By Bénédicte Faure, European Chronic Disease Alliance
There is extensive evidence on the cost-effectiveness of the WHO Best Buys and other recommended interventions to address the risk factors of chronic diseases. Many good practices in prevention and control are available and already implemented in different countries. Momentum is growing internationally on the urgency to act on chronic diseases, which affect one-third of the European population aged 15 and over in Europe[1], and 23.5% of working-age Europeans[2]. There is evidence, knowledge, expertise and capacity to leverage funding mechanisms across the European Union (EU) to act. Further, we know the central role that health plays in national and global development agendas and in building, strong, sustainable societies and economies. So, what are we waiting for?
Perhaps the answer to this question is political ambition. The UN High-Level Meeting on Non-communicable Diseases (NCDs) on 27th September provides a window of opportunity to bring game-changing results. This hinges on a strong political outcome document – which needs political ambition, determination and will. The outcome document must contain time-bound commitments from Member States to deliver measurable progress, including national NCD plans, associated with a rigorous review in 2022. Achievement of the 25×25 goals will help reach the UN Sustainable Development Goal (SDG) 3 on “good health and wellbeing”, in particular target 3.4 on NCDs. It will also contribute to the success of at least nine other SDGs[3] including to reducing poverty, reducing inequalities, improve air quality, promote economic growth.
The Lancet Taskforce on NCDs and economics made a clear case for investment in prevention and management, highlighting how price policies are effective tools to control NCDs without a negative impact on population groups with low socioeconomic status [4]. Fiscal measures should be directed toward incentivising healthy diets and lifestyles, implementing the Framework Convention on Tobacco Control[5] and reducing alcohol consumption. Together with interventions aimed to limit citizens’ exposure to marketing of unhealthy food and drink products and promote physical activity, they have the potential to create health-friendly environments, conducive to healthy lives and facilitating healthy choices. This is particularly important when data show that in all EU countries, citizens’ mean daily salt intake exceeds the recommended levels [6]; millions of Europeans still consume trans fats at levels that significantly increase their risk of coronary heart disease [7]; exposure to high levels of air pollution is causing the premature death of over 400 000 Europeans annually [8]; and half of the EU population is reported to never exercise or play sport [9]. This situation has clear economic and societal consequences: it is estimated that external health-related costs of air pollution alone range between 330-940 billion euro per year [10].
The ECDA and other civil society organisations in Europe stand ready to support Member States and the EU institutions implement strong commitments to reduce the prevalence and mortality from chronic diseases in Europe. The Global Week for Action on NCDs on 3-9 September 2018 will be the occasion to put NCDs in the spotlight and sustain the momentum generated by the UN High-Level Meeting for tangible action.
EU Member States and the European Commission must be proactive in this fight. Europe, with the highest burden of chronic diseases globally, can be the leader.
[1] OECD/EU (2016), Health at a Glance: Europe 2016 – State of Health in the EU Cycle, OECD Publishing, Paris.
[2] Mapping European Welfare Models: State of the Art of Strategies for Professional Integration and Reintegration of Persons with Chronic Diseases
[3] Investing in non-communicable disease prevention and management to advance the Sustainable Development Goals. Nugent, Rachel et al. The Lancet , Volume 391 , Issue 10134 , 2029 – 2035
[4] Investing in non-communicable disease prevention and management to advance the Sustainable Development Goals. Nugent, Rachel et al. The Lancet , Volume 391 , Issue 10134 , 2029 – 2035
[5] WHO Framework Convention on Tobacco Control
[6] European Commission: EU Science Hub: Health Promotion and Disease Prevention | Dietary Sodium/Salt
[7] WHO Europe (2015), Eliminating transfats in Europe – A policy brief.
[8] EEA (2017). Air Quality in Europe – 2017 Report. European Environment Agency
[9] Special Eurobarometer 472 – Sport and physical activity. December 2017
[10] Commission Communication. A Europe that protects: Clean air for all. May 2018