We must deal with those terrible diseases

By DEBORAH CHEN

Saturday, September 24, 2011

WE would like to congratulate the Jamaica Observer for its excellent and timely editorial "Fluffy might be nice, but it is not healthy". We are facing an epidemic in Jamaica, the Caribbean and internationally, and until we recognise it as such, corrective and preventive action will elude us.

I had the privilege to be an NGO representative at The UN summit on Non Communicable Diseases (NCDs) on what was a historic occasion. For only the second time in history, a health issue has been put on the global agenda at the UN. This was long overdue as NCDs (cardiovascular disease, cancer, diabetes and chronic respiratory disease) were not included in the Millennium Development Goals which were agreed by the UN in 2000. Yet, NCDs are the leading cause of death in the world, including Jamaica.

The World Economic Forum (WEF) in a recent study estimates that if we continue as we are, over the period 2011-2025 the cumulative economic losses to low and middle-income countries (LMIC) will be an average of nearly US$500 billion per year. This amounts to an average per person of US$25 in low income countries, US$50 in lower middle income countries and US $139 in upper-middle-income countries (Jamaica is classified by the World Bank as a upper middle income country).

While it may seem overwhelming in these harsh economic times to be able to afford to tackle this epidemic — the alternative is even more costly. The question should be — can we really afford NOT to deal with this epidemic. So where do we go from here?

In a recent study by the World Health Organisation (WHO), it was shown that the cost for a core set of NCD "best buy" intervention strategies is comparatively low. Measures for reducing tobacco and harmful alcohol use, as well as unhealthy diet and physical inactivity, are estimated to cost US$2 billion per year for all LMICs -- less than US$0.40 per person. Individual-based NCD "best buy" interventions bring the total annual cost to US$ 11.4 billion. On a per-person basis, that translates to under US$1 in low-income countries to US$3 in upper middle-income countries. These individual interventions include strategies such counseling and drug therapy for cardiovascular disease and measures to prevent cervical cancer.

This would prevent the early death of millions of people worldwide and billions of dollars could be saved. A PAHO 2007 report stated that in Jamaica half of total reported annual deaths were due to NCD's and the 2008 Jamaica Healthy Lifestyle Survey found that Jamaicans 15-74 years old suffer from a high prevalence of cardiovascular disease with 36 per cent having at least one disease and 30 per cent two or more.

Most, if not all of us, know someone who has suffered and died from one of these diseases. Saving lives would also reduce economic losses suffered due to the fact that these diseases primarily afflict individuals in the prime of their working life affecting businesses, and leaving families to deal with the harsh economic reality of the main bread winner being taken from them prematurely.

We note that the Minister of Health expressed concern that the UN declaration failed to commit the international community to increased and sustained resources in achieving this goal. While there is a possibility of resources being made available globally to deal with this epidemic, we must not wait on this but rather put our efforts into focusing on what we CAN do based on the "best buys" as outlined by the WHO. This includes tobacco control legislation which ensures smoke-free workplaces and indoor public areas, bans on tobacco advertising, promotion and sponsorship, warning labels on cigarette packages (these labels have already been developed and are awaiting the Council for Trade and Economic Development (COTED) approval, restricted access to retailed alcohol, reduced salt intake in food, replacement of transfat with polyunsaturated fat and public awareness through mass media on diet and physical activity among others.

We are happy to note that the Minister of Health did say that Jamaica is committed to the UN resolution and that the country is committed to eliminating unhealthy industrial trans fats in foods. He also acknowledged the importance of measures to reduce the consumption of tobacco. We therefore anticipate that there will be no further delay in passing the long-awaited tobacco control legislation. We hope that there will be implementation of these "best buy" measures as soon as possible so that we can stem the tide of this epidemic facing us.

Deborah Chen is Executive Director of the Heart Foundation of Jamaica. She is also vice president elect of the World Heart Federation and president elect of the InterAmercian Heart Foundation.

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We must deal with those terrible diseases