Author: Alessandro Demaio, MBBS MPH PhD

What’s an NCD?

With the UN NCD Review this week in New York City, we recap on what Non-Communicable Diseases are… And why they matter.

This week in New York City, all eyes in the Global Health community will be on the UN NCD Review. As the last three years have flashed by since the 2011 High-Level Meeting, now is the moment to take stock and reflect on the progress – and challenges – of tackling this growing epidemic.

General Assembly resolution 66/2 of 19 September 2011, containing the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases called for the convening of a comprehensive review and assessment in 2014 of the progress achieved in the prevention and control of non-communicable diseases.


Forgotten what NCDs are? Watch this short voxpop from NCDFREE and jog your memory…


So what are the facts on NCDs?

- Non-Communicable Diseases are a group of varied and often chronic conditions including diabetes, heart disease (including stroke), cancers, chronic lung diseases and mental illness.

- Together, NCDs are the leading contributors of global morbirity and morbitity accounting for 60% of global deaths in 2010.

- 80% of global NCD mortality occurs in the world’s low and middle-income countries, representing a barrier to economic and social development.

- NCDs threaten to slow, halt and at worst, reverse progress on the MDGs and their replacement agenda.


To understand more, click on the e-lecture below to learn what NCDs are, who they affect and what you can do.



Dr Alessandro Demaio (@SandroDemaio) is Postdoctoral Fellow in Global Health at the Harvard Global Equity Initiative, Harvard Medical School and an Assistant Professor at the University of Copenhagen.

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A Peruvian Story of Cancer, and Health

This week, we bring you the latest in our Global Health short films, by Alessandro and the team at NCDFREE - partnering this time, with GlobalRT. Set in Lima, the films follows the stories for two young females affected by and affecting cancer. This film was commissioned and co-funded by GlobalRT, UICC and NCDFREE.



Earlier this year, I wrote a short piece on cancer care while shooting a global health film in the Peruvian capital, Lima. Highlighting the progress, myths and challenges in oncology and public health – and exploring some of the incredible work of innovative healthcare providers in resource-poor settings.

As an academic, I see an essential mandate of my role is to break down the barriers between science and the community. Not only to develop and further science – but also to communicate it to a broad audience in a way that is engaging, understandable and relevant.

To do this, I am always looking for new, effective ways to connect with a wide audience and with them, question the things we do as a society. Challenge the everyday rhetoric and flag processes, conditions or ideas that are unjust, unsustainable, inefficient or inequitable. Focusing on Global Public Health.

One very important way I see we as academics can continue to reach and engage everyone in science in 2014 – is through film. With this in mind and together with our sensational team at NCDFREE, we have now made a handful of short video-based narratives over the last 12 months – each focusing on an important health issue, hero or message.

For this latest film, we travelled to Peru to capture the story of a young cancer survivor and mother – and the doctor who made her survival possible. Entitled “Veronica: a Peruvian story of cancer, and health” – we highlight the journeys of two strong young woman affected by and affecting Non-Communicable Disease (NCDs). We aim to engage, inspire and challenge you – and your ideas about health.

Supported and commissioned by GlobalRT and the UICC – this film was shot working closely with an incredible local videographer, Lali Houghton.

For more information on radiotherapy and the important work of GlobalRT – or on NCDFREE and the making of this short film – head to the websites.


Dr Alessandro Demaio is Postdoctoral Fellow in Global Health and NCDs at the Harvard Global Equity Initiative, Harvard Medical School and an Assistant Professor at the Copenhagen School of Global Health. To follow the next journey in Global Health film, connect with Sandro on Twitter via @sandrodemaio and @NCDFREE.

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NCDFREE Bootcamp for Global Health Advocacy, Melbourne

10320451_729359773753428_5023284381833903433_nA mid-week morsel from NCDFREE.

The wrap-up film from their recent Advocacy and Innovation Bootcamp. Bringing together 50 bright young minds from all disciplines the organisation had three outcomes in mind. The first, for the group to mingle, strike friendships and develop new link and maybe collaborations with other sectors. The second was to impart new skills in design and innovation thinking, leadership, public speaking and social entrepreneurship. Finally, NCDFREE wanted something from these bright young minds. NCDFREE sourced their next film and campaign ideas through a challenge-pitching competition.

A fun day for everyone, but enough talk, here’s an insight into the real deal…



Follow Sandro on Twitter.


