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Doh D, Dahwa R, Renzaho AMN. A Scoping Review of Non-Communicable Diseases among the Workforce as a Threat to Global Peace and Security in Low-Middle Income Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1143. [PMID: 39338026 PMCID: PMC11431123 DOI: 10.3390/ijerph21091143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 08/20/2024] [Accepted: 08/26/2024] [Indexed: 09/30/2024]
Abstract
Non-communicable diseases (NCDs) continue to pose a threat to public health. Although their impact on the workforce is widely recognized, there needs to be more understanding of how NCDs affect peace and security, particularly in low-middle-income countries. To address this, we conducted a scoping review and presented a narrative to explore how NCDs in the workforce threaten peace and security. Out of 570 papers screened, 34 articles, comprising 26 peer review and 8 grey literature, met the study criteria. Our findings reveal that while no study has drawn a direct relationship between NCDs in the workforce in LMICs and peace and security, several studies have demonstrated a relationship between NCDs and economic growth on one hand and economic growth and peace and security on the other. Therefore, using economic growth as a proximal factor, our findings show three pathways that link NCDs in the workforce to peace and security: (i) NCDs lead to low productivity and poor economic growth, which can threaten public peace and security; (ii) NCDs in the workforce can result in long-term care needs, which then puts pressure on public resources and have implications for public expenditure on peace and security; and (iii) household expenditures on caring for a family member with an NCD can destabilize families and create an unfavourable condition that threatens peace and security. This research highlights the dual threat of NCDs to health and security, as they impact human resources and community structures crucial for peace and security. The results underscore the importance of considering the workplace as a strategic setting for NCD prevention, which will have long-term implications for economic growth and peace and security.
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Affiliation(s)
- Daniel Doh
- School of Allied Health, University of Western Australia, Perth, WA 6009, Australia;
| | - Rumbidzai Dahwa
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP 167, Zimbabwe;
| | - Andre M. N. Renzaho
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2060, Australia
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Allen LN, Wild CEK, Loffreda G, Kak M, Aghilla M, Emahbes T, Bonyani A, Hatefi A, Herbst C, El Saeh HM. Non-communicable disease policy implementation in Libya: A mixed methods assessment. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000615. [PMID: 36962549 PMCID: PMC10021530 DOI: 10.1371/journal.pgph.0000615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 10/09/2022] [Indexed: 11/12/2022]
Abstract
The Libyan Ministry of Health is keen to understand how it can introduce policies to protect its population from non-communicable diseases (NCDs). We aimed to perform an implementation research assessment of the current situation, including challenges and opportunities. We used an explanatory sequential mixed methods design. We started with a quantitative assessment of NCD policy performance based on review of the WHO NCD Progress Monitor Reports. Once we had identified Libya's NCD policy gaps we performed a systematic review to identify international lessons around barriers and successful strategies for the policies Libya has not yet implemented. Finally, we performed a series of key stakeholder interviews with senior policymakers to explore their perspectives around promising policy actions. We used a realist paradigm, methods triangulation, and a joint display to synthesise the interpretation of our findings and develop recommendations. Libya has not fully implemented any of the recommended policies for diet, physical activity, primary care guidelines & therapeutics, or data collection, targets & surveillance. It does not have robust tobacco policies in place. Evidence from the international literature and policymaker interviews emphasised the centrality of according strong political leadership, governance structures, multisectoral engagement, and adequate financing to policy development activities. Libya's complex political and security situation are major barriers for policy implementation. Whilst some policies will be very challenging to develop and deploy, there are a number of simple policy actions that could be implemented with minimum effort; from inviting WHO to conduct a second STEPS survey, to signing the international code on breast-milk substitutes. Like many other fragile and conflict-affected states, Libya has not accorded NCDs the policy attention they demand. Whilst strong high-level leadership is the ultimate key to providing adequate protections, there are a range of simple measures that can be implemented with relative ease.
