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Non-communicable diseases

Lavanya Malhotra: Tackling obesity with gold

24 Jul, 14 | by BMJ

Lavanya MalhotraThe Dubai municipality has come up with a novel way to promote a balanced diet and exercise in the city: slim down, and the reward will be worth your weight in gold. Or rather, you will receive 1 g of gold for every kg shed. Earlier this week it was estimated that more than 15 000 people had signed up, with the final numbers expected to be more since registration closed yesterday. Already this is more than the 9666 people who took part in a similar scheme last year.

An initiative like this is especially important in Dubai. The United Arab Emirates (UAE) has been ranked as the fifth most obese nation in the world, according to a 2012 report published in the BMC Public Health journal. More than 66% of men and 60% of women in the UAE are overweight or obese, according to the Lancet‘s Global Burden of Disease Study 2013. more…

Bijal Chheda-Varma: Bariatric surgery is unsustainable

22 Jul, 14 | by BMJ

Bijal Chheda-Varma2Obesity is widely recognised as one of the greatest health threats of the 21st century across the developed world, with about a third of the global population now obese or overweight.

While the evidence of the problem is undisputed, there is little agreement as to how to solve it. Many solutions are being brandished about in terms of both prevention and cure; in the UK, for example, a sugar tax has been suggested, and NICE has issued its headline grabbing draft recommendations that patients with a BMI of 30 or more should be given bariatric surgery. From my experience of treating overweight and obese patients, it seems clear that, as standalone solutions, these are not sustainable as they do not address the root causes of obesity. more…

Richard Smith: Three myths blocking progress against NCD

16 Jul, 14 | by BMJ

richard_smith2The church at the House of St Barnabas was standing room only to hear Professor Robert Lustig, a paediatric endocrinologist from San Francisco, castigate our current attempts to counter the global pandemic of NCD. (I judge that we’ve reached the stage where NCD, like AIDS, no longer needs to be spelt out.)

Lustig, who has a YouTube video that has been viewed 4.9 million times and who has been interviewed by The BMJ, is clearly somebody who loves his high profile and his capacity to bewitch an audience. Although I’d heard a professor I admire dismiss him as “wholly wrong,” he didn’t encounter much dissent at the meeting organised by C3 Collaborating for Health. He spoke without notes and a PowerPoint presentation, the modern way.

Lustig built his talk around the three myths that he thinks are blocking progress on reducing the burden of NCD. For 30 years, he said, we’ve been concentrating on reducing total calories and fat but made little or no progress. Thinking has been based on bad science. more…

Richard Smith: Rebranding and telling stories about NCD

3 Jun, 14 | by BMJ

richard_smith2I was delighted to be asked to organise this series of events on non-communicable diseases, but I had a problem—I had no idea what NCDs are or were. So Kate Hoyland from UCL’s Grand Challenge of Global Health introduced an evening entitled “The NCD Makeover Show.”

We who live in the NCD ghetto don’t know how to get our message across. The person in the street has never heard of NCD and so will not demand global action or change their own lives. We can’t even agree on our name. We don’t like being defined by what we are not so we don’t like “non-communicable disease”; and we’ve abandoned the term chronic disease. So we’ve homed in on the acronym of NCD—but sometimes it’s NCDs and sometimes NCD.

So how can we do better? “Recognise,” said Fred Hersch from NCDFree, “that the solutions lie outside traditional thinking.” Thus we heard about branding and storytelling. more…

K M Venkat Narayan: Global non-communicable diseases—the second in a series of reflections

2 Jun, 14 | by BMJ

On 30 April 2014, I wrote my first reflection on the topic of non-communicable diseases to whet your appetite, and promised seven more. My first reflection, if you recall, was: “Keep the growth of NCDs in perspective by acknowledging the incredible positive changes in life expectancy and economic wellbeing the world over—thanks to development and mechanization.” Here is the second:

Acknowledge the increasing convergence of health and economic challenges worldwide

