Global forum on food security and nutrition

46. Clemens Goldson, Yos Marketing and Manufacturing, Jamaica

The UN Decade of Action on Nutrition is a welcome move. Inviting comments from the global community is a wonderful way of seeking to get everyone involved in a matter that should be of concern to us all.

NCDs are a global problem spread by ignorance and poor communication. Addressing the problem requires an improvement in the way we communicate. Vulnerable populations must be reached and informed of the importance of nutrition in physical and cognitive development and in the prevention of NCD.

One great problem is the assumption that foods available to children must be safe or they would be banned in the same way that cigarettes are. Unfortunately this is not so and so foods that may result in harm to children by causing poor cognitive and physical development or exposure to development of an NCD is as readily available as foods that lead to healthy outcomes. Foods that have been proven to be unhealthy should not be offered for sale to children and should at the very least carry a label warning of the danger they pose.

Many corporations now report a triple bottom line so we can see their impact on people and planet. Their posture with respect to NCD should be included in measuring their impact on people. Of particular interest would be the sale of products harmful to children’s health in places used primarily by children such as schools and amusement places for children.

Good nutrition has several positive impacts on people and countries and so must be promoted by every possible means.

Information, clear, concise and readily available is the chief means of combatting the misinformation and ignorance on which poor nutrition thrives. The UN. FAO and WBG must use the several channels of communications available to them to bring current information on how nutrition impacts national development, physical development, cognitive development and the achievement of the SDG.

The United Nations must seek to reach ordinary citizens in the many countries it serves. It should work with sister agencies such as FAO, WHO and the WBG to show how poor nutrition impacts their areas of operation.

WHO has had the health promoting schools drive for 20 years now without any meaningful impact in many countries. The urgency of the NCD problem has not been communicated to many organizations or to ordinary citizens.  Most parents are unaware of the danger most treats sold in stores and in schools pose to their children. Teachers in many schools practice unsafe eating and so set a poor example for students. If health promotion in schools is to be effective then teachers and parents must become actively involved in teaching children what are good nutritious choices.

Teachers should be required to eat nutritious meals and maintain a BMI within 10% of the recommended normal. Schools should not permit unhealthy foods to be sold within their boundaries. Information on nutrition should be included in student’s instruction from the earliest age and throughout their school life. Given the stated benefit of good nutrition such an approach will be good for people and planet.

The Global Action Plan for the Prevention and Control of NCDs 2013-2020 states that: Noncommunicable diseases (NCDs) – mainly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes – are the biggest cause of death worldwide. More than 36 million die annually from NCDs (63% of global deaths), including 14 million people who die too young before the age of 70. More than 90% of these premature deaths from NCDs occur in low- and middle-income countries, and could have largely been prevented. Most premature deaths are linked to common risk factors, namely tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. (http://www.who.int/nmh/events/ncd_action_plan/en/)

Physical exercise has been identified as a risk factor above. The benefits of physical exercise is not taught in schools and no time is set aside for physical exercise in the school day in most schools on the island of Jamaica. If not in schools then where should the value of exercise be taught? Putting exercise into the curriculum is a matter of will rather than cost. What plans exists to make exercise a part of the school day? Music, marching band, games and exercise drills are all ways in which physical exercise may be introduced into student’s daily learning activities. Music has been suggested since it is liked by children and offers other benefits than physical exercise. (see  http://www.nafme.org/20-important-benefits-of-music-in-our-schools/ for other benefits of music in schools)

Unhealthy diets is also a factor in NCDs. Since 1995 the WHO has been promoting Healthy Schools. Why is this initiative not evident in schools in Jamaica. What has prevented it from being implemented?

WHO's Global School Health Initiative, launched in 1995, seeks to mobilise and strengthen health promotion and education activities at the local, national, regional and global levels. The Initiative is designed to improve the health of students, school personnel, families and other members of the community through schools (http://www.who.int/school_youth_health/gshi/en/)

Why has this initiative not worked? What will be done to improve outcomes?

One notable failure is communication beyond the education community. Teachers may know of the initiative and realize its value but they have not been motivated to implement it. Parents, children and communities are unaware of its existence and of its purpose. If the Decade of Action on Nutrition is to be successful then parents, communities and children must be included in the communication loop.

This report includes not only the four major NCDs (the focus of the UN meeting), but also mental illness, which is a major contributor to the burden of disease worldwide. This evaluation takes place in the context of enormous global health spending, serious concerns about already strained public finances and worries about lacklustre economic growth. The report also tries to capture the thinking of the business community about the impact of NCDs on their enterprises.

Five key messages emerge:

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  First, NCDs already pose a substantial economic burden and this burden will evolve into a staggering one over the next two decades. For example, with respect to cardiovascular disease, chronic respiratory disease, cancer, diabetes and mental health, the macroeconomic simulations suggest a cumulative output loss of US$ 47 trillion over the next two decades. This loss represents 75% of global GDP in 2010 (US$ 63 trillion). It also represents enough money to eradicate two dollar-a-day poverty among the 2.5 billion people in that state for more than half a century.
  
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  Second, although high-income countries currently bear the biggest economic burden of NCDs, the developing world, especially middle-income countries, is expected to assume an ever larger share as their economies and populations grow.
  
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  Third, cardiovascular disease and mental health conditions are the dominant contributors to the global economic burden of NCDs.
  
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  Fourth, NCDs are front and centre on business leaders’ radar. The World Economic Forum’s annual Executive Opinion Survey (EOS), which feeds into its Global Competitiveness Report, shows that about half of all business leaders surveyed worry that at least one NCD will hurt their company’s bottom line in the next five years, with similarly high levels of concern in low-, middle- and high-income countries – especially in countries where the quality of healthcare or access to healthcare is perceived to be poor. These NCD-driven concerns are markedly higher than those reported for the communicable diseases of HIV/AIDS, malaria and tuberculosis.
  
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  Fifth, the good news is that there appear to be numerous options available to prevent and control NCDs. For example, the WHO has identified a set of interventions they call “Best Buys” There is also considerable scope for the design and implementation of programmes aimed at behaviour change among youth and adolescents, and more cost-effective models of care – models that reduce the care-taking burden that falls on untrained family members. Further research on the benefits of such interventions in relation to their costs is much needed.
  

It is our hope is that this report informs the resource allocation decisions of the world’s economic leaders – top government officials, including finance ministers and their economic advisors – who control large amounts of spending at the national level and have the power to react to the formidable economic threat posed by NCDs. (http://apps.who.int/medicinedocs/en/d/Js18806en/)

Health Professionals, International Agencies, Educators, Public Officials Businesses and some NGOs all understand the threat that NCDs pose.

It is time that Parents, Communities and Children be included in the communications loop. They are the ones who can make the decade successful by changing their behaviour and to do so they must be given compelling reasons. Ignorance and misinformation are the main reasons why some behaviours still exists and information is the best way to dispel these.