European Strategy for the Prevention and Control of Noncommunicable Diseases

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European Strategy for the Prevention and Control
of Noncommunicable Diseases Strategies for
Promotion of Healthy Lifestyles
St Petersburg. Russian Federation 11 December
2007 Dr Jill Farrington, Coordinator,
Noncommunicable Diseases WHO Regional Office for
Europe
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CVD causes more gt50 of all deaths in Europe
Cardiovascular mortality (up to 65 years) in the
WHO European Region
lt 300
lt 240
lt 180
lt 120
Last available data
0 - 60
No data
SDR per 100000
.and is a main contributor to the almost 20 year
difference in life expectancy across Europe
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The main causes are known
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Determinants of health

• Health inequalities cannot be reduced by the
  health service alone.
• Determinants of health cannot be tackled by the
  health service alone

Source Dahlgren G, Whitehead M. 1991
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Strategic direction

• Tobacco Control
• European Strategy for Tobacco Control 2002
• Framework Convention on Tobacco Control
• Alcohol Control
• Framework for Alcohol Policy in the WHO European
  Region 2005
• Diet, Physical Activity, Obesity
• Global strategy for diet, physical activity and
  health 2004
• 2nd European action plan for food and nutrition
  policy 2007
• Ministerial Conference on Counteracting Obesity
  2006
• Steps to health a European framework to promote
  physical activity for health

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Strategic direction

• Mental health
• Mental Health Action Plan for Europe 2005
• Children and adolescents
• Childrens Environment Health Action Plan for
  Europe (CEHAPE) 2004
• European strategy on child and adolescent health
  and development 2005
• Violence and injuries
• Resolution on preventing injuries in the European
  Region (RC55/R9)

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Outline of European NCD Strategy

• Introduction
• Challenges
• Potential for health gain
• Guiding principles
• Strategic approach
• Framework for action
• Taking action
• The way forward

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Comprehensive and balanced
Upstream approach
Disease prevention
Health-oriented health services
Health promotion
Spanning the continuum
Diseases
Determinants
Risk factors

• Comprehensive approach
• Population-level prevention programmes
• Targeting high risk individuals
• Improved quality and coverage of care
• Systematic reduction of inequalities

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Objectives and Framework for Action

• Objectives
• To take integrated action on risk factors and
  their underlying determinants across sectors
• To strengthen health systems for improved
  prevention and control of noncommunicable
  diseases
• Framework for Action

ADVOCACY
KNOWLEDGE
REGULATION AND FINANCING
CAPACITIES
COMMUNITY SUPPORT
HEALTH SERVICE DELIVERY
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Building on existing commitments
A coherent and mutually reinforcing framework
NCD WHA53.17
Diet Physical activity WHA57.17
Infant Child Feeding WHA55.25
Food Nutrition EUR/RC50/R8
Tobacco EUR/RC52/R12
Alcohol EUR/RC55/R1
Children Environment EUR/RC55/R6
Children Adolescents EUR/RC55/R4
Mental Health EUR/RC55/R2
Commitments
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Building on existing commitments
A coherent and mutually reinforcing framework
NCD WHA53.17
Diet Physical activity WHA57.17
Infant Child Feeding WHA55.25
Advocacy
Knowledge
Food Nutrition EUR/RC50/R8
Regulation and financing
Tobacco EUR/RC52/R12
Capacities
Alcohol EUR/RC55/R1
Community support
Children Environment EUR/RC55/R6
Health service delivery
Children Adolescents EUR/RC55/R4
Mental Health EUR/RC55/R2
Framework
Commitments
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Building on existing commitments
A coherent and mutually reinforcing framework
NCD WHA53.17
Diet Physical activity WHA57.17
Advocacy
Infant Child Feeding WHA55.25
Knowledge
Food Nutrition EUR/RC50/R8
Regulation and financing
Tobacco EUR/RC52/R12
ACTIONS
Capacities
Alcohol EUR/RC55/R1
Community support
Health service delivery
Children Environment EUR/RC55/R6
Children Adolescents EUR/RC55/R4
Mental Health EUR/RC55/R2
Framework
Commitments
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Regulation and financing

• Develop and enforce regulatory frameworks e.g.
• Restrict advertising, sponsorship and promotion
  of tobacco, alcohol and certain foods
• Protect people against environmental smoke
• Use licensing and sales laws to control tobacco
  and alcohol supply
• Control quality of consumer information about
  tobacco, alcohol, food products
• Develop clear and understandable nutritional
  labelling
• Agreements with industry on levels of added salt,
  fat and sugars to manufactured food
• Regulate the built environment to promote walking
  and cycling
• Use fiscal measures to promote healthier choices
  e.g.
• Use subsidies to influence food-related behaviour
  within schools /workplaces
• Use health financing mechanisms to effect change
  e.g.
• Use financial incentives for enhanced disease
  prevention services and to improve quality of care

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Key messages

• Prevention throughout life is effective and must
  be regarded as an investment
• All settings should be health-supporting
  environments to make healthy choices easy choices
• People should be empowered to promote their own
  health, actively manage disease and interact with
  health services effectively
• Health and medical services should be fit for
  purpose, responding to present disease burden and
  increasing opportunities for health promotion
• Universal access to health promotion, disease
  prevention and health services is central to
  achieve equity in health
• Governments at all levels have the responsibility
  to build healthy public policies and ensure
  action across all sectors concerned

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An integrated approach
CANCER Prevention Early detection Diagnosi
s treatment Palliative care
HEART DISEASE STROKE Population-level public
health prevention programmes Risk factor
detection control Emergency care /acute case
management Rehabilitation /long-term case
management End-of-life care
Population-level health promotion disease
prevention Targeting high risk groups
individuals Improved quality coverage of
effective care
Systematic reduction of inequalities in health
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Summary

• Tackling NCD Significant potential for health
  gain
• Main causes are known
• Effective interventions are known
• Prevention is a vital investment
• Comprehensive and integrated approach is needed
• European NCD strategy provides an opportunity to
• Establish a unifying framework for NCD action
• Build on what is already in place
• Assess refine current approaches
• Develop or further strengthen public policies for
  tackling NCD in a comprehensive and integrated
  way

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Thank you!