1. Global Strategy on Diet Physical activity and Health:
Adaptation at local and national levels to the Americas
Dr Godfrey Xuereb
Team Leader
Population-based Prevention
Department of Chronic Diseases and Health Promotion

2. World Health Organization
1 April 2017
Noncommunicable disease and risk factors
Tobacco use
Unhealthy diets
Physical inactivity
Harmful use of alcohol
Heart disease and stroke 
Diabetes
Cancer
Chronic lung disease
60% of global deaths due to NCDs
This is just to remind ourselves that the focus of the GS and the HLM and its political declaration is on the four groups of NCDs that constitute around 80%of NCD deaths and that share the same risk factors and therefore also the same strategies

3. High blood pressure continues to go up
40%
30%
High-income countries
Upper Middle-income countries
% of population
Lower middle-income countries
20%
Low-income countries
10%
1980
2008
Raised blood pressure (2008)
Source: WHO NCD Country Profiles (2010)

4. Overweight continues to increase
70%
60%
50%
High-income countries
40%
Upper Middle-income countries
% of population
Lower middle-income countries
30%
Low-income countries
20%
10% 0%
Overweight (2008)
Source: WHO NCD Country Profiles (2010)
1980
2008

5. WHO Mandates to date
2000
2003
2004
2008
Global Strategy for the Prevention and Control of Noncommunicable Diseases
Global Strategy on Diet, Physical Activity and Health
Action Plan on the Global Strategy for the Prevention and Control of NCDs
2010
2009
2011
Global Strategy to Reduce the Harmful Use of Alcohol
WHO Global Status Report on NCDs
Political Declaration on NCDs
2012+
Realizing the commitments made in the Political Declaration

6. "Best buys" interventions to address NCDs
01/04/2017
"Best buys" interventions to address NCDs
Population-based interventions
addressing NCD
risk factors
Tobacco use
Excise tax increases
Smoke-free indoor workplaces and public places
Health information and warnings about tobacco
Bans on advertising and promotion
Harmful use of alcohol
Excise tax increases on alcoholic beverages
Comprehensive restrictions and bans on alcohol marketing
Restrictions on the availability of retailed alcohol
Unhealthy diet and physical inactivity
Salt reduction through mass media campaigns and reduced salt content in processed foods
Replacement of trans-fats with polyunsaturated fats
Public awareness programme about diet and physical activity
Individual-based interventions
addressing NCDs in primary care
Cancer
Prevention of liver cancer through hepatitis B immunization
Prevention of cervical cancer through screening (visual inspection with acetic acid [VIA]) and treatment of pre-cancerous lesions
Cardiovascular disease and diabetes
Multi-drug therapy (including glycaemic control for diabetes mellitus) for individuals who have had a heart attack or stroke, and to persons at high risk (> 30%) of a cardiovascular event within 10 years
Providing aspirin to people having an acute heart attack 6

7. The General Assembly adopted by consensus the resolution titled "Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases" (document A/66/L.1).

8. What does the Political Declaration say on Diet & PA

9. What does the Political Declaration say on Diet & PA

10. Physical Inactivity

11. Physical inactivity - 4th leading risk factor for global mortality
Source: WHO's report on "Global health risks"
1.5 billion adults
are insufficiently active

12. Percentage of insufficient physical activity comparable country estimates, 2008
Age standardized; by WHO Region and World Bank income group, men and women
Source: Global Status Report on NCDs, WHO, 2001

13. Prevalence of insufficient physical activity
Prevalence of insufficient physical activity*, ages 15+ age standardized Males, 2008
Source: Global Status Report on NCDs, WHO, 2001

14. Prevalence of insufficient physical activity
Prevalence of insufficient physical activity*, ages 15+ age standardized Females, 2008
Source: Global Status Report on NCDs, WHO, 2001

15. Being inactive costs the country and the individual
New study* just released on the health care costs of physical inactivity in Canadian adults shows that the estimated direct, indirect and total health care costs in 2009 were:
Direct: 2.4 billion C$ (3.8% of overall health care costs)
Indirect: 4.3 billion C$
Total Costs: 6.8 billion C$ (3.7% of overall health care costs)
Other studies** have shown that 19% of the coronary artery disease cases in Canadian men are due to physical inactivity
* Janssen, 2012, Appl. Physiol. Nutr. Metab.
** Katzmarzyk and Janssen, 2004 Can.J. Appl. Physiol.

16. What does the Global Strategy Say

17. Global recommendations on PA for Health
5-17 yrs old
At least 60 minutes of moderate to vigorous intensity PA daily.
+18 yrs old:
At least 150 minutes of moderate-intensity aerobic PA spread throughout the week or
At least 75 minutes of vigorous-intensity aerobic PA spread throughout the week or an equivalent combination.
65yrs old & above:
Should perform PA to enhance balance and prevent falls on 3 or more days/ week.
When they cannot do the recommended amounts of PA due to health conditions, they should be as physically active as their abilities and conditions allow.

18. What does the Global Strategy Say

19. National strategies on diet and physical activity
Conduct a situation analysis - GSHS
Mexico
GSHS
Cuba
Dominican Republic
Belize
Honduras
Guatemala
Nicaragua
El Salvador
Guyana
Costa Rica
Venezuela
Suriname
Panama
Columbia
Ecuador
Anguilla
Antigua and Barbuda
Bahamas
Barbados
British Virgin Islands
Cayman Islands
Dominica
Grenada
Guyana
Jamaica
Montserrat
St. Kitts and Nevis
St. Lucia
St. Vincent and the Grenadines
Trinidad and Tobago
Peru
Brazil
Bolivia
Paraguay
Chile
Completed Survey
Implementation Workshop
Data collection underway
Uruguay
Argentina*
Data collection complete

20. National strategies on diet and physical activity
Establish a coordinating team to develop the policy/ strategy/ programme
Review of Policies in selected Low and Middle Income Countries

21. National strategies on diet and physical activity
Multisectoral collaboration:
Coordinating mechanism headed or chaired by ministry of health.
Multisectoral collaboration containing representation from all key sectors.

22. What does the Global Strategy Say

23. School Policies and programs
CARICOM supports Physical Education Standards for all Caribbean States – Feb 2011, Port of Spain.

24. Recommended actions for Member States
Introduce transport policies that promote active and safe methods of travelling to and from schools, such as walking or cycling;
Ensure that walking, cycling and other forms of physical activity are accessible to and safe for all;

25. Recommended actions for Member States
Improve sports, recreation and leisure facilities

26. Recommended actions for Member States
Increase the number of safe spaces available for active play

27. Recommended actions for Member States
Urban
Planning

28. The Floor is Yours ! 28