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Affiliation(s)
- Luke N. Allen
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Cervantée E. K. Wild
- Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Giulia Loffreda
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, Scotland
| | - Mohini Kak
- World Bank Middle East and North Africa, Tunisia
| | | | | | | | - Arian Hatefi
- World Bank Middle East and North Africa, Washington, DC, United States of America
| | | | - Haider M. El Saeh
- Libya National Centre for Disease Control, Tajoura, Libya
- University of Tripoli, Tripoli, Libya
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Bakhtiari A, Takian A, Majdzadeh R, Ostovar A, Afkar M, Rostamigooran N. Intersectoral collaboration in the management of non-communicable disease's risk factors in Iran: stakeholders and social network analysis. BMC Public Health 2022; 22:1669. [PMID: 36056315 PMCID: PMC9439719 DOI: 10.1186/s12889-022-14041-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/22/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction As the major cause of premature death worldwide, noncommunicable diseases (NCDs) are complex and multidimensional, prevention and control of which need global, national, local, and multisectoral collaboration. Governmental stakeholder analysis and social network analysis (SNA) are among the recognized techniques to understand and improve collaboration. Through stakeholder analysis, social network analysis, and identifying the leverage points, we investigated the intersectoral collaboration (ISC) in preventing and controlling NCDs-related risk factors in Iran. Methods This is a mixed-methods study based on semi-structured interviews and reviewing of the legal documents and acts to identify and assess the interest, position, and power of collective decision-making centers on NCDs, followed by the social network analysis of related councils and the risk factors of NCDs. We used Gephi software version 0.9.2 to facilitate SNA. We determined the supreme councils' interest, position, power, and influence on NCDs and related risk factors. The Intervention Level Framework (ILF) and expert opinion were utilized to identify interventions to enhance inter-sectoral collaboration. Results We identified 113 national collective decision-making centers. Five councils had the highest evaluation score for the four criteria (Interest, Position, Power, and Influence), including the Supreme Council for Health and Food Security (SCHFS), Supreme Council for Standards (SCS), Supreme Council for Environmental Protection (SCIP), Supreme Council for Health Insurance (SCHI) and Supreme Council of the Centers of Excellence for Medical Sciences. We calculated degree, in degree, out-degree, weighted out-degree, closeness centrality, betweenness centrality, and Eigenvector centrality for all councils. Supreme Council for Standards and SCHFS have the highest betweenness centrality, showing Node's higher importance in information flow. Interventions to facilitate inter-sectoral collaboration were identified and reported based on Intervention Level Framework's five levels (ILF). Conclusion A variety of stakeholders influences the risk factors of non-communicable diseases. Through an investigation of stakeholders and their social networks, we determined the primary actors for each risk factor. Through the different (levels and types) of interventions identified in this study, the MoHME can leverage the ability of identified stakeholders to improve risk factors management. The proposed interventions for identified stakeholders could facilitate intersectoral collaboration, which is critical for more effective prevention and control of modifiable risk factors for NCDs in Iran. Supreme councils and their members could serve as key hubs for implementing targeted inter-sectoral approaches to address NCDs' risk factors. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14041-8.
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Affiliation(s)
- Ahad Bakhtiari
- Health Equity Research Centre (HERC), Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Takian
- Health Equity Research Centre (HERC), Tehran University of Medical Sciences, Tehran, Iran. .,Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Reza Majdzadeh
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Afkar
- Center for Non-Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Narges Rostamigooran
- Secretariat of Supreme Council of Health and Food Security, Ministry of Health and Medical Education, Tehran, Iran
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Berner-Rodoreda A, Jahn A. Commercial Influence on Political Declarations: The Crucial Distinction Between Consultation and Negotiation and the Need for Transparency in Lobbying Comment on "Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-communicable Diseases". Int J Health Policy Manag 2022; 11:1219-1221. [PMID: 34634870 PMCID: PMC9808164 DOI: 10.34172/ijhpm.2021.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/10/2021] [Indexed: 01/12/2023] Open
Abstract
Suzuki and colleagues' rare and elaborate analysis of the political processes behind the 2018 United Nations (UN) non-communicable diseases (NCD) Declaration discloses various pathways towards influencing global public health policies. Their study should be a wake-up call for further scientific political scrutiny and analysis, including clearly distinguishing between consultations such as UN multi-stakeholder hearings preceding high-level meetings and the actual negotiating and decision making process. While stakeholder positions at interactive hearings are documented and published and thus made transparent, the negotiating process among member states is not publicly known. The extent to which intergovernmental negotiations are influenced at country or regional levels by commercial interests through direct and indirect lobbying outside of public consultations should be given more attention. Lobby registers should be implemented more stringently and legislative footprints required and applied not only to legally binding but also to internationally important documents such as political declarations.
