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World Health Organization Official Urges
Increased Attention to the Role of Noncommunicable Diseases in Global
Health
In a December 8 lecture entitled “Global Health: More Than Infectious
Diseases,” Derek Yach, MB, ChB, BSc, MPH and Executive Director
of the Noncommunicable Diseases and Mental Health Cluster at the World
Health Organization (WHO), advocated focusing on noncommunicable diseases
in global health policy and interventions.
Yach noted that a variety of groups, including the media, foundations,
major corporations, the Group of Eight industrialized nations, private
donors and international organizations such as the United Nations determine
how global health is defined and the content of global health programs.
Certain of those groups have particular areas of focus which are aligned
with their interests. The media, for example, has focused on infections
like SARS and other “killer diseases” rather than on illnesses
which kill people on a daily basis. Major corporations have focused on
infections and hunger rather than on health issues which relate to business,
such as the sale of alcohol and tobacco products.
Dr. Derek Yach |
With the global health environment being shaped by these forces, Yach
argued that the wrong choices are being made with respect to global health.
He noted that noncommunicable diseases kill the most people in most parts
of the world, and that cancer and diabetes have become problems in various
countries as lifestyles and diet have changed. While hunger and stunting
have decreased in many parts of the world, obesity has become more common.
Five million deaths per year are now due to tobacco and that number is
expected to rise to 10 million. Yach noted that those countries with the
most rapidly developing economies are also showing sharp increases in
unhealthy consumption. Based on those and similar facts, Yach argued that
“we need to act on the risks” and urged focusing on early
childhood and issues with lifelong perspectives.
Yach noted that prevention of noncommunicable diseases is undervalued
and underused for several reasons, among them that visibly sick patients
demand treatment, the gains of prevention are often invisible, and powerful
commercial interests obstruct policy change. In addition, noncommunicable
diseases are often viewed as diseases of affluence, and efforts to combat
them are viewed as being less pressing than fighting more visible killers.
In discussing the worldwide low capacity at the national level for prevention
and control of noncommunicable diseases, Yach cited, among other things,
few national policies and strategies, limited resources, fragmented and
uncoordinated care, a low level of commitment to prevention, a lack of
surveillance systems, inadequate treatment guidelines, and a severe lack
of investment in research.
Yach noted several signs of positive change. He discussed WHO efforts
to combat tobacco use worldwide. He said that recent reports on obesity
prepared by major banks classifying companies by how likely their portfolios
are to survive on a long-term basis based on the healthfulness of their
products are having a substantial effect. Globally, there is increased
advocacy for health-related programs and an increased recognition of a
need to transform the primary care system from one that provides acute
care to one that deals with lifelong chronic conditions. Additionally,
workplaces are contributing more to the health of workers.
-Story by Christy Gordon.
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