WHO Bulletin: Prevention and management of non-communicable diseases

1 February, 2019

The latest WHO Bulletin (February 2019) is now freely available here: https://www.who.int/bulletin/volumes/97/2/en/

This is a special issue on the prevention and management of non-communicable diseases. I am reminded of the WHO report Saving Lives, Spending Less, which describes 16 'best buys' (2018).I list these below together with a comment from me.

'Implementing the WHO Best Buys will prevent over 17 million cases of ischemic heart disease and stroke by 2030 in low- and lower-middle-income countries'. It's interesting to reflect that many of these best buys are rooted in education, information and communication:

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Reduce tobacco use

1. Increase excise taxes and prices on tobacco products

2. Implement plain/standardized packaging and/or large graphic health warnings on all tobacco packages

3. Enact and enforce comprehensive bans on tobacco advertising, promotion and sponsorship

4. Eliminate exposure to second-hand tobacco smoke in all indoor workplaces, public places and public transport

5. Implement effective mass-media campaigns that educate the public about the harms of smoking/tobacco use and second-hand smoke

Reduce harmful use of alcohol

1. Increase excise taxes on alcoholic beverages

2. Enact and enforce bans or comprehensive restrictions on exposure to alcohol advertising (across multiple types of media)

3. Enact and enforce restrictions on the physical availability of alcohol in sales outlets (via reduced hours of sale)

Education

1. Implement community-wide public education and awareness campaigns for physical activity

Reduce unhealthy diet

1. Reduce salt intake through the reformulation of food products to contain less salt, and the setting of maximum permitted levels for the amount of salt in food

2. Reduce salt intake through establishing a supportive environment in public institutions such as hospitals, schools, workplaces and nursing homes, to enable low-salt options to be provided

3. Reduce salt intake through behaviour change communication and massmedia campaigns

4. Reduce salt intake through the implementation of front-of-pack labelling

Manage cardiovascular disease and diabetes

1. Provide drug therapy (including glycaemic control for diabetes mellitus and control of hypertension using a total risk approach) and counselling for individuals who have had a heart attack or stroke and for persons with high risk (≥ 30%) of a fatal or non-fatal cardiovascular event in the next 10 years

Prevent and manage cancer

1. Vaccination against human papillomavirus (2 doses) of girls aged 9 to 13 years

2. Prevention of cervical cancer by screening women aged 30 to 49 years, either through: visual inspection with acetic acid linked with timely treatment of pre-cancerous lesions; pap smear (cervical cytology) every 3–5 years, linked with timely treatment of pre-cancerous lesions; human papillomavirus test every 5 years, linked with timely treatment of precancerous lesions

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You can review the original report Saving Lives, Spending Less here: https://apps.who.int/iris/bitstream/handle/10665/272534/WHO-NMH-NVI-18.8...

Comment (NPW): I do have a query about the best buys under 'Reduce unhealthy diet'. All four of them are singularly focused on 'Reduce salt intake'. I'm surprised there is no mention of saturated fats or sugar. Nor is there a best buy around reducing meat intake (important not only for human health but also for planetary health).

Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org