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Andriyanto A, Rofi’ah I, Bahtiar B, Wicaksono A, Zakiyah A, Yulianti I, Merbawani R. The Effectiveness of Social Support Management of Diabetes on Glucose Control of Type 2 Diabetes Mellitus Patients: Quasi-Experiments. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Family plays a role in managing risk factors for diabetes mellitus (DM) in family members. The family can use diet and activity management as a form of prevention of risk factors and care for family members diagnosed with type 2 DM to keep it from getting to the level of severity.
AIM: The study aims to analyze Social Support Management of Diabetes (SoSMeD) for glucose control of type 2 DM patients.
METHODS: The study used a quasi-experiment pre-post-test with a control group design. The SoSMeD intervention was conducted for 3 months. The samples were taken by a random sampling technique of 50 respondents in each group. The measurement tool checks for glucose during the GDA-test 3 times, analyzed using a paired t-test.
RESULTS: The results show significant differences between the intervention and control groups after being given SoSMeD in carrying out glucose control for patients with type 2 DM (p = 0.001).
CONCLUSION: SoSMeD interventions provide type 2 DM sufferers with glucose control. Based on the findings, it is recommended that nurses should provide proper nursing interventions by involving families in diabetes management.
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Balouchi A, Rafsanjani MHAP, Al-Mutawaa K, Naderifar M, Rafiemanesh H, Ebadi A, Ghezeljeh TN, Shahraki-Mohammadi A, Al-Mawali A. Hypertension and pre-hypertension in Middle East and North Africa (MENA): A meta-analysis of prevalence, awareness, treatment, and control. Curr Probl Cardiol 2021; 47:101069. [PMID: 34843808 DOI: 10.1016/j.cpcardiol.2021.101069] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/11/2021] [Accepted: 11/21/2021] [Indexed: 01/03/2023]
Abstract
Hypertension (HTN) is one of the most important public health challenges, especially in developing countries. Despite individual studies, information on the exact prevalence of prehypertension (pre-HTN) and HTN in the Middle East and North Africa (MENA) is lacking. This meta-analysis was conducted to evaluate prevalence of pre-HTN and HTN, awareness, treatment, and control in the MENA region. PubMed, Web of Science, and Scopus databases were searched from inception to April 30, 2021. Keywords included hypertension, pre-hypertension, awareness, treatment, and control. The quality of the included studies was evaluated using the Hoy scale. A random-effects model was evaluated based on overall HTN. The heterogeneity of the preliminary studies was evaluated using the I2 test. A total of 147 studies involving 1,312,244 participants were included in the meta-analysis. Based on the results of the random-effects method (95% CI), the Prevalence of pre-HTN and HTN were 30.6% (95% CI: 25.2, 36.0%; I2 = 99.9%), and 26.2% (95% CI: 24.6, 27.9%; I2 = 99.8%), respectively. The prevalence of HTN awareness was 51.3% (95% CI: 47.7, 54.8; I2 = 99.0%). The prevalence of HTN treatment was 47.0% (95% CI: 34.8, 59.2; I2 = 99.9%). The prevalence of HTN control among treated patients was 43.1% (95% CI: 38.3, 47.9; I2 = 99.3%). Considering the high prevalence of HTN, very low awareness, and poor HTN control in the region, more attention should be paid to preventive programs for HTN reduction.
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Affiliation(s)
- Abbas Balouchi
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | | | - Kholoud Al-Mutawaa
- Senior consultant community Medicine, Head of Non-communicable Disease Department, Ministry of Public Health, Doha, Qatar
| | - Mahin Naderifar
- Department of Nursing, Zabol University of Medical Sciences, Zabol, Iran
| | | | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Tahereh Najafi Ghezeljeh
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Azita Shahraki-Mohammadi
- Assistant Professor of Medical Library and Information Sciences, Department of medical library and information sciences, Paramedical school, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Adhra Al-Mawali
- Director/Centre of Studies & Research, Ministry of Health, Oman.
