Editorial: Necessary but not good enough

Published in The Hindu on October 3, 2011

A political declaration adopted recently by more than 30 world leaders and 100 senior Ministers at the United Nations General Assembly is a welcome first step in tackling four non-communicable diseases (NCDs) — cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. The declaration calls on all governments to “advance the implementation of multi-sectoral, cost-effective interventions in order to reduce the impact of the common NCD risk factors without prejudice to the right of sovereign nations to determine and establish their taxation policies, other policies, where appropriate.” Unfortunately, the consensus declaration is a let-down when it comes to committing to robust measures, including legislation, for taming the risk factors related to the NCDs. Evidently, pressure from the food and beverage industry on the governments of some rich countries stymied forward-looking efforts to discourage the consumption of unhealthy food and to regulate harmful market practices. We know that policy-led solutions aimed at the prevention and control of NCDs by taming the risk factors do work: this can include banning a practice, product or ingredient; mandatory labelling; or limiting the quantity of an ingredient in a product. Ban on smoking at work and public places and mandated pictorial warnings on tobacco products have produced good results. WHO Director-General Margaret Chan did well to demand full implementation of the WHO Framework Convention on Tobacco Control and call on the heads of state and government to “stand rock-solid against the despicable efforts of the tobacco industry to subvert this treaty.”

Dr. Chan also did well to speak out against “processed foods, very high in salt, trans-fats, and sugar,” which were “readily available and heavily marketed” and had become “the new staple food in nearly every corner of the world.” Trans-fat increases the risk of cardiovascular disease but the food industry loves it because trans-fat extends the shelf life of products. Denmark took the first bold step in 2003 by banning it; Austria and Switzerland followed in 2009, and a few more countries are likely to mandate a reduction or complete elimination of trans-fat. Salt and sugar cannot be completely eliminated, but their intake can be reduced. There are effective ways of discouraging their consumption — for example, banning marketing directed at children and restricting the sale of these products at and near schools. Developing countries like India can do their people a world of good by acting on this knowledge of what needs to be done here and now to reduce their unconscionably high NCD burden.