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Interview: Global Health Film-Maker


This week, we continue our PLOS TGH podcasting – as Melbourne-based Global Health enthusiast Lilli Morgan interviews film-maker Lali Houghton on location, as he films a short film for NCDFREE, GlobalRT and UICC in Lima, Peru.


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Climate Change – Health Threat or Opportunity?

This week, we support the great work of  The Global Climate and Health Alliance – in time for the release of the latest IPCC WG report. This infographic explains the major ideas and themes – we encourage you to share it far and wide. 

IPCC Climate Change Infographic 02


The Global Climate and Health Alliance was formed in Durban in 2011 to tackle climate change and to protect and promote public health. The Alliance consists of health organizations from around the world united by a shared vision for a sustainable future. Specifically the Alliance members work together to: (1) Ensure health impacts are integrated into global, national and local responses to climate change; (2) Encourage the health sector to mitigate and adapt for climate change.

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Global Health PodCast Interview with Dr Fiona Lander, Medical Doctor & Human Rights Lawyer

This week on PLOS Translational Global Health, we continue our podcast series in Global Health with medical doctor and human rights lawyer, Fiona Lander. Coming from  Melbourne, in South-East Australia, Alessandro asks Fiona about her time with the United Nations, in medical practice and travelling the globe.

uni-news2Dr Fiona Lander holds degrees with dual honours in Medicine/Surgery and Laws from Monash University. She works in the areas of intellectual property and pro bono law, alongside her medical practice in the field of emergency medicine. Fiona previously worked in India as Senior Officer assisting the United Nations Special Rapporteur on the right to health, and has also worked with the Health and Human Rights team of the World Health Organisation in Geneva, Switzerland. She is the founder of the Global Health and Medicine working group at the Henley Club, Melbourne.

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Global Health PodCast Interview with Prof Kerin O’Dea, Nutrition & Public Health Expert

This week on PLOS TGH, we continue exploring the medium of Global Health podcasts. Coming from central Melbourne, in South-East Australia, Alessandro interviews the globally recognised and respected Professor in Nutrition and Public Health – Kerin O’Dea.


Kerin-ODeaProfessor Kerin O’Dea is Professor: Nutrition and Public Health in the Health Sciences Division of the University of South Australia. Professor O’Dea is currently engaged in research on an NHMRC Program Grant titled ‘Improving Chronic Disease outcomes for Indigenous Australians: Causes, Interventions, System Change.’ Professor O’Dea is interested in the therapeutic potential of traditional diets and lifestyles of numerous populations, including Indigenous Australians.

Key previous senior academic and research leadership positions include: Director of the Sansom Institute for Health Research, UniSA (2009-2012), Professorial Fellow, University of Melbourne, Department of Medicine, St Vincent’s Hospital (2006-2009); Director, Menzies School of Health Research, Darwin NT (2000-2005); Deakin University (1988-1997) as Professor of Human Nutrition, Dean of Health & Behavioural Sciences (1993-1994) and Pro Vice Chancellor Research (1995-1996).

She has been an active part of numerous national committees over many years advising government on health and medical research, Indigenous health, nutrition, and diabetes.


Prof O’Dea in The Lancet:

Having contributed to the explosion in nutrition-related research in the past few decades, O’Dea says it’s now time for concerted action. “One of the things that characterises much public health research is that we describe how bad things are but don’t do enough intervention,” she says. “Today, taking no action can be more expensive than the interventions themselves.”


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7 New Year’s Resolutions for a Healthier World

It’s that time again – ‘zero one, zero one’. The new year begins and the old slips away. A time for celebrating, enjoying and reflecting. A time to think about the important things in our lives and how we can prioritise them.

As 2014 starts, many of us will be making resolutions. Promises, big and small, for the year ahead. But this year, let’s not just think of the local – or the ‘me’ – when contemplating our New Year’s commitment.

Thinking beyond the horizon, what small but important actions can each of us do to help the wider community achieve happier, healthier lives?

Here are seven simple suggestions…

1. Donate some time and get back much more

Volunteers are a crucial part of our modern economy and a functioning society. Donating a small amount of time and an enormous repertoire of skills, unpaid workers who choose to give some hours each week or month can make the world of difference for organisations and people doing great things. Find something that you love to do anyway or find a group that you enjoy hanging out with – it is a rich and meaningful way to give back, have fun and catalyse a better world.

2. Forego a meal out, to feed those in need

Christmas is an expensive time and most of us are under some financial pressures, but making a small contribution to a charity or community group not only makes us warm and fuzzy – but keeps them running. Every dollar counts.