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Jailobaeva K, Falconer J, Loffreda G, Arakelyan S, Witter S, Ager A. An analysis of policy and funding priorities of global actors regarding noncommunicable disease in low- and middle-income countries. Global Health 2021; 17:68. [PMID: 34187499 PMCID: PMC8240078 DOI: 10.1186/s12992-021-00713-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Noncommunicable diseases (NCDs), including mental health, have become a major concern in low- and middle-income countries. Despite increased attention to them over the past decade, progress toward addressing NCDs has been slow. A lack of bold policy commitments has been suggested as one of the contributors to limited progress in NCD prevention and management. However, the policies of key global actors (bilateral, multilateral, and not-for-profit organisations) have been understudied. METHODS This study aimed to map the key global actors investing in action regarding NCDs and review their policies to examine the articulation of priorities regarding NCDs. Narrative synthesis of 70 documents and 31 policy papers was completed, and related to data collated from the Global Health Data Visualisation Tool. RESULTS In 2019 41% of development assistance for health committed to NCDs came from private philanthropies, while that for other global health priorities from this source was just 20%. Through a range of channels, bilateral donors were the other major source of NCD funding (contributing 41% of NCD funding). The UK and the US were the largest bilateral investors in NCDs, each contributing 8%. However, NCDs are still under-prioritised within bilateral portfolios - receiving just 0.48% of US funding and 1.66% of the UK. NGOs were the key channels of funding for NCDs, spending 48% of the funds from donors in 2019. The reviewed literature generally focused on NCD policies of WHO, with policies of multilateral and bilateral donors given limited attention. The analysis of policies indicated a limited prioritisation of NCDs in policy documents. NCDs are framed in the policies as a barrier to economic growth, poverty reduction, and health system sustainability. Bilateral donors prioritise prevention, while multilateral actors offer policy options for NCD prevention and care. Even where stated as a priority, however, funding allocations are not aligned. CONCLUSION The growing threat of NCDs and their drivers are increasingly recognised. However, global actors' policy priorities and funding allocations need to align better to address these NCD threats. Given the level of their investment and engagement, more research is needed into the role of private philanthropies and NGOs in this area.
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Affiliation(s)
- Kanykey Jailobaeva
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Jennifer Falconer
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Giulia Loffreda
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Stella Arakelyan
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Sophie Witter
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Alastair Ager
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
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Lee A, Nakamura K. Engaging Diverse Community Groups to Promote Population Health through Healthy City Approach: Analysis of Successful Cases in Western Pacific Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6617. [PMID: 34205471 PMCID: PMC8296388 DOI: 10.3390/ijerph18126617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/10/2021] [Accepted: 06/17/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND A substantial global burden of health can be attributed to unhealthy lifestyles and an unhealthy living environment. The concept of a Healthy City is continually creating and improving physical and social environments to enable healthy living. The aim of this paper is to investigate how the Healthy City concept would tackle the complexity of health by addressing the socio-economic and political determinants of health in the Western Pacific Region. METHODS The SPIRIT model adopted by the Alliance for Healthy Cities can provide a framework for an integrated and holistic approach to enable policy, environment, social matters, behaviours, and bio-medical interventions to take their rightful place side by side. The performance of cities awarded by the AFHC was analysed under each domain of the SPIRIT model to show the efforts striving to acquire the qualities of a healthy city. FINDINGS Two cities have incorporated the Healthy City concept in most of their policies outside the health sector, with a high level of commitment from city leaders and citizens, so the Health City activities were recognised as part of the means to advance the cityies' general planning. One city has made use of its strong network of key stakeholders from different sectors and disciplines to establish a "Medical-Social-Community' model. All three cities have collected health information to reflect health status, determinants of health and issues reflecting health promotion to enable the creation of a city health profile and show positive changes in health. The cities have engaged key stakeholders to launch a variety of health-promoting programmes according to the needs of the population. CONCLUSION The AFHC can play an important role in linking the cities with strong action in Healthy City activities to support other cities in Healthy City development.
