WHO Europe launches new action plan for noncommunicable diseases – including alcohol policy measures – and appeals for urgent joint policy action to achieve global goals and targets
The WHO European Region has made progress in key areas of noncommunicable disease (NCD) control:
- Death rates from cardiovascular disease (CVD) continue to decline;
- Clear downward trend in smoking continues;
- Alcohol intake is steadily decreasing.
However, this overall European picture masks significant differences within and between countries and population groups:
WHO Europe estimates that the Region will fall short of the global goals, set out in the WHO NCDs global action plan, of reducing tobacco use and physical inactivity and simply fail to halt the rise in obesity unless action is accelerated.
We know that managing noncommunicable diseases and conditions can unlock unimaginable health gains. Actions taken today by the whole of government will determine whether countries succeed in achieving the Sustainable Development Goals (SDGs). People who will die in middle age in 2030 from preventable causes are young adults today. There could not be a greater sense of urgency if we want to prolong lives,” said WHO Regional Director for Europe, Dr Zsuzsanna Jakab.
Reducing this burden requires focusing on population-level, targeted approaches across a wide range of issues – tobacco control, alcohol control, reducing consumption of salt and saturated and trans fats, and hypertension control.”
Accelerating health gains through a shared risk factor approach
Alcohol, one of four major risk factors for NCDs, is the leading risk factor for the disease burden in eastern Europe, associated with alarming injury and violence rates and fluctuations in CVD mortality, and the European Region overall leads in harmful drinking globally, particularly among youth.
The WHO European Region has launched a new action plan for NCDs at the Regional Committee meeting in Copenhagen in September 2016. The plan outlines actions to considerably reduce the burden of NCDs, improve quality of life and make healthy life expectancy more equitable.
In addition to early detection of NCDs, the action plan advocates the use of fiscal policies and marketing restrictions to promote public health and healthy lifestyles.
Win-win thanks to NCDs prevention
The plan also highlights how gains in one area benefit other conditions. Achieving the SDGs requires focusing on a broader set of risk factors and determinants.
Given the fact that 66% of premature deaths in the WHO European Region are caused by four major NCDs, tackling major risk factors, such as tobacco and alcohol use, unhealthy diets, physical inactivity, hypertension, obesity and environmental factors, at least 80% of all heart disease, stroke and diabetes and 40% of cancer could be prevented.
Therefore, the plan outlines clear priority interventions on population-level:
- Promoting healthy consumption via fiscal and marketing policies: tobacco, alcohol, food
- Product reformulation and improvement: salt, fats and sugars
- Salt reduction
- Promoting active living and mobility
- Promoting clean air
The way forward
The WHO NCD project office based in the Russian Federation is initiating action in 23 countries, representing a major increase in capacity to address NCDs in the European Region. It is expected to lead the Region in using evidence-based best practices and to promote an intersectoral approach to communicating policy and sharing information. Priorities will be based on the NCD action plan, which can be seen as an important milestone on the way to the UN General Assembly in 2018, where the achievements of the UN Declaration of 2011 will be reviewed.
Promoting healthy consumption via fiscal and marketing policies
To use fiscal policies and marketing controls to full effect to influence demand, access and affordability for tobacco, alcohol and foods and drinks high in saturated fats, trans fats, salt and sugar.
Policies can reduce alcohol use, with the greatest gains for younger and heavier alcohol users and those exposed to the heavy alcohol intake of others. The impact of marketing, including online social media, on the use of alcohol should be fully recognized, particularly for young people, and systems for managing alcohol marketing such as regulatory frameworks can reduce exposure for the benefit of public health.
Voluntary agreements are often ineffective and regulation or legislation is often needed. Through skilful and successful marketing and modifying product design features, the tobacco and alcohol industries have created a fast growing market for female and underage smokers and alcohol users.
Beverages containing alcohol also contribute to total energy intake and weight gain.
Combinations of actions, for example, in the areas of tobacco and alcohol control or which address several issues simultaneously, are often more cost effective than relying on one action alone.
Nevertheless, the levying of taxes to influence individual choices on tobacco and alcohol use, as well as the consumption of food, is consistently seen as a cost-effective intervention to promote better behavioural choices. If earmarked, such tax income could be used to finance public health programmes.