Ottawa, 11 April 2017.- Representatives of national programs on noncommunicable diseases (NDCs) from 29 countries in the Americas attended the CARMEN network meeting, on 11 April to review the progress in reducing NCDs and their risk factors. Strategies and innovative approaches to reduce premature mortality from NCDs were also reviewed, in preparation for the 3rd United Nations General Assembly High-level Meeting on NCDs, to be held in 2018.
The meeting, organized by the Pan American Health Organization (PAHO) and the Public Health Agency of Canada (PHAC), coincided with the 20th anniversary of the creation of the CARMEN network. This is a regional platform for dialogue, advocacy and capacity-building on NCDs, coordinated by PAHO, to promote the development and implementation of policies and plans to reduce the burden of NCDs, principally cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases; and their common risk factors - tobacco use, harmful use of alcohol, unhealthy diet, and physical inactivity.
CARMEN, an acronym for "Collaborative Action for Risk Factor Reduction and Effective Management of NCDs", began in 1997 with five countries/territories -Canada, Chile, Cuba, Costa Rica and Puerto Rico- and it has expanded progressively to include all the countries in the Region of the Americas. It is composed of national health authorities and professionals responsible for national NCD programs, policies, and health services.
At the meeting, examples of cost-effective strategies to reduce tobacco use and harmful use of alcohol, to promote healthy diets, and to strengthen NCD management and surveillance were discussed. Multi-sector approaches, that involve not only the health sector but other government sectors such as education, finance, trade or urban planning ,were highlighted.
Burden of NCDs in the Americas
In the Region of the Americas, approximately 4.8 million people die each year from NCDs, mainly cardiovascular diseases, cancer, diabetes and chronic respiratory diseases. Of these deaths, 35% occur in people aged 30-69 years of age. NCDs have a significant impact on health and wellbeing, and represent a big challenge for health systems and economic development.
The countries of the Region have committed to reduce premature mortality from NCD by one third by the year 2030. To achieve this, cost effective interventions need to be implemented to reduce tobacco use and harmful use of alcohol, to promote healthy eating and physical activity and to integrate interventions for the management of NCDs in the health system at the primary care level.
To reduce risk factors, the following policy measures are effective: taxation on tobacco, alcohol and sugar sweetened beverages; advertising and marketing bans on alcohol, tobacco, and restrictions on marketing foods and beverages to children and adolescents; replacement of trans fats by unsaturated fats in ultra-processed foods; reduction of salt consumption; and the promotion and protection of breastfeeding.
Regarding the strengthening of health systems to address NCDs through primary care, evidence based guidelines for the diagnosis and treatment of cardiovascular diseases, diabetes, cancer and chronic respiratory diseases, along with provision of essential NCD medicines and basic technologies are recommended. In addition, vaccination against Human Papiloma Virus (HPV) to prevent cervical cancer, and vaccination against Hepatitis B to prevent liver cancer are recommended for cancer prevention.