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European Health Forum Gastein, October 6-9 2004 Avoidable chronic diseases: the neglected global epidemic Corinna Hawkes Visiting Research Fellow International.

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Presentation on theme: "European Health Forum Gastein, October 6-9 2004 Avoidable chronic diseases: the neglected global epidemic Corinna Hawkes Visiting Research Fellow International."— Presentation transcript:

1 European Health Forum Gastein, October 6-9 2004 Avoidable chronic diseases: the neglected global epidemic Corinna Hawkes Visiting Research Fellow International Food Policy Research Institute

2 European Health Forum Gastein, October 6-9 2004 Chronic disease mortality

3 European Health Forum Gastein, October 6-9 2004 Upward trend Percentage of global mortality from leading chronic diseases increased from 46.3% since 1990 Percentage predicted to increase to over 60% in 2020

4 European Health Forum Gastein, October 6-9 2004 Leading chronic disease mortality by WHO region

5 European Health Forum Gastein, October 6-9 2004 Avoidable risk factors Tobacco Number of cigarettes smoked nearly doubled since 1960 Alcohol 19% increase in alcohol consumption since 1990 Physical activity More sedentary lifestyles Diet Increase in fats, sweetners, salt (diet / nutrition transition)

6 European Health Forum Gastein, October 6-9 2004 Emerging threats: obesity 10.3% 15.9% 19.6% 31.8% 5.1% 0.3%

7 European Health Forum Gastein, October 6-9 2004 Costs of chronic diseases CHD: Costs UK over £7 billion per year (1999) Diabetes: 6% of health care costs in Sweden (1998) Obesity: Between 2%-6% of national health care spending in OECD countries (1998-2003)

8 European Health Forum Gastein, October 6-9 2004 Response of key players

9 European Health Forum Gastein, October 6-9 2004 World Health Organization 46 resolutions since 1956 Framework Convention on Tobacco Control (2003) Global Strategy on Diet, Physical Activity and Health (2004)

10 European Health Forum Gastein, October 6-9 2004 WHO Expenditure – the good news WHO spends more than any other agency on chronic diseases US$ 44.2 million in 2002 Increase since 1998

11 European Health Forum Gastein, October 6-9 2004 WHO Expenditure – the bad news At WHO HQ, US$2.4 million on prevention and control of leading chronic diseases; US$1.1 million on risk factor prevention/ surveillance, diet, pa, CVD management Overall, 3.5% of WHO expenditure on chronic diseases 4.7% of WHO EURO budget ($US 3.2 million)

12 European Health Forum Gastein, October 6-9 2004 Bilaterals and development banks Official Development Assistance for health US$ 2.9 billion in 2002 0.01% (US$ 3.2 million) to chronic diseases (44% from the UK and Sweden) World Bank US$ 4.2 billion health loans 1997-2001 2.6% (US$ 109.5) to chronic diseases

13 European Health Forum Gastein, October 6-9 2004 UN health and development initiatives Excluded from Millennium Development Goals Excluded from WHO Commission on Macroeconomics and Health Excluded from major UN initiatives (ILO, UNICEF, UNFPA)

14 European Health Forum Gastein, October 6-9 2004 The challenge of development Chronic diseases are associated with more economic development, not less Life expectancy increases as incomes rise BUT economic development brings with it risks for chronic diseases

15 European Health Forum Gastein, October 6-9 2004 Example: the diet transition TRADE In India, trade policy reform of vegetable oil market in 1995 India grew from a relatively small importer of edible oils to the world’s leading net importer by 1998 Palm oil consumption rose from 0% in 1972/74 to 38% in 1999/2001

16 European Health Forum Gastein, October 6-9 2004 FOREIGN DIRECT INVESTMENT (FDI) From the U.S… Processed food companies: $36 billion in 2000, from $9 billion in 1980 Food retailers: $13 billion in 1999, from $4 billion in 1990 Restaurants: $5.7 billion in 1998

17 European Health Forum Gastein, October 6-9 2004 $74.3 million pa for chronic disease prevention and control* $54.7 billion FDI *From WHO ($44.2 million), ODA ($3.2 million), World Bank ($21.9 million)

18 European Health Forum Gastein, October 6-9 2004 MARKETING Targeted at children Aims to convert non-users to users

19 European Health Forum Gastein, October 6-9 2004 IMPACT ON GLOBAL DIETS Food… Availability Price Desirability Sales Consumption Processes of economic development affect what people eat

20 European Health Forum Gastein, October 6-9 2004 The policy challenge Promoting healthy diets means challenging economic forces How do we promote economic development on the one hand and challenge it on the other? A barrier for policy development E.g. WHO Global Strategy process How to stem the rising tide of chronic diseases without discouraging global economic development?

21 European Health Forum Gastein, October 6-9 2004 The policy message Learn from environmental arena Frame as an issue of sustainable development From: “Grow now and treat diseases later” to… “Grow good economies with good health”

22 European Health Forum Gastein, October 6-9 2004 Policy actions Tackle underlying causes Reach out to different sectors Identify common interests Balance competing agendas Make markets work for chronic disease prevention Win-win solutions for economic development and chronic disease prevention

23 European Health Forum Gastein, October 6-9 2004 Making markets work Agriculture and trade Reform agricultural subsidy structures to promote risk-reducing foods Build institutions to allow small producers to access the market for high value foods Foreign investment Develop a policy framework for FDI New business models for transnational food companies

24 European Health Forum Gastein, October 6-9 2004 Build evidence with targeted research Health impact assessments of policies How does food production, trade processing and distribution influence changing food consumption patterns? What are the “win-win” solutions for both agriculture and healthy diets?

25 European Health Forum Gastein, October 6-9 2004 Thank you!


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