In the past few days there has been plenty of talk about the United Nations’ “all-out attack” on non-communicable diseases (NCDs), including cancer, cardiovascular disease, and diabetes. Here is how the UN describes it:
The two-day high-level General Assembly meeting, attended by more than 30 heads of State and Government and at least 100 other senior ministers and experts, adopted a declaration calling for a multi-pronged campaign by governments, industry and civil society to set up by 2013 the plans needed to curb the risk factors behind the four groups of NCDs – cardiovascular diseases, cancers, chronic respiratory diseases and diabetes.
Steps range from price and tax measures to reduce tobacco consumption to curbing the extensive marketing to children, particularly on television, of foods and beverages that are high in saturated fats, trans-fatty acids, sugars, or salt. Other measures seek to cut the harmful consumption of alcohol, promote overall healthy diets and increase physical activity. The overall toll of NCDs is estimated at 36 million out of a total of 57 million annually.
“This will be a massive effort, but I am convinced we can succeed,” Secretary-General Ban Ki-moon told the opening session of the landmark summit, only the second ever to deal with health (the first was HIV/AIDS), noting that over a quarter of all people who die from NCDs succumb in the prime of their lives, the vast majority of them in developing countries.
For those of us concerned with NCDs this is a pretty big deal. If nothing else, the UN is certainly able to bring attention to this issue, which will hopefully translate into action from its member states. And for that reason I would say that the mood I’ve seen is one of cautious optimism. But it waits to be seen whether or not this declaration has any teeth. For example, here is what Mark Tremblay of the Healthy Active Living and Obesity Research Group at the Children’s Hospital of Eastern Ontario had to say [Full disclosure: Mark is my supervisor, although the views expressed in this post are mine alone]:
The Healthy Active Living and Obesity Research Group (HALO) at the Children’s Hospital of Eastern Ontario (CHEO) Research Institute applauds Canada’s endorsement of the declaration that positions healthy active living as the recipe required to reverse the global NCD trends.
“Canadian children and youth are less active, less fit, more obese and more sedentary than ever before” says Mark Tremblay, Director of HALO. “Inattention to this crisis to date has resulted in the mortgaging of the health of the current generation of children and youth, and the true test of the importance of the UN Declaration will be the action and investments individual countries make to preserve and promote healthy active living.” (emphasis mine)
In contrast, the Canadian Medical Association has been openly critical of the declaration in general, and Canada’s role in particular:
Critics say that Canada was instrumental in pressing for the exclusion of a pledge to support universal health care, in removing a passage that would have limited the impact that food and alcohol corporations have on public health policies, and in not addressing trade-related barriers to global health.
[National director of the Centre for Science in the Public Interest] says Canadian officials were also instrumental in the removal of a passage that would have acknowledged that food and alcohol corporations, much in the manner of tobacco companies, may have inherent conflicts of interest in advising on public health policies.
In another article published online yesterday morning, the CMA voiced numerous additional concerns over the document itself:
No money. No targets. No consensus on controversial issues such as guaranteeing access to affordable drugs, stiffened measures against the tobacco and alcohol industries, and regulations to curb international trade in unhealthy products.
It seems the United Nations’ newly-minted political declaration on noncommunicable diseases (NCDs), including cardiovascular diseases, cancer, diabetes and chronic pulmonary disease, has no shortage of flaws.
While the declaration “has some good provisions on breast feeding and eliminating marketing of food high in sugar, fat and salt to children … time-bound targets are absent,” notes Indrani Thuraisingham, head of the Consumers International (a world federation of 220 consumer groups in 115 countries) regional office for Asia Pacific and the Middle East. “Ultimately, the summit should lead member states to truly effective solutions rather than weak voluntary industry pledges,” she said.
So while the UN seems to have high aspirations, we’ll have to wait and see whether this will amount to anything useful. Hopefully I’m just being overly cynical, but this doesn’t really seem like the “all out attack” most people were hoping for.