The
Newsletter of the Pan American Health Organization - August
2006New Offensive against Chronic Diseases
A doctor measures a patient's blood pressure in Chile, where over 30 percent suffer from hypertension. © Victor Hugo Durán
Heart problems, cancer, and stroke used to be considered "diseases of the rich." But not any longer. In most countries of Latin America and the Caribbean, chronic diseases are now the leading cause of premature death and disability, accounting for two out of every three deaths in the total population.
In response to these trends, the Pan American Health Organization (PAHO) is spearheading a new Regional Strategy and Action Plan for the Prevention and Control of Chronic Diseases, which will be presented to the PAHO Directing Council for approval in September.
The plan, still under development, will include policies and actions to address the key risk factors for chronic diseases, including obesity and overweight, lack of physical activity, and tobacco use, as well as other underlying risk factors such as poor fetal growth and undernutrition in the first three years of life.
The strategy will build on the WHO Global Strategy on Diet, Physical Activity and Health, the Framework Convention on Tobacco Control, and other international frameworks. Key elements will include a comprehensive, integrated approach to health promotion, developing and advocating policy changes, strengthening surveillance of chronic diseases in PAHO member countries, promoting community-based actions, creating partnerships and networks, and encouraging a comprehensive, intersectoral approach to management of chronic diseases and risk factors.
PAHO's Noncommunicable Diseases unit has been seeking input on the plan from member countries. In February, more than 50 experts from 15 countries and several PAHO units participated in an expert consultation meeting on the plan. Since then, several countries have held their own national consultations and PAHO has organized six video consultations to help finalize the effort.
Risk factors in the region
Studies in several PAHO member countries have shown that 50–60 percent of adults in the region are overweight or obese, as are 7–12 percent of children under 5. Meanwhile, 30–60 percent of the region's inhabitants do not get the minimum recommended levels of physical activity. According to a recent Global Youth Tobacco Survey, from 14 percent to 40 percent of young people in Latin American countries use tobacco, and in the Caribbean, 14 percent to 21 percent.
"These risk factors lead to sickness and deaths that have a very high cost, not only at the individual and family level but also for health-care systems, social services, and overall economic and social stability," says Alberto Barceló, PAHO regional advisor on noncommunicable diseases.
Barceló says the new plan will focus on proven cost-effective interventions, particularly those based on public policy, legislation, and comprehensive health promotion.
An example is Brazil's "Move it, São Paulo" (Agita São Paulo) program, which was found to be highly cost effective in a World Bank study of chronic disease interventions. It promotes physical activity by working with schools, older adults, and hundreds of partner organizations and communities.
Other examples include tobacco tax increases, which the same World Bank study found to be extremely cost-effective, leading to "quick decreases in tobacco use, rates of cardiovascular disease, and hospitalizations from myocardial infarction."
Other cost-effective interventions include legislation to decrease salt content in processed foods, appropriate food labeling and enforcement measures, and legislation and health education aimed at reducing cholesterol.