WHO urges stronger action to reduce deaths from noncommunicable diseases in Europe by one third

The interventions range from policies that promote physical activity and curb tobacco and alcohol consumption, to reducing salt and sugar and eliminating trans-fats in food. The actions countries can take to achieve the target will be in focus at the WHO European High-level Conference on Noncommunicable Diseases taking place in Ashgabat, Turkmenistan, on 9–10 April 2019.

“NCDs are the leading cause of death in the Region, and pose a massive barrier to economic and social development. While Europe is the only WHO region in the world where premature deaths from NCDs are decreasing fast enough currently to meet the target, it is also where the highest rates of alcohol and tobacco consumption are found globally. Many more lives could be saved by implementing the WHO best buys. Countries have these effective policies at their fingertips yet implementation is sadly lacking,” said Dr Zsuzsanna Jakab, WHO Regional Director for Europe.

NCDs – such as cardiovascular disease, cancer, chronic obstructive pulmonary diseases and diabetes – account for nearly 90% of deaths and 84% of ill-health in Europe and put increasing strain on the well-being of the population, the health systems working to treat patients, and the overall economic development of the Region, as well as increasing inequity. This burden continues to rise disproportionately in low- and lower-middle-income countries.

Closing the east–west divide in reducing NCDs

“The best buys are measures which are known to curb rates of disability and death from NCDs. The rate of implementation of the best buys is increasing in Europe, but there is still great room for improvement. We have the tools – it is now time to deliver. By implementing these interventions, countries can hope to close the health divide in Europe and achieve SDG 3.4 to reduce premature deaths from NCDs by 33% by 2030,” said Dr Bente Mikkelsen, Director of the Division of Noncommunicable Diseases and Promoting Health through the Life-course.

Closing the divide between NCD rates in eastern and western parts of the Region will reduce premature mortality rates significantly overall and reduce the significant inequities. For example, the risk of dying from cardiovascular diseases is 2–3 times higher for men born in the eastern part of the Region. However, by implementing the best buys countries can dramatically reduce this risk through interventions targeting the consumption of food high in salt, sugar and fats, use of tobacco and alcohol, as well as by strengthening their health systems.

Editors notes:

Best buy interventions

WHO is urging countries to implement the best buys to address NCDs. The interventions address the four key risk behaviours (tobacco use, the harmful use of alcohol, unhealthy diet and physical inactivity) with the four key disease groups (cardiovascular diseases, diabetes, cancer and chronic respiratory disease). Mental health and air pollution were added as the fifth NCD and the fifth risk factor, respectively, at the third High-level Meeting of the General Assembly on the Prevention and Control of NCDs, held in New York in September 2018.

Chronic respiratory disease, linked to smoking, has been a persistent problem in Europe. The Region has the highest proportion of tobacco use in the world, with an estimated 252 million adults (or 29%) smoking, while 18% of NCD deaths in Europe are attributable to tobacco use. Almost one in five premature NCD deaths could be avoided if tobacco use was eliminated.

WHO best buy interventions for tobacco include increasing taxation on tobacco products in order to make them less affordable. Another best buy intervention is to enforce bans on tobacco advertising and promotion, as well as sponsoring anti-tobacco mass media campaigns.

The interventions are effective – the Russian Federation, for example, experienced a dramatic reduction in tobacco and alcohol consumption following implementation of best buys with support from the Government. Smoking was reduced by 23% between 2009 and 2016, and alcohol consumption plummeted by 24% between 2010 and 2016.

In central Asia, traditional food markets and street vendors play a central role in cuisine, selling many processed meats, yoghurts and ready-to-eat meals. Unfortunately, many of these foods are energy-dense products rich in saturated fat, trans-fats and salt. The problem is worsened with increased use of processed foods, which are often rich in fats, including trans fats, sugar and salt. All these ingredients are strongly linked to the development of NCDs – specifically diets high in trans-fats, which increase the risk of heart disease by 23%.

Implementation of the WHO best buys will have a positive influence on all NCDs. They propose such options as eliminating industrial trans-fats through the development of legislation to ban their use in the food chain (recently adopted in a large number of European countries, including in Eurasian Economic Union Member States), or reducing sugar consumption through effective taxation and mass media campaigns on healthy diets, including social marketing campaigns to reduce the intake of salt and saturated fats and promote consumption of fruits and vegetables.

LINKS

Best Buys:

https://www.who.int/ncds/management/best-buys/en/