New mindset needed to tackle non-communicable diseases, says UN official
“For ages, the mindset of public health has been geared towards the prevention and control of infectious diseases,” Director-General Margaret Chan told WHO’s Executive Board in Geneva. “It has been geared towards episodes of acute illness, and not towards long-term care or towards prevention that requires efforts well beyond the health sector. This mindset must change, and that will not be easy.”
Dr. Chan stressed that because of their gradually increasing nature, NCDs are harder to tackle, and this will require a different approach from Governments and international organizations that focuses on prevention as well as treatment in cases where the disease is already advanced.
“The impact of NCDs comes in waves. What we are seeing now in much of the developing world is a first wave. This is marked by growing numbers of people with raised blood pressure, raised cholesterol, and the early stages of diabetes. The growing prevalence of obesity and overweight, seen nearly everywhere, is the warning signal that big trouble is on its way,” Dr. Chan said.
“The second wave, which is yet to come, will be much more horrific. One statistic tells the story.
Of the estimated 346 million people worldwide who suffer from diabetes, more than half are unaware of their disease status. For many of these people, the first contact with the health services will come when they start to go blind, need a limb amputation, experience renal failure, or have a heart attack,” she added.
Dr. Chan reiterated WHO’s commitment to make this issue a priority in its agenda for this year to achieve the goals set during the political declaration on NCDs in September. That declaration called for a multi-pronged campaign by governments, industry and civil society to set up by 2013 the plans needed to curb the risk factors behinds the four groups of NCDs – cardiovascular diseases, cancers, chronic respiratory diseases and diabetes.
She also emphasized that for any public health approach to be successful, governments will have to strive to end socio-economic inequality in their societies. Citing a recent report from the Organization for Economic Cooperation and Development (OECD), Dr. Chan stressed that societies with the least inequality had the best health outcomes, regardless of the levels of spending on health.
“Money alone does not buy better health. Good policies that promote equity have a better chance,” she said. “Universal health coverage is a powerful equalizer. Changes in health status are a powerful indicator of overall social and economic well-being,” she added.