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Affiliation(s)
- Albert Lee
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Secretariat, Alliance for Healthy Cities, Tokyo 101-0062, Japan;
- Department of Rehabilitation Science, Hong Kong Polytechnic University, Hong Kong, China
| | - Keiko Nakamura
- Secretariat, Alliance for Healthy Cities, Tokyo 101-0062, Japan;
- WHO Collaborating Centre for Healthy Cities and Urban Policy Research, Graduate School, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
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Stewardship of noncommunicable diseases in Iran: a qualitative study. INTERNATIONAL JOURNAL OF HEALTH GOVERNANCE 2021. [DOI: 10.1108/ijhg-07-2020-0074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeNoncommunicable diseases (NCDs) count for over 80% of premature death worldwide. More than 76% of the total burden of diseases in Iran is devoted to NCDs. In line with the World Health Organization action plan, Iran has developed its national action plan that led to establishment of the National Committee for Prevention and Control of NCDs (INCDC), whose aim is 30% mortality reduction attributed to NCDs by 2030. The stewardship of health system is the cornerstone of performing and sustaining meaningful actions toward prevention and control of NCDs. The literature is tiny on how to materialize the stewardship and governance of health system. The purpose of this article is to report the findings of a national study that aimed to identity functions and subfunctions of stewardship of NCDs and its related risk factors in Iran.Design/methodology/approachThis is a qualitative study. The authors conducted interviews with 18 purposefully selected interviewees until the authors reached saturation. Thematic content analysis was used for analysis and MAXQDA 10 was employed for data management. The difficulty of coordinating with interviewers and health policymakers in the field slowed the process of research progress.FindingsThe authors identified seven themes and categorized them as main functions for appropriate stewardship of NCDs in Iran, including intelligence generation; strategic framework; evidence-based policies/decisions; system design; resource allocation/development; capacity-building and enforcement/alignment; and categorized them as important.Practical implicationsThe seven themes presented as stewardship functions include concepts and practical examples of the experiences and performance of leading countries in the field of NCDs control that can help policymakers and health managers for better descion-making.Originality/valueIran adopted its national action plan in 2015 and WHO selected Iran as a fast-track country in 2017. The study confirmed that to achieve the global targets, appropriate and contextual stewardship for any specific setting is fundamental. Iran needs to improve its stewardship for prevention and control of NCDs and implement its national action plan. Therefore, the functions and policies outlined in this article for the proper performance of NCDs can improve more meaningful practices in this area in Iran and many other countries.
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Megally R, Al-Jawaldeh A. Impact of sin taxes on consumption volumes of sweetened beverages and soft drinks in Saudi Arabia. F1000Res 2020; 9:1117. [PMID: 33510893 PMCID: PMC7809884 DOI: 10.12688/f1000research.25853.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 07/29/2024] Open
Abstract
Background: The consumption of sweetened drinks plays a major role in increasing the burden of diseases such as obesity and cardiovascular diseases. The prevalence rate of obesity and overweight individuals in Saudi Arabia has increased alarmingly among children over the past decade, revealing a crucial need the initiate and monitor effective prevention measures of obesity. Hence, this paper aims to measure the impact of sin taxes of sugar-sweetened beverages on the consumption level of such beverages in Saudi Arabia. Building enough evidence to guide other countries in the Eastern Mediterranean Region (EMR) on how to reduce the level of sugar intake consumption to reduce obesity and malnutrition has an impact on the economy as a whole. Methods: The excise taxes on sugar-sweetened beverages were applied in 2017. The impact of this was measured using a time series data set that covered sales volumes of soft drinks in Saudi Arabia from 2010 to 2020. Results: Sin taxes had a significant negative impact on the sales volume over the years. A significance level of <1% was found as sales volume of soft drinks decreased by 57.64% from 2010 to 2017 when sin taxes were applied on energy and soft drinks. Conclusions: Sin tax policy is recommended to other countries in the EMR to reduce obesity levels among children. These recommendations advocate the recommended priority actions by the World Health Organization for the strategy on nutrition for the EMR 2020-2030.
