World Health Organization TOWARDS A GLOBAL DIET AND PHYSICAL ACTIVITY STRATEGY APPROACH - PROGRESS - CHALLENGES DEREK YACH EXECUTIVE DIRECTOR NONCOMMUNICABLE DISEASES AND MENTAL HEALTH

World Health Organization THE PROBLEM UNHEALTHY DIETS AND PHYSICAL INACTIVITY ARE MAJOR CONSTRIBUTORS TO THE BURDEN OF DISEASE WORLDWIDE WHAT’S NEW?

World Health Organization Global prevalence of diabetes current estimates Number of people with diabetes: –177 million (154 million projected) Top 10 countries (number of people with diabetes): –India, China, USA, Indonesia, Russia, Japan, UAE, Pakistan, Brazil, Italy Source: WHO/EIP Global Burden of Disease

World Health Organization Global prevalence of underweight and obesity in adults for year 2000 by level of development Prevalence (%) BMI = Body Mass Index Source: WHO, SDE/NHD, 2000

World Health Organization NCD related mortality In the mid-90s in South Africa 17% of all death were due to CVD, in China 34% and in Russia 55% * Between 2000 and 2020 deaths due to cancer will increase from 2.6 to 3.5 million in developed countries and from 3.6 to 6.3 million in developing countries # *Global Cardiovascular Infobase # WHO National Cancer Control Programmes, 2002

World Health Organization The behavioural factors lead to high blood pressure & hypertension, blood glucose intolerance & diabetes, elevated blood cholesterol & hypercholesterol anaemia, overweight and obesity. NCD risk factors

World Health Organization MAJOR RISKS FOR DEATH High BMI Low fruit consumption & high cholesterol Tobacco (men) High cholesterolAlcohol abuseHigh blood pressure Tobacco (men) Unsafe sex TobaccoHigh blood pressure Underweight High income countries Middle income countries Low income countries

World Health Organization NCDs are to a great extent preventable diseases Evidence for prevention exists Population-based prevention is the most cost-effective and the only affordable option for major public health improvement in NCD rates Major changes in population rates can take place in a surprisingly short time

World Health Organization Diet and risk of NCD Healthy diet, maintaining normal weight and adequate physical activity throughout the life span are the most effective ways of preventing NCD Simple changes in lifestyles can powerfully prevent chronic diseases and promote health

World Health Organization WHO RESPONSE Science: WHO/FAO expert report; World Health Report- Risks to Health 2002 WHA resolutions - WHO Global Strategy DG statements Advocacy: World Health Day 2002, process for Global Strategy Stakeholder involvement

World Health Organization WHO/FAO expert consultation report - example comments Physical activity is the key to obesity Its not the soft drinks Breastfeeding is bad for breast cancer in baboons Reduced salt threatens iodine programs What about the nuts, spices…?

World Health Organization OUR MANDATE World Health Assembly 2002: Resolution on diet, physical activity and health: calls for preparation of Global Strategy

World Health Organization “High blood pressure and high blood cholesterol, strongly linked to cardiovascular and cerebrovascular diseases, are also closely related to excessive consumption of fatty, sugary, salty foods. They become even more dangerous when combined with deadly forces of tobacco and excessive alcohol consumption. Obesity, a result of unhealthy consumption, is itself a serious health risk” Dr Gro Harlem Brundtland, Director General 55th World Health Assembly, Geneva

World Health Organization I shall also reinvigorate WHO’s work on diet, food safety and human nutrition – linking basic research with efforts to tackle specific nutrient deficiencies in populations and the promotion of good health through optimal diets. Dr Gro Harlem Brundtland, Director General 55th World Health Assembly, Geneva

World Health Organization Consultation Process Member states Member states Civil Society Civil Society Private sector Private sector UN agencies UN agencies Phase II WHO Strategy on Diet, Physical Activity and Health WHA 2004 EB Jan 2004 Secretariat Reference group Reference group Phase III Preparation of consultation process and finalization of expert report Phase I

World Health Organization STAKEHOLDER INVOLVEMENT CLIMATE TO TALK DEFINE JOINT ACTIONS FOR GOOD ACKNOWLEDGE THAT SOME AREAS WILL TAKE A LONG TIME ADDRESS GLOBAL DIVERSITY

World Health Organization CHALLENGES NGO’s AND PRIVATE SECTOR’s AGENDA IS VAGUE SCIENCE DISPUTED: MEDIA CONTROVERSY DOMINATES COMPLEX TRADE-OFFS LONG TIME TO SEE RESULTS

World Health Organization CHALLENGES TO NGOs MORE COHERENT “DEMANDS” OPEN DECLARATION OF INTERESTS GLOBALLY APPLICABLE MESSAGES ACKNOWLEDGE COMPLEXITY AND TRADE-OFFS BROADER ALLIANCE OF NGOs