The traditional view in international health has generally been that the health priorities for developed and developing countries are different. For example, when people think of developing countries, they often think of diseases of poverty: undernutrition, infectious diseases, and maternal and child health. This agenda is still unfinished, but as data from the massive Global Burden of Disease project are beginning to show, the world is making huge progress in reducing infant and maternal deaths, and deaths from major infectious diseases. In fact, the top three leading causes of death worldwide in 2010 were all chronic non-communicable diseases: ischemic heart disease, stroke, and chronic obstructive pulmonary disease. Furthermore, diabetes has jumped from number 15 in 1990 to number nine in 2010 as a cause of death. To put this in context: cardiovascular disease is now the leading cause of death even in rural Bangladesh. more…

Florence Smith: NCDs and HIV—where’s the intersection?

30 May, 14 | by BMJ

florence_smithAt first glance, NCDs (non-communicable diseases) and HIV/AIDS seem to have little in common. However, a recent symposium, organised by the London School of Hygiene and Tropical Medicine and FHI360, showed that there is great scope for those working on these two big issues in global health to learn from each other.

HIV/AIDS has caused around 36 million deaths worldwide over the last three decades, but with new treatments mortality rates have dropped dramatically, and it now accounts for around 1.6 million deaths a year. NCDs kill just over 36 million people annually, with 80% of those deaths occurring in low and middle income countries. The World Health Organization has set a target to reduce deaths from NCDs, in those aged under 70, by 25% by 2025. more…

K M Venkat Narayan: Letter to Prime Minister Narendra Modi—please make the nation’s health an urgent priority

27 May, 14 | by BMJ

Dear Prime Minister Modi: Congratulations on your impressive victory in the world’s largest election, and best wishes as you take office. Talking to people in my native city of Bangalore, I can sense the palpable excitement and optimism that your win has brought to the youth in India. People are longing for a decisive government that can usher in important policy changes and set the country forward: your emphasis on economic development, affording opportunities to the common man, and eliminating or reducing poverty all resonate very much with the people.

There is one other priority that needs urgent attention: people’s health. This is a critical need, not only because good health is important in its own right, but also because it will help realize the country’s economic and creative potential. A huge advantage that India has today is the “demographic dividend,” with 50% of her population under the age of 25 years. Health should be an important priority to realize the full potential of these young people, and to ensure that they’re not lost from the workforce during the peak of their productivity. Furthermore, with a substantial number of people living longer into ripe old ages, it will be important to keep them healthy, productive, and fulfilled.

more…

K M Venkat Narayan: Global non-communicable diseases—a series of reflections

30 Apr, 14 | by BMJ

Non-communicable diseases (NCDs)—such as diabetes, cardiovascular diseases, cancers, chronic obstructive pulmonary disease, and poor mental health—are major and growing public health threats for all regions of the world—rich and poor, urban and rural. Left unchecked, the impact of these conditions on the health and economies of nations, families, and individuals can become devastating.

Rightly, therefore, the public health advocacy community has raised the alarm of a coming crisis through a large number of publications and high profile meetings, such as the UN high level summit on NCDs in September 2011. In the words of Margaret Chan, director general of the World Health Organization, “We must act now with a sense of urgency.” John Seffrin, chief executive officer of the American Cancer Society, also noted about NCDs: “If we don’t intervene, that [NCDs] will be calamitous. The cumulative economic output loss over the next few years could be as much as $47 trillion.”

more…

Richard Smith: UN meeting on NCDs – day two

21 Sep, 11 | by BMJ

Richard SmithTuesday 20 September. Day two
7.10 Traffic is gridlocked near the UN building because so many streets are shut. Obama hits the UN today—not unfortunately the NCD meeting. more…

Richard Smith: A diary of the UN meeting

20 Sep, 11 | by BMJ Group

Richard SmithMonday 19 September. Day one

7.10 I arrive at the junction of 47 Street East and 2nd Avenue to meet the Pepsico people who are holding a breakfast meeting in the UN dining room. I meet several cronies that I haven’t seen for a long while and reflect traitorously that global health is maybe like medical ethics or medical history, places where ageing health figures go before they disappear altogether. more…

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