/ 20 November 2006

Health expert gives chronic-disease warning

Failure to deal with preventable chronic diseases such as those induced by smoking and overeating could erode the gains made in combating other types of disease, public health expert Dr Derek Yach said on Monday.

Yach, director of global health programmes at the Rockefeller Foundation, was speaking at a conference of the Oxford Health Alliance in Cape Town.

The alliance, founded in 2002, is an international grouping of academics, researchers and representatives of governments, business and NGOs, united by what it says is ”outrage over this preventable, rapidly escalating epidemic”.

Yach, a South African who is one of the architects of the first international treaty on tobacco control, said chronic diseases include cardiovascular diseases such as heart disease and strokes, diabetes, cancer and chronic chest disease.

”Together, that group constitute over 50% of all deaths in the world,” he told the South African Press Association in an interview.

”It’s an issue because the bulk of the public health decision-making in the world still believes that the world is dominated by infectious diseases.

”And we have seen the shift [towards chronic disease] occur in every region of the world, with the exception of sub-Saharan Africa, at relatively fast rates.

”This is the agenda that dominates the major causes of death in China, India, the Middle East, Latin America and virtually all of the world with the exception of parts of sub-Saharan Africa.”

Currently a billion people in the world are overweight or obese, compared with 800-million who are hungry or underweight, which is ”quite a reversal of the past”.

There are also 1,3-billion people in the world who smoke, and most of those smokers are in low- or low middle-income countries.

”So the future is going to clearly require us to think about controlling these chronic diseases, otherwise the dramatic successes we’ve seen in reducing infectious diseases over the last decades will be eroded.”

Former United States Secretary for Health Tommy Thompson told the conference that people generally wait until they fall ill, then go to hospital and spend thousands of rands getting well again.

This is not what they do to their cars, which enjoy regular services and maintenance.

”We certainly should not do it with our bodies,” he said.

He said he used to walk around taking the cigarettes from smokers’ mouths.

”I got slapped several times. People thought I was nuts,” he said.

He also banned smoking, not only in the health services department building, but also on the property, which meant smokers had to walk across the street.

”What I was trying to do was to make sure that people realised tobacco was wrong, and that people should quit,” he said.

The alliance said that in South Africa, one in three men and half of women are overweight, and that cardiovascular disease is the most common cause of death for those aged 45 and older.

It said that if three risk factors — smoking, poor diet and lack of exercise — are completely eliminated, 80% of heart disease, strokes and type two diabetes will be prevented, as well as 40% of cancers.

As many as 39-million premature deaths can be prevented worldwide over the next decade by addressing these three risk factors.

In a report issued earlier this month, it said chronic diseases could ”exact a toll” of up to 6,8% of a country’s gross domestic product.

Chronic diseases are predicted to become the most common causes of death by 2015 in both the developed and the developing world.

Monday also saw the launch of an alliance website, www.3four50.com, on which anyone interested can watch the conference live.

The website will also serve as a forum for debate on health issues. — Sapa