Put aside a small amount each week and very quickly this adds up to a substantial donation. A great idea is to forego a meal out at a restaurant or cafe each week. This $10 becomes $500 over the 12 months ahead, and can feed a small crowd in-need.

3. Lend your voice to a campaign that matters to you

Very often, your greatest asset is not in your hip pocket, but in your throat. Lending your voice to a worthy cause, or throwing your vocal support behind a campaign or community group can make the world of difference. You can even do it online.

It doesn’t take long, but can make a lasting impact.

4. Ditch the car to give legs to the environment

I’ve said it before and I will again, for every kilometre you walk or ride instead of drive your car, you not only improve your health and the health of those around you – but you also save the community a small fortune. Why not start the year by walking to get the milk, taking the kids to school by foot or jogging into work?

5. Don’t hesitate to ask why

Some conversations are hard to have. No-one likes to talk about the state of politics, or climate change mitigation. Even a chat about the health of our most marginalise populations seems to be a social faux pas nowadays.

We can change this by starting 2014 with a conversation. How about “why isn’t Australia doing enough about climate change?“ or “why are we building roads faster than we build railways” or “why are alcohol and fast food companies still allowed to sponsor sport?“…

Talking and engaging others is the first step to solving these bigger challenges.

6. Buy consciously

For most of us, Santa was generous and we rarely go without the things we really desire. But being in this position – in a nation with little want – we also have an opportunity (read responsibility) to think before we buy. Every dollar we spend is a vote for the company that made the product we purchase, a vote for the way they produced it and even the marketing tactics they used to lure us in.

Vote with your dollars and show you support local business, ethical companies, responsible advertising and sustainable corporate practice.

7. Break a habit, for a better life

Finally, sometimes giving something up can actually make your life richer.This New Year, move from ‘contemplation’ to ‘action’ in one or more of three domains. Improve your health and the health of others simply by not doing something.

Cut down your alcohol drinking and consider a few non-alcoholic days per week. Quit smoking or support someone you know to quit – smoking is so 2013. Finally, break your sugar-drink habit. With increasing scientific evidence that soft drink (aka soda) contributes an enormous burden to society, maybe January is time to replace the juice, lemonade and cola with simple H2O – water.


As a new year dawns, there are so many simple ways to help build a healthier, more cohesive world through personal action. Going into 2014, let’s all jump in and take our own small resolution to ensure the 12 months ahead are a wonderful time for all.

Happy New Year – to you, and to Global Health.



On Twitter? Connect with Sandro via @SandroDemaio for more on Global Health.

This article was simul-blogged at The Conversation.

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PodCast Interview with Siri Tellier, Global Health Demographer

This week on Translational Global Health – we’re experimenting with something new! The first of our PodCast interviews with leading health thinkers. Leading us off, is the inspiring Siri Tellier – of the University of Copenhagen, Denmark, and Renmin University, China.

Talking about life, interests and her incredible work in North Korea, Afghanistan and more…


Siri Tellier holds an Master’s from Harvard School of Public Health, 1970, with a specialization in public health demography.

She has 40 years of experience in international health, including as Director of International Department of Red Cross in Denmark (1992-2001), as well as long term field postings as representative of UNFPA in Afghanistan, China, and the Democratic People’s Republic of Korea, Programme Director for Community Participation in Water and Sanitation with the UNDP, and Chair of the UN Theme Group on HIV/AIDS in China.

Siri has 20 years of teaching experience, and since 2009 she has been responsible for the module Health in Emergencies and Refugee Health on the University of Copenhagen’s master’s programmes in Disaster Management and International Health.

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Five Reasons Why ‘Food’ Is A Massive Global Health Issue

Last week in Stockholm, Sweden, I was asked to present an insight into the links between food and global health to the Swedish Medical Society Conference; a brief outline on the parallels and overlap between what we eat, the systems that produce and support that consumption, and the health of our populations.

Now this is no easy task – and not because the overlaps are limited – quite the opposite – but because I had only 10 minutes to do it in!

With this in mind, I proposed just 5 of the reasons why food is, and must be, a Global Health Issue.

Reason number one, we are what we eat.

Put simply, globally, locally and individually – we are what we eat. Improvements in nutrition may have given us enormous health benefits this last century, but food-related disease, including obesity, has now become our greatest health challenge for the current century.

In addition to half a billion people still undernourished worldwide – today diabetes, heart disease, cancers and lung disease, are the leading cause of global deaths. In China, a nation rapidly undergoing nutritional and epidemiological transition, one in two or 500 million people are thought to be prediabetic or diabetic.

