer.
The first target is a 25% relative reduction in overall mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases. However, the report found that nearly a fifth of countries (19%) did not have a well functioning civil registration system to record causes of death, had a weak health system, and had inadequate funding for prevention and control of non-communicable diseases. Just 45% of low income countries had capacity for reporting cause specific mortality. Another key target is the reduction of tobacco use by 30%, but the report warned that although significant progress had been made in this area tobacco was still responsible for six million preventable deaths a year. The report found that countries seemed “complacent” about efforts to control tobacco, which, “coupled with insufficient political will and tobacco industry interference, is hindering efforts to move ahead.”
In 2013 only 46 countries, including 35 low and middle income countries, had complete smoking bans in indoor working places, public transport, and indoor public places. And some of these countries were considering extending the smoking ban to include spaces such as parks, outdoor cafes, and even some streets. 1 2
World Health Organization. Global status report on non-communicable diseases. January 2015. www.who.int. Coombes, R World leaders sign up to tackle non-communicable diseases. BMJ 2011;343:d6034.
Cite this as: BMJ 2015;350:h331 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
News
NEWS Most countries will fail to meet targets on non-communicable diseases, says WHO Anne Gulland London
Most countries are set to fail to meet global targets on tackling non-communicable diseases, a report by the World Health Organization has said.1 The report looks at progress made on targets set in 2013, two years after world leaders agreed to tackle this growing problem at a United Nations high level meeting.2 In 2013 the World Health Assembly adopted a monitoring framework with 25 indicators and nine voluntary global targets set for 2025. However, in the latest report WHO said that while some countries were making progress, most were off course to meet the global targets on non-communicable disease. Progress remained “uneven and inadequate,” WHO warned, and the report highlighted “missed opportunities to strengthen governance, prevention and reduction of risk factors, health care, and surveillance and monitoring, particularly in low and middle income countries.”
Non-communicable diseases are the leading cause of deaths worldwide and were responsible for 38 million of the world’s 56 million deaths in 2012. Some 16 million of these deaths (40%) occurred in people aged under 70. People living in WHO’s Africa and South East Asian regions were most at risk of dying from a non-communicable disease, and 25% of deaths in South East Asia and 21% in Africa between the ages of 30 and 70 were caused by a non-communicable disease.
The report found that as at December 2013 only 70 countries had at least one operational national plan in line with the global action plan on non-communicable diseases. Just 56 countries had a plan to reduce physical inactivity; only 60 countries had national plans to reduce unhealthy diets; 69 countries had a plan to reduce the burden of tobacco use; 66 countries had a plan to reduce the harmful use of alcohol; and just 42 countries had monitoring systems to report on the nine global targets.
Shanthi Mendis, the report’s author, said that many of WHO’s recommendations were affordable to most countries, even low and middle income countries. “Every country can make good progress, even if they don’t reach the actual target,” she said. “It’s clear that when you look at the set of interventions we have costed, most of these costs can be met by the countries themselves.”
For personal use only: See rights and reprints http://www.bmj.com/permissions
Mendis said that many countries were spending large amounts on curative interventions while neglecting primary healthcare and early interventions, an approach she described as “trying to mop the floor with the tap open.” She added, “They need to re-channel some of the resources put into curative interventions toward public health approaches, towards the 15 interventions we have highlighted which cost less than one dollar a person.” WHO’s “best buys” include promoting and protecting breast feeding, restricting or banning alcohol advertising and promotion, replacing trans fats with polyunsaturated fats, and introducing hepatitis B immunisation to prevent liver cancer.
The first target is a 25% relative reduction in overall mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases. However, the report found that nearly a fifth of countries (19%) did not have a well functioning civil registration system to record causes of death, had a weak health system, and had inadequate funding for prevention and control of non-communicable diseases. Just 45% of low income countries had capacity for reporting cause specific mortality. Another key target is the reduction of tobacco use by 30%, but the report warned that although significant progress had been made in this area tobacco was still responsible for six million preventable deaths a year. The report found that countries seemed “complacent” about efforts to control tobacco, which, “coupled with insufficient political will and tobacco industry interference, is hindering efforts to move ahead.”
In 2013 only 46 countries, including 35 low and middle income countries, had complete smoking bans in indoor working places, public transport, and indoor public places. And some of these countries were considering extending the smoking ban to include spaces such as parks, outdoor cafes, and even some streets. 1 2
World Health Organization. Global status report on non-communicable diseases. January 2015. www.who.int. Coombes, R World leaders sign up to tackle non-communicable diseases. BMJ 2011;343:d6034.
Cite this as: BMJ 2015;350:h331 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
