Global population getting fatter, sicker – a call for action

Global population getting fatter, sicker – a call for action

Men smoking with traditional bamboo water pipes in Viet Nam.

By Susann Roth

Non-communicable diseases act as key barriers to poverty alleviation and sustainable development, and we have to start with ourselves by making healthy lifestyle choices everyday.

Who of us has a body mass index under 25, exercises 150 minutes per week, sleeps an average 7-9 hours each night, has a diet rich in fiber and vegetables and low in saturated fat, breathes fresh unpolluted air, and is not exposed to commuting stress? I am pretty sure that less than 10% of us say “yes” to all of the above health indicators recognized by the World Health Organization (WHO), which defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

This is actually true for the majority of the world’s population, but more so for those living in middle- and low-income countries, who don’t belong to the privileged few who can make lifestyle choices. And sadly, many of us—even here at ADB—who can make healthy lifestyle choices still smoke, are still overweight, don’t exercise enough, don’t sleep well and expose ourselves to all kinds of additional risk factors that will lead to non-communicable diseases and mental health problems sooner or later in our lives.

The 2014 WHO Global Status Report on Non-Communicable Diseases (NCDs) reflects the sad trend of the health status of the world’s population, and reads like a bleak forecast on future disasters or impacts of climate change. As we are increasingly recognizing the devastating social, economic, and public health impact of NCDs, of populations that become fatter and sicker, WHO launched in 2012 its Global Action Plan for Prevention and Control of NCDs 2013–2020, which includes 9 voluntary global targets and a monitoring framework.

All these written and verbal commitments, however, are yet to be backed up by strong investments. Wouldn’t you expect that a global threat of the scale of NCDs would encourage all stakeholders (individuals, communities, local and national governments, the private sector) to immediate action? No – the world actually supports unhealthy lifestyles for the sake of economic growth, the kind of growth that make countries richer and lets people live longer but at the same time makes people fatter and sicker.

When not treated, infectious diseases kill fast. NCDs, on the other hand, come silently, kill slowly, and burden the individual and societies. So, why don’t we see massive education campaigns, starting with pre-school children, to ban unhealthy processed food and advertisements of such products, invest in improving living conditions and physical exercise, and providing incentives to live healthy lives?

One reason is surely that such efforts require a multi-stakeholder approach and commitment – and that’s difficult. Too many vested interests want to make money out of the human weakness and inability to make healthy lifestyle choices because of pleasure, convenience, lack of awareness and actually often simply because people are poor. And of course it’s easier to build more hospitals, provide more health care, and create more financial incentives to treat patients, as the health care business thrives on sick people. This is fundamentally wrong and is leading to rapidly rising health care costs everywhere and to unproductive, unhealthy societies. To some extend it is also related to aging populations. But there again is a misconception. Aging by itself is not expensive – it becomes expensive when people don’t age healthy, but get sicker earlier in live and then live longer but are sicker.

At ADB, we can advance a healthy lifestyle agenda by:

  1. Raising awareness among ministries of finance about the urgency and importance of cross-sectoral investments in NCD prevention.
  2. Investing in better health management information systems which capture NCD burden and lifestyle risks.
  3. Developing health sector loans—including investments in health promotion and policies—which lead to government and community action.
  4. Linking investments with performance on NCD outcomes and lifestyle changes.
  5. Strengthening health information systems for countries to better understand where and what the burden of NCDs on their population actually is.
  6. Leveraging collaborations with the private sector, which is supporting the “triple bottom line,” and bring together stakeholder like pharmaceutical company Novo Nordisk and its Cities Changing Diabetes initiative.

For all of that to happen, first we must understand that NCDs act as key barriers to poverty alleviation and sustainable development, and we have to start with ourselves and make healthy lifestyle choices everyday, as promoted and supported by ADB’s Wellness Week.