Towards a Global Strategy on Diet, Physical Activity and Health Dr Pekka Puska, Director Noncommunicable Disease Prevention and Health Promotion Department World Health Organization, Geneva World Health Organization
The World Health is in Transition Epidemiological: NCD overriding CD, & double burden of diseases in many developing countries. Demographic: Population ageing. Nutritional: Diets are rapidly changing and physical activity reduced. Urbanization: Great changes in lifestyle Globalisation: Increasing global influences. World Health Organization
Deaths by broad cause group 2001 Total deaths: 56 554 000 Noncommunicable Injuries (9%) conditions (58.5%) Communicable diseases, maternal and perinatal conditions and nutritional deficiencies (32.5%) World Health Organization Source: WHO, World Health Report 2002
Deaths, by broad cause group and WHO Region, 2000 % 75 Source: WHO, World Health Report 2001 50 25 AFR EMR SEAR WPR AMR EUR Noncommunicable Communicable diseases, maternal Injuries conditions and perinatal conditions and nutritional deficiencies World Health Organization
NCDs are to a great extent preventable diseases • Medical 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. World Health Organization
World Deaths in 2000 attributable to selected leading risk factors Blood pressure Tobacco Cholesterol Underweight Unsafe sex Fruit and vegetable intake High Body Mass Index Physical inactivity Alcohol Unsafe water, sanitation, and hygiene Indoor smoke from solid fuels Iron deficiency Urban air pollution Zinc deficiency Vitamin A deficiency Unsafe health care injections Occupational risk factors for injury Number of deaths (000s) 0 1000 2000 3000 4000 5000 6000 7000 8000 World Health Organization Source: WHR 2002
6 out of the 10 main risk factors relate to diet and physical activity • Blood pressure • Cholesterol • Fruit and vegetable intake • High BMI • Physical Activity • Alcohol World Health Organization
Diet and risk of NCD Eating healthily, maintaining normal weight, not smoking, and being physically active throughout the life span can prevent: • Up to 80 % of cases of coronary heart disease • Up to 90 % of type 2 diabetes • About one third of cancers World Health Organization
Global strategy on diet, physical activity and health: our mandate • WHA resolution on a Global Strategy for prevention and control of NCDs (2000) • WHA discussion paper on health promotion (2001) • WHA resolution on diet, physical activity and health: calls for preparation of Global Strategy (2002) World Health Organization
Phase VI Implementation at country level Implementation at country level WHO Strategy on Diet, Physical Activity and Health WHO Strategy on Diet, Physical Activity and Health Phase III WHA 2004 WHA 2004 EB Jan 2004 EB Jan 2004 Reference Reference Secretariat Secretariat group group Consultation Process Consultation Process Phase II Member Member UN Civil Private UN Civil Private states states Agencies Society sector Agencies Society sector Phase I Preparation of consultation process Preparation of consultation process and finalization of expert report and finalization of expert report World Health Organization
The Regional Member State Consultations SEARO 10 - 12 March 2003 New Delhi AFRO 18 - 21 March 2003 Harare EURO 2 - 4 April 2003 Copenhagen AMRO 21 - 24 April 2003 San José EMRO 30 Apr -2 May 2003 Cairo WPRO 9 - 11 June 2003 Kuala Lumpur more than 80 Member States participated World Health Organization
Process with Stakeholders - private sector • Dialogue with representatives of food, non-alcoholic beverage, sport and insurance companies, individually and through International Business Leaders Forum • World Economic Forum: WHO D-G met with executives from food companies (Jan 03) • WHO D-G Roundtable with executives from food, non- alcoholic beverage, sport and insurance companies (May 03) • Consultation with industry food, non-alcoholic beverage and sport trade associations (June 03) World Health Organization
Process with Stakeholders - civil society • Dialogue with representatives of international CSOs and NGOs; individually and through networks • On-line discussion, arranged with Stakeholder Forum, to solicit views from CSOs/NGOs on the Global Strategy (May-April 03) • WHO D-G Roundtable with representatives of international civil society organisations (May 03) • Consultation with international CSOs/NGOs whose focus includes chronic diseases, nutrition, PA (May 03) World Health Organization
Process with Stakeholders - UN and Intergovernmental Agencies • Dialogue with representatives of UN and other agencies, individually and at international meetings • Meeting of UN Standing Committee on Nutrition (March 03) • Consultation with UN and other agencies, with representatives from FAO, IFPRI, IAEA, UNECE, UNESCO, UNDP, UNSCN, World Bank, and WFP(June 03) • WHO/FAO Expert Report, WHO/FAO Fruit and Vegetable Promotion Initiative, Codex World Health Organization
May 2004 57th World Health Assembly Incorporation of Member States’ comments, suggestions 113th Executive Board Session January 2004 Global Strategy provided to Member States Middle or late within EB agenda item on NCD Prevention November 2003 Preparation of all EB documents (WHO/GOV) October 2003 Internal comments, and advice from Reference Group, Regional Offices August/ Drafting the Global Strategy document (secretariat) September 2003 Recommendations from Member States Recommendations from Member States and other stakeholders and other stakeholders World Health Organization (Consultations of Spring 2003: http://www.who.int/hpr/gs.consultation.document.shtml) (Consultations of Spring 2003: http://www.who.int/hpr/gs.consultation.document.shtml)
Global Strategy - content • Introduction • The challenge • The opportunity • Goals and Objectives • Evidence for Action • Principles for Action • Obligations and Responsibilities for Action (WHO, Member States, International Partners, Civil Society/NGOs, Private Sector) • Follow-up and Future Developments • Conclusions World Health Organization
Key topics the strategy addresses • National strategies on diet and PA:healthy choices • National dietary guidelines • National PA guidelines • Information environment: health claims, marketing, labelling, nutrition education • National food and agriculture policies: pricing, food programmes • Prevention in health services • Surveillance, research and evaluation • Institutional capacity • Reference to international standards like CODEX ALIMENTARIUS World Health Organization
WHO aims at effective, evidence based strategies that • are based on national policies, • but address the reality of global process. World Health Organization
Implementation • WHO/ROs to develop regional strategies • WHO/HQ and RO to provide technical support to countries in developing national diet & PA strategies • WHO to continue to interact with all stakeholders • WHO to continue with strong advocacy World Health Organization
It is important to have the strategy adopted, but that is not an aim itself. It should lead to effective implementation in countries and to successful reduction of NCD rates in countries and globally. World Health Organization
World Health Organization
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