Supporting population-based approaches to preventing NCDs

By Kremlin Wickramasinghe

This week, the British Heart Foundation Centre on Population Approaches for Non-Communicable Disease (NCD) Prevention in the Nuffield Department of Population Health, University of Oxford was officially designated as the WHO Collaborating Centre on Population Approaches for NCD Prevention.

Dr Shanthi Mendis, Senior Advisor, NCDs, World Health Organization Head Quarters, explained how this new collaborating centre would contribute to the Global action plan for the prevention and control of NCDs 2013-2020, which set a global target of reducing the premature mortality from NCDs by 25% by 2025. She indicated that the new centre will mainly contribute to the following two objectives of the Action Plan:

  • To reduce exposure to modifiable risk factors for NCDs through creation of health-promoting environments
  • To promote and support national capacity for high quality research and development for prevention and control of NCDs

She said that an interesting question to ask  is why  we need another collaborating centre in a developed country when we see more than 80% of NCD deaths occurring in low and middle income countries (LMICs)? In her answer she pointed out that we have large research and evidence gaps to support the implementation of the most cost effective interventions in high income countries and well as in LMICs and that collaboration with this new centre would enable the sharing of experience and the strengthening of the WHO’s response to the growing problem of NCDs.

Forum at the WHO CC launch. Photo:Prachi Bhatnagar

Forum at the WHO CC launch. Photo: Prachi Bhatnagar

Dr Gauden Galea, Director, Division of NCDs and Life Course in the WHO European office discussed current population based approaches in Europe. Although 50 countries in the region have ratified the WHO Framework Convention on Tobacco Control, the majority of those countries have struggled to implement important population based interventions fully. Only two countries have successfully introduced pictorial warning on cigarette packages and only three countries have completely banned advertising, promotions and sponsorships.  He demonstrated that similarly, in tackling alcohol and unhealthy diets, countries have shown a higher level of adoption of policies that raise public awareness or that provide information but smaller numbers of countries have implemented interventions such as taxes and other measures to affect food prices and the re-formulation of food products to reduce unhealthy nutrients. He demonstrated how the new centre would continue to work with the WHO on areas such as nutrient profiling, fiscal interventions, marketing of unhealthy food and the use of new data sources for NCD prevention.

Mr Simon Gillespie, Chief Executive, British Heart Foundation (BHF) welcomed this recognition for a research group they have funded for more than 20 years. As the leading funding body for cardiovascular disease research in the UK, he mentioned that the BHF would continue to support cardiovascular disease prevention research to make a greater impact nationally and internationally.

Dr Mike Rayner Director of the new collaborating centre emphasised the importance of population based NCD prevention approaches to create healthy societies rather than just healthy individuals. He argued that the aim of a population based approach should be to shift the distribution of risk factors for NCDs in the population rather than those at greatest risk and to focus on more the distal risk causes of  NCDs such as the price of goods and services. He concluded by saying that a population approach is complementary to an individual/high risk approach but that population based approaches have been neglected.

Picture, left to right: Dr Gauden Galea, Dr Shanthi Mendis, Dr Mike Rayner, Professor Rory Collins, Mr Simon Gillespie.

Picture, left to right: Dr Gauden Galea, Dr Shanthi Mendis, Dr Mike Rayner, Professor Rory Collins, Mr Simon Gillespie. Photo: Andrew Trehearne

This workshop also highlighted wider trends that NCD prevention community should focus on such as global warming, resource depletion and  rising food prices. It was mentioned that the post 2015 development agendadiscussions should be used as an opportunity to link NCD prevention with the sustainability agenda. New areas such as the use of social media data and supermarket data for surveillance and prevention of NCDs were also mentioned by speakers during the panel discussion.

When a question was raised about the advice for the next generation it was mentioned that one important role would be to identify research gaps in areas where countries are struggling to implement cost effective interventions and try to improve our understanding on how to implement them. This would require stronger collaboration within and outside the population health disciplines such as economics, anthropology and politics.

The new collaborating centre will be working with the WHO, the BHF and other partners in capacity building by organising workshops and short courses, contributing to WHO’s work in the development of guidelines/manuals on population level NCD prevention, assisting WHO to develop methods for evaluating NCD prevention programmes and providing WHO with statistical analysis and systematic reviews related to population level NCD prevention.

This launch brought NCD prevention experts from leading academic research groups, the World Health Organization and a major non-governmental organisation concerned with NCDs  (the British Heart Foundation) to a single forum. Discussions ranged from generating evidence, using that evidence to developing guidelines, providing technical support to countries, funding actionable research and advocacy by these different organizations. It was evident that bringing these different organizations to the same forum allowed us to understand how these different roles would contribute to unpack the complexity around determinants of NCDs and the importance of working in collaboration, to develop sustainable solutions.

Connect with Kremlin on Twitter via @KremlinKW

This blog originally appeared on the Plos Blog. Read the original article here.

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