Diseases which are both caused and solved, in part, by food.

In Europe, the USA and Australia, obesity rates range from the low teens to mid thirty percent, and obesity-related disease is already crippling populations, health systems and national budgets – concurrently under strain from the economic crisis.

Now this is not to suggest that it is simply a question of calories in versus calories out, but the food we eat, can afford and have access to – and how this is marketed, packaged and served – is a large dictator of our health.

Reason number two: Poverty is not a protector from food-related disease, but a risk factor for it.

In the 20th century, the global health scourges were more likely resulting from under-nutrition. This is no longer. Today – our leading global health challenge results from over-nutrition related malnutrition, with 80% of this disease burden occurring in the world’s low and middle income nations.

The commonly spouted theory that malnutrition resulting from overconsumption is a rich-person’s problem is a dangerous myth.

Risk factors such as obesity and poor diet – as well as diseases such as diabetes, heart disease, lung diseases, cancers and mental illness – are linked with poverty, not affluence. Diseases deeply linked with the quality and quantity of our diets, these are all linked with social and economic derivation.

Reason three: Dietary risks represent profound health opportunities.

The 2010 Global Burden of Disease Study ranked the top causes of global disability and deaths. It is no surprise to many of us, that diet-related diseases topped the charts. But what can surprise some, is that diet itself was named the number one risk factor for morbidity and mortality globally.

The good news though, is that this is a risk factor. This is a disease modifier and amplifier, but if addressed, it is also a disease minimiser and an opportunity for prevention. The quality and quantity of our diets may be an enormous threat to current global health, but inversely it can also become an enormous opportunity for creating a healthier future – if managed appropriately.

The fourth reason: Big Food is a complex, heterogenous and prickly beast.

In 2013, top food companies have more power than some governments, but are unelected and have very different incentives – we must understand this.

The world’s biggest food company alone employs 330,000 people and has an annual revenue of almost 100 billion US dollars – two-thirds the GDP of New Zealand and twice the GDP of Croatia. This company also produces 1 billion products each and every day.

In short, some of these companies have more economic power than some national governments and probably more global political influence than many national governments. Yet, the leaders of these companies are unelected and their driving incentives are market-based and focused on profit, not development, environmental sustainability, social justice or health.

This is a challenge – a huge challenge – and currently there is no clear consensus on how to manage this risk.

Do we work with them? Do we shut the door? Do we regulate or let them regulate? Can they really be trusted to fund governments and elections?

These companies exert an enormous influence on population health and I categorise their behaviours into three groups. The good, the bad and the ugly.

The good companies – those which supply food staples, share the need to create healthy populations and sustainable practices – must be engaged and led by government, but in an independent, mature, arms-length and transparent way.

The bad must be recognised, called out, improved and, when necessary, regulated.

The ugly are the most dangerous. We must recognise that selfish and deliberate decisions by food multi-nationals have caused enormous public health costs in the past decades. These Big Food corporations and their practices must be controlled, even limited – this is essential for global health.

The final reason, there is a growing disconnect between food, cooking and people.

Food is essential to global health, right down to the individual level. As food systems become more processed, supply-chains become longer, and our diets are characterised by a long list of chemicals rather than ingredients – we are losing our personal connection to food. Our understanding of how to choose it, cook it and consume it. And this is occurring almost ubiquitously.

Understanding food and where it comes from, is an essential knowledge nugget for a healthy society – and crucial for those working in health. As the Journal of the American Medical Association recently published, the old medical adage of “see one, do one, teach one” must also become “see one, taste one, cook one, teach one”.

Engaging with the education and political sectors to ensure this is understood, would be time and energy well spent for any global health enthusiast or doctor. Food must become a more accepted part of the clinical mandate.

Looking Forward.

To conclude, Food is an essential part of health and wellbeing – chosen, prepared, cooked and consumed correctly, food is medicine – it can and has been an enormous catalyst to gains in life expectancy and quality of life to populations around the globe.

But – and this is an important ‘but’ – mismanaged, unregulated, recklessly advertised, poorly produced and over consumed, food can have dire public health consequences. And those consequences are currently playing out around the world.

Food companies, governments, the medical community, the food supply, what we eat, how we eat, food policies and what we subsidise, how much we eat and what we waste will all dictate whether, in the next century, food can once again be a catalyst of health – or continues as a risk to it.

One thing is clear – food is, and must be, a Global Health Issue.


Connect with Sandro on Twitter via @SandroDemaio.

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