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Urbanisation, globalisation and
business:the story of NCDs
Thomas Abraham
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What we will explore today.. Why the world is getting wealthier, but
not necessarily healthier… We have seen great advances in medicine
so people no longer die of infectious diseases at a young age
Instead we are living longer, but also being sicker
Heart diseases, cancers and other chronic conditions are major global health issues
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What are non-communicable diseases? Diseases or conditions that are not
transmissible, or caused by injury Cardiovascular disease, cancer,
diabetes, chronic respiratory diseases ( asthma, other pulmonary diseases)
Also referred to as chronic diseases
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WHO Director General Margaret Chan:“The worldwide increase of non-communicable diseases is a slow-motion disaster, as most of these diseases develop over time”
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What are the chronic diseases? Cardiovascular disease: coronary heart
disease and strokeCoronary heart disease, or ischaemic heart disease: leading cause of death globally; caused by atherosclerosis, or hardening of the blood vessels of the heartStroke: Where the blood supply to the brain is affected by diseases of the blood vessels ( cerebrovascular disease)
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Cancer: A range of diseases in which abnormal cells proliferate and spread out of control
Chronic respiratory illnesses: asthma, other pulmonary diseases that can obstruct breathing. Smoking, pollution are risk factors
Diabetes: When the body does not produce enough insulin, and/or an inability of the body’s cells to respond to insulin
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Causes of chronic diseases
(Source WHO)
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Globalisation, business and disease Many of the risk factors for non-
communicable diseases arise from the activities of large global corporations
Tobacco, fast food chains, food industry,alcohol
Public health would say- regulate. Businesses say “consumers should have a choice”
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Obesity Raised BMI a risk factor for diseases
such as type 2 diabetes, cardiovascular diseases, and several cancer
BMI- body mass index (weight/height squared)
18.5-25 is considered normal
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The way we eat and the way we live
Changes in the global food system major drivers of obesity epidemic
Increase in cheap, high energy food Global distribution systems Persuasive marketing Our living environmentHave all combine to create an epidemic of obesity
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At the same time The amount of energy we need to
expend for our daily lives has decreased:
Demand for physical activity has decreased in our life styles
Our built environment : transportation systems, elevators, escalators etc all are geared towards reducing our energy use.
We live in an “obesogenic environment”
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What can be done Individual action: ie going to the gym,
eating healthier, is not not enough Policy changes are required, because this is
a larger environmental issue “Obesity is the signal that something is
terribly wrong in the policy environment. Widespread obesity in a population is not a marker of failure of individual willpower, but of failure in policies at the highest level.” Margaret Chan, WHO
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What policy makers want to see Regulation of advertising and
marketing by food companies to children
Ban fast food in schools Regulation/reduction of high calorie,
low nutritional value foods Global food processing industry is a
giant worth over US $1 trillion.
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Poor countries face a “double burden” of disease: both infectious diseases as well as a growing burden of non-communicable diseases.
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Big Tobacco “The only legally sold product that kills
upto half its users.”
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Big 5 tobacco companies China National Tobacco company (33.7% of
global share) $26.8 bill. rev Philip Morris International (17.6%) US$ 81.8
bill. rev British American Tobacco ( 15.1%) US$ 43
bill. rev Japan Tobacco International (6.4%) US$ 37.4
bill Imperial Tobacco (3.6%) US$ 21.5 billion rev.
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Big tobacco has fought regulation http://www.jeffreywigand.com/
7ceos.php
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Framework convention on tobacco control Entered into force in 2005, negotiated
despite obstruction form tobacco industry
Requires countries to take steps incuding
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http://www.bat.com/
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http://www.who.int/cardiovascular_diseases/resources/atlas/en/