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Affiliation(s)
- Rania Megally
- Economics, British University in Egypt, Giza, 11837, Egypt
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo, 11371, Egypt
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Megally R, Al-Jawaldeh A. Impact of sin taxes on consumption volumes of sweetened beverages and soft drinks in Saudi Arabia. F1000Res 2020; 9:1117. [PMID: 33510893 PMCID: PMC7809884 DOI: 10.12688/f1000research.25853.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 12/20/2022] Open
Abstract
Background: The consumption of sweetened drinks plays a major role in increasing the burden of diseases such as obesity and cardiovascular diseases. The prevalence rate of obesity and overweight individuals in Saudi Arabia has increased alarmingly among children over the past decade, revealing a crucial need the initiate and monitor effective prevention measures of obesity. Hence, this paper aims to measure the impact of sin taxes of sugar-sweetened beverages on the consumption level of such beverages in Saudi Arabia. Building enough evidence to guide other countries in the Eastern Mediterranean Region (EMR) on how to reduce the level of sugar intake consumption to reduce obesity and malnutrition has an impact on the economy as a whole. Methods: The excise taxes on sugar-sweetened beverages were applied in 2017. The impact of this was measured using a time series data set that covered sales volumes of soft drinks in Saudi Arabia from 2010 to 2020. Results: Sin taxes had a significant negative impact on the sales volume over the years. A significance level of <1% was found as sales volume of soft drinks decreased by 57.64% from 2010 to 2017 when sin taxes were applied on energy and soft drinks. Conclusions: Sin tax policy is recommended to other countries in the EMR to reduce obesity levels among children. These recommendations advocate the recommended priority actions by the World Health Organization for the strategy on nutrition for the EMR 2020-2030.
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Affiliation(s)
- Rania Megally
- Economics, British University in Egypt, Giza, 11837, Egypt
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo, 11371, Egypt
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Stoeva P. International norm development and change: can international law play a meaningful role in curbing the lifestyle disease pandemic? BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2020; 20:18. [PMID: 32703214 PMCID: PMC7376856 DOI: 10.1186/s12914-020-00239-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/14/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The magnitude of the noncommunicable epidemic is difficult to overstate. The projected cost of the epidemic is substantial. It disproportionately affects people in low- and middle-income countries as well as poorer and marginalised communities in high-income countries. The international community has taken various steps to address the four modifiable risk factors causing the majority of noncommunicable diseases (NCDs), however, action has so far fallen short of expectations. Both analysts and international institutions are advocating the adoption of a new international legal norm to address the NCD crisis. MAIN TEXT Drawing on existing knowledge from international relations and international legal studies, this article argues that a new international treaty is not only currently improbable, but also not strictly desirable. In-depth critical analysis and reflection is needed regarding the strengths and weaknesses of a legal approach to addressing the NCD pandemic. The argument is set out in three sections - the first reviews contributions of agentic constructivism, which focus on the process of normative emergence and change, and draws on empirical examples to highlight overlooked aspects of normative development and how they relate to NCD politics. The second engages with the critique of legal principles. Critical approaches to law seek to expose the myths that legal principles are neutral, objective, good. The third section discusses the characteristics of practice in the NCD field and its implications on process and principles for the pursuit of a legal solution to the NCD crisis. CONCLUSIONS Any advocacy for an international norm to address NCDs needs to be nuanced and demonstrate awareness of the nature and character of both the norm development process and resulting international legal principles. As analysts, we are responsible for advocating inclusive and ethical norms, but also for highlighting the implications of inequalities and differences between and within states and societies. There may be a viable international legal instrument that would support dedicated policies to curb the NCD epidemic, but such an instrument needs to be actively advocated for and negotiated with a wide range of stakeholders, navigating a complex international framework of existing norms and conflicting, powerful interests.
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Affiliation(s)
- Preslava Stoeva
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
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Tabaszewski R. The role of local and regional authorities in prevention and control of NCDs: the case of Poland. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2020; 20:17. [PMID: 32698827 PMCID: PMC7374884 DOI: 10.1186/s12914-020-00238-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 07/13/2020] [Indexed: 11/23/2022]
Abstract
Background Freedom from noncommunicable diseases is a component of the human right to health. The obligation to reduce the pandemic of civilisation diseases should result from the provisions of the constitution, national law and local regulations. This means that representatives of local and regional communities also take responsibility for limiting the pandemic of civilisation diseases. Main body The goal of this debate is to examine the effectiveness of the decentralised polish model for dividing the competences of preventing and combating non-communicable diseases into three levels: local, regional and central. The representatives of regional and local communities are responsible for encouraging the inhabitants of their communities to change their lifestyle: eating habits, increase physical activity, remain outdoors more frequently, reduce stimulants, and apply prevention, namely undergo regular medical check-ups and provide the body with all the necessary nutrients. Limiting the proliferation of noncommunicable diseases also requires, in vertical terms, sound financial efforts on the part of local authorities. In the example of Poland, the claim about the effectiveness of the multi-level governance model which is presented in the literature will be verified. Conclusion The excessive division of competences and the dispersion of resources between regional and local authorities may hamper the effective treatment and prevention of NCDs. A lack of cooperation between the central government, which carries out an independent policy on public health, and local authorities, which use only a portion of the public funds allocated to health, obstructs the debate on priorities at the societal level and does not encourage residents to take a stand on how to allocate extra funds.
