The Role of the World Bank in The Role of the World Bank in Addressing Childhood Obesity Dr. Shiyan Chao The World Bank PACO III HIGH LEVEL MEETING ON CHILDHOOD OBESITY PREVENTION Aruba June 6, 2013

Outline 1 Growing Burden of Non-Communicable Diseases 2 Changing the Role of the World Bank 3 Knowledge Production and Sharing 4 Opportunities 5 Way forward

Diabetes Chronic respiratory disease Cancer Cardiovascular diseases TOTAL NCD DEATHS Millions Other NCDs NCDs #1 KILLER IN AMERICAS 149 million smokers 30-40% of hypertensive 25% persons >15 years old obese 37% deaths are below age 70 years Approx 250,000,000 people live with an NCD in the Americas region

Increase Burden of Disease due to NCDs in D isability-Adjusted Life Years (DALYs) 4

Changing of the World Bank’s Roles The World Bank’s roles in the Health Sector in the Region are changing: From HIV/AIDS Investment to Health System Strengthening From investment lending to Non-lending Technical Assistance From Bank alone investment to leveraging partnerships 5

The World Bank Portfolio in the Caribbean 6

Engaging in NCDs Prevention and Control Knowledge Production – The Bank has produced a number of reports on NCDs Knowledge Sharing – The UN High Level Meeting on NCDs – South to South Learning Investment Projects on NCDs 7

Generating knowledge on NCDs Three Major Publications on NCDs – Jamaica: Non-Communicable Diseases in Jamaica: Moving from Prescription to Prevention (2010) – OECS: Reducing the Burden of Non-Communicable Diseases in the Eastern Caribbean (2010) – Latin America and Caribbean Region (LAC): Promoting Healthy Living in LAC (2013) 8

Focusing on Obesity

Highest Female (15yr+) Overwt/Obesity in the world (WHO 2011) Rank Country% 1Nauru82 2Tonga81 3Micronesia79 4Cook Is.73 5Samoa72 6Niue70 7Kuwait67 Rank Country% 8Barbados63 9Palau62 10Trinidad61 11Dominica60 12Egypt59 13USA55 14Jamaica53

ADULT OVERWEIGHT/OBESITY TRENDS IN THE CARIBBEAN

Strategies to address Obesity

Preventing childhood obesity through Multisctoral Approach Pregnancy, Early childhood School age Youth Working age Old age A life-cycle approach Protection: Social pensions Prevention: Old- age pensions, disability insurance Promotion: Employment services, entrepreneurship, training and skills Protection: Cash and in-kind transfers, public works programs Prevention: Unemployment, disability insurance Promotion: Nutrition/ECD, Prevention of childhood Obesity Promotion: CCTs for (girls’) education Protection: Child allowances, school feeding Promotion: Youth employment programs, skills training

Interventions to Childhood Obesity Parental education School education Information for households and communities Education Supply of healthy food Agriculture production, trade Demand for healthy food School Lunch Programs Nutrition Enabling environment (urban planning, transportation, etc Physical activiteis

The Way Forward

1616 What the World Bank can help Setting up objectives/goals Identifying Strategy/resources Assessing results/impact ▪ What can we do: set up goals and identify interventions ▪ How to best achieve the goals? ▪ What are the priorities ? ▪ What are resources available? ▪ What are the trade-offs? ▪ What are the outputs, outcomes and results? ▪ What are the short-term and long –term impact? Knowing the statistics ▪ Who are obese (age, gender and socioeconomic status) ▪ What are the risk factors 16 The World Bank