5th Welsh Immunisation Conference Welcome Address on behalf of CMO Wales Dr Sara Hayes Senior Medical Officer 12th March 2008

Setting the Scene Vaccine Uptake in Wales (Oct – Dec 2007 Commentary 95.3 13 LHBs on or above 95% PCV2 94.9 First reported rate since start of programme Obesity rates in Wales Major public health issue affecting all ages and its likely impact is currently unknown Levels of overweight and obesity are rising with currently 19% of the population of Wales being obese and a further 36% classified as overweight. Rise in overweight and obesity in children and young people represents a serious upward trend with self reported obesity data collected as part of the Health Behaviour in School Aged Children Study 2004 showing that 20% of boys and 14% of girls aged over 13 were overweight in Wales. In the second sweep of the Millennium Cohort Study, 21.9% of the three-year-old children in Wales were found to be overweight, and 5.2% obese. An analysis by the UK Government’s Foresight Programme has suggested that by 2050 we could be in a situation where only 10% to 15% of the UK population have a healthy body weight. COVER report for quarter Oct – Dec 2007, NPHS

Epidemiology drives immunisation Today’s conference covers: HPV BCG Travel health immunising the immuno-compromised child Food and Fitness 5-year Implementation Plan The Welsh Assembly Government has moved towards an integration of healthy eating and physical activity policies and programmes where appropriate. This recognises the fact that the effects of diet and physical activity on health often interact particularly in relation to obesity. Following a public consultation we launched the Food and Fitness – Promoting Healthy Eating and Physical Activity for Children and Young People in Wales 5-Year Implementation Plan on 29 June 2006. The plan sets out some of the ways in which the Assembly Government is helping to support parents and children and young people in their efforts to eat well, stay fit and achieve the highest standard of health possible. The plan builds on existing national strategies and initiatives and local programmes and provides a framework for integrating action on nutrition and physical activity for children and young people in Wales. One of the seven key actions set out in the Plan is to: Provide an environment that will encourage children and young people to access opportunities for physical activity and healthier foods; As part of this we have made a commitment to foster links between the planning, transport, architectural, and public health sectors, to: encourage and develop knowledge of professionals on the role of the environment in encouraging physical activity and healthy eating; promote partnership working and share examples of good practice; and create awareness of current policies and practice.

Quality of service delivery We can all play our part by paying attention to the small details . PANNW & Website Both as part of our commitment to make current public health knowledge easily accessible to professionals, and to further the joint nutrition and physical activity agenda, we are working with the Wales Centre for Health to integrate the networks for professionals involved in promoting physical activity and improving nutrition. The purpose of the public health networks is to pool expertise and skills in specialist area of public health, share good practice, manage public health knowledge, encourage co-operative working and act as a source of learning and professional development. The Physical Activity Network for Wales and the Nutrition Network for Wales have developed a single website, which will enable partners to access information where nutrition and physical activity interact and overlap, as well as continuing to provide partners with access to information relating specifically to nutrition and physical activity. The integrated website provides a further opportunity to bring partners together to share their expertise, knowledge, resources and good practice and feel linked and supported to a broader network working on similar objectives and with common aims. www.physicalactivityandnutritionwales.org.uk www.gweithgareddcorfforolamaethcymru.org.uk

MMR is still a challenge Number of confirmed cases Commentary Measles 971 (13 in Wales) Highest recorded since current surveillance scheme began in 1995 90 cases in babies under 1 year of age Mumps 1442 (15 in Wales) Wales had the lowest rates Rubella 27 5 occurred in women of child-bearing age 190 81 2. Tackling obesity is a complex issue The Foresight report Tackling Obesities: Future Choices and the National Institute for Health and Clinical Excellence (NICE) Guidance on obesity have provided a better understanding of the nature of the challenge, and of the interventions needed to make an impact. It is clear from these comprehensive, evidence-based reports that a whole system approach is required, from production and promotion of healthy diets to redesigning the built environment to promote walking, together with wider cultural changes to shift societal values around food and activity. This will require a broad set of integrated policies, which should include strategies and interventions which are: long term; address behavioural change; include both population and targeted measures: and must necessarily include action not only by government, both central and local, but also action by industry, communities, families and society as a whole. Source: HPA report on cases in England and Wales 2007

MMR is still a challenge 190 81 2. Tackling obesity is a complex issue The Foresight report Tackling Obesities: Future Choices and the National Institute for Health and Clinical Excellence (NICE) Guidance on obesity have provided a better understanding of the nature of the challenge, and of the interventions needed to make an impact. It is clear from these comprehensive, evidence-based reports that a whole system approach is required, from production and promotion of healthy diets to redesigning the built environment to promote walking, together with wider cultural changes to shift societal values around food and activity. This will require a broad set of integrated policies, which should include strategies and interventions which are: long term; address behavioural change; include both population and targeted measures: and must necessarily include action not only by government, both central and local, but also action by industry, communities, families and society as a whole.

Maintaining a robust service Programmes being discussed today are all routine programmes delivered by highly trained professionals We also need to retain capacity to deliver large immunisation programmes at short notice to deal with localised, national or international outbreaks of disease. Obesity rates in Wales Major public health issue affecting all ages and its likely impact is currently unknown Levels of overweight and obesity are rising with currently 19% of the population of Wales being obese and a further 36% classified as overweight. Rise in overweight and obesity in children and young people represents a serious upward trend with self reported obesity data collected as part of the Health Behaviour in School Aged Children Study 2004 showing that 20% of boys and 14% of girls aged over 13 were overweight in Wales. In the second sweep of the Millennium Cohort Study, 21.9% of the three-year-old children in Wales were found to be overweight, and 5.2% obese. An analysis by the UK Government’s Foresight Programme has suggested that by 2050 we could be in a situation where only 10% to 15% of the UK population have a healthy body weight.

Excellent progress In summary: The schedules are always under review and new candidates are always under discussion Congratulations for improving uptake while coping with an increasingly complex schedule from the addition of further vaccines Obesity rates in Wales Major public health issue affecting all ages and its likely impact is currently unknown Levels of overweight and obesity are rising with currently 19% of the population of Wales being obese and a further 36% classified as overweight. Rise in overweight and obesity in children and young people represents a serious upward trend with self reported obesity data collected as part of the Health Behaviour in School Aged Children Study 2004 showing that 20% of boys and 14% of girls aged over 13 were overweight in Wales. In the second sweep of the Millennium Cohort Study, 21.9% of the three-year-old children in Wales were found to be overweight, and 5.2% obese. An analysis by the UK Government’s Foresight Programme has suggested that by 2050 we could be in a situation where only 10% to 15% of the UK population have a healthy body weight.

Thank You – Diolch yn fawr Dr Sara Hayes