Urbanisation, globalisation and

business:the story of NCDs

Thomas Abraham

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

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

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”

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)

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

Causes of chronic diseases

(Source WHO)

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”

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

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

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”

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

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.

Poor countries face a “double burden” of disease: both infectious diseases as well as a growing burden of non-communicable diseases.

Big Tobacco “The only legally sold product that kills

upto half its users.”

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.

Big tobacco has fought regulation http://www.jeffreywigand.com/

7ceos.php

Framework convention on tobacco control Entered into force in 2005, negotiated

despite obstruction form tobacco industry

Requires countries to take steps incuding

http://www.bat.com/

http://www.who.int/cardiovascular_diseases/resources/atlas/en/