Integrated Prevention of Non-Communicable Diseases

Joint statement to the 113th meeting of the Executive Board of the World Health Organization, Geneva, 19-24 January 2004. 

Mr Chairman, honourable members of the Executive Board, Director-General, Regional Directors, ladies and gentlemen,

This statement is made jointly by the International Obesity Task Force (IOTF) on behalf of the International Association for the Study of Obesity (IASO), the International Diabetes Federation (IDF), the World Heart Federation (WHF), the International Union of Nutritional Sciences (IUNS) and the International Pediatric Association (IPA).

As NGOs collaborating closely with the WHO in the prevention of chronic non-communicable diseases, we have an important stake in this discussion. We wish to express our clear commitment to the proposals before you and take this opportunity to pay tribute to all those WHO staff who have worked with dedication on this difficult task.

The need for this strategy was never more urgent. A major global epidemic of cardiovascular disease, type 2 diabetes, overweight and obesity, affects both the developing and developed world. It is driven by inappropriate diet and inactivity. The problem begins in the earliest days of childhood reflecting the critical importance of good in utero nutrition, extended breastfeeding and sound nutritional practices in infancy onwards in the prevention of long term diet-related non-communicable diseases.

Children are increasingly vulnerable to the inadequacies of diet and activity now resulting in high levels of obesity, the unprecedented development of type 2 diabetes and exposure to cardiovascular risks from an early age.  In this respect I would mention that the IOTF, as part of its WHO collaboration programme, will today submit for consideration by the Director General and his advisers a comprehensive assessment of the best available evidence of the global challenge of childhood obesity.

Already the need for the global strategy has been reinforced by not one, but a succession of major reports that provide irrefutable evidence for action. 

The WHO 797 report, Diet, Nutrition and the Prevention of Chronic Diseases, informed the International Conference on Nutrition in 1992 and its World Declaration and Plan of Action for Nutrition, which, incidentally, was endorsed by a resolution of World Health Assembly in 1993. 

The WHO 894 report, Obesity: Preventing and Managing the Global Epidemic, highlighted that many countries are struggling with childhood undernutrition while facing a double burden of diet-induced non-communicable diseases.

The WHO International Agency for Research in Cancer published its Handbook for Weight Control and Physical Activity, providing further exhaustive analyses of diet, activity and weight-related diseases in 2002.

Latterly the WHO/FAO 916 report, to which a number of our eminent leading scientific members including the President and Vice-Presidents of the IUNS, and several other IOTF experts contributed, delivered a rigorous assessment of the best available evidence, peer reviewed and subject to a more exhaustive  public consultation process than any previous scientific study. This provided a scientific judgement reached independently of particular interests. 

The evidence supporting the role of excessive consumption of saturated fats, sugars and salt in the development of non-communicable diseases is robust and indisputable. The benefit of promoting a healthier diet – particularly increasing the consumption of fruit and vegetables – in order to reduce or prevent chronic diseases is acknowledged in WHO’s worldwide promotion of the 5-a-day goal.

We believe this board should confirm its support for both the 916 report, and all those other supporting WHO reports which build the firmest scientific foundation for the global strategy.

This strategy deserves the broad support of all WHO member states, and international agencies, but it must also address other important determinants of health affected by trade, agriculture and economic environments. The Codex Alimentarius Commission should be encouraged to play an important role in these areas.
 
We note that the food and drink industry has far greater means at its disposal to provide the solutions to improving dietary health. It must be encouraged to rise to this challenge, seizing the significant new opportunities to optimise the nutritional quality of diets. It must honour the public commitments to contribute to improving dietary health already given by some industry leaders.

We would welcome a stronger emphasis on the role of international NGOs providing expertise and guidance in the further development of the strategy and in supporting its long-term implementation. There is a clear role for responsible bodies, well resourced but protected from commercial influence, to act in the interests of people as part of the transparent verification mechanisms necessary to ensure the strategy is sustained in an effective manner.

The WHO must now provide leadership to take this forward. Members of the Board are challenged to support the first significant opportunity to address the nutritional challenges of the 21st century in a coherent manner and to shape a new vision of public health focused on the prevention of chronic diseases. This has the potential to transform the health of billions of the world's citizens. This historic challenge demands unreserved commitment from all parties. Therefore we urge you to give this resolution your wholehearted support and commendation to the next World Health Assembly.  

Signed

Professor  Claude Bouchard
President, International Association for the Study of Obesity

Professor Pierre Lefèbvre
President, International Diabetes Federation

Professor Philip Poole-Wilson
President, World Heart Federation

Professor Mark Wahlqvist
President, International Union of Nutritional Sciences

Professor Ricardo Uauy
President-elect, International Union of Nutritional Sciences

Professor Philip James
Vice President, IUNS and Chairman of the International Obesity Task Force

Professor Jane Green Schaller
President, International Pediatric Association

WHO Global Strategy on Diet, Physical Activity and Health