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Affiliation(s)
- Robert Tabaszewski
- Department of Human Rights and Humanitarian Law, The John Paul II Catholic University of Lublin, Al. Raclawickie 14, 20-950, Lublin, EU, Poland.
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Lee A, Lo ASC, Keung MW, Kwong CMA, Wong KK. Effective health promoting school for better health of children and adolescents: indicators for success. BMC Public Health 2019; 19:1088. [PMID: 31409312 PMCID: PMC6691553 DOI: 10.1186/s12889-019-7425-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 07/31/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Improvement of health literacy, health behavioural change, creating a supportive physical and social environment to be more conducive to health should be the focus of child and adolescent public health. The concept of Health Promoting School initiated by World Health Organization aims to move beyond individual behavioural change and to consider organisational structure change such as improvement of the school's physical and social environment. The aim of this study is identification of the key indicators for successful implementation of Health Promoting School by analysing the findings of the school health profile based on the structured framework of Hong Kong Healthy School Award Scheme and the health status of students investigated by the Hong Kong Student Health Survey. METHODS This is a retrospective correlation study. Analysis of variance (ANOVA) was utilised to analyse for significant improvement of school health profile measured at baseline (n = 104) and among those schools implemented the Hong Kong Healthy School Award Scheme (n = 54). Those indicators showing statistical significance were chosen to be part of the core indicators reflecting effective Health Promoting School. Each of those selected core indicators was then correlated with the related student health outcomes measured by the Hong Kong Student Health Survey Questionnaire to further identify the core indicators. RESULTS A total of 20 core indicators among all the six Key Areas of Health Promoting School (6 indicators under action competencies, 2 under community link, 2 under physical environment, 2 under social environment, 4 under healthy school policies, 1 under services of school health protection) have been identified with the method mentioned above. CONCLUSIONS This study has identified the indicators with most significant impact on a wide range of health related outcomes. Those are key indicators for motivating positive change of the schools and students. They can be considered as school performance indicators to help schools embarking their Health Promoting School journey as another key education objective.
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Affiliation(s)
- Albert Lee
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, 4th Floor, Lek Yuen Health Centre, 9 Lek Yuen Street, Shatin, New Territories, Hong Kong.
| | - Amelia Siu Chee Lo
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, 4th Floor, Lek Yuen Health Centre, 9 Lek Yuen Street, Shatin, New Territories, Hong Kong
| | - Mei Wan Keung
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, 4th Floor, Lek Yuen Health Centre, 9 Lek Yuen Street, Shatin, New Territories, Hong Kong
| | - Chi Ming Amy Kwong
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, 4th Floor, Lek Yuen Health Centre, 9 Lek Yuen Street, Shatin, New Territories, Hong Kong
| | - Kwok Keung Wong
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, 4th Floor, Lek Yuen Health Centre, 9 Lek Yuen Street, Shatin, New Territories, Hong Kong
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Baugh Littlejohns L, Wilson A. Strengthening complex systems for chronic disease prevention: a systematic review. BMC Public Health 2019; 19:729. [PMID: 31185993 PMCID: PMC6558784 DOI: 10.1186/s12889-019-7021-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 05/21/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND While frameworks exist for strengthening health care systems and public health systems, there are no practical frameworks to describe, assess and strengthen systems for chronic disease prevention (CDP) using complex systems approaches. METHODS A systematic and integrative review of peer reviewed literature was conducted to answer the following questions: How can systems for CDP be defined? What are key attributes of effective systems? How are complex systems approaches discussed? Search terms were identified and the Medline, SCOPUS, and Global Health databases were searched December 2017 and January 2018. Reference lists and selected journals were hand searched. A working definition for a system for CDP was developed to provide a guideline for inclusion. Key exclusion criteria were literature did not address the research questions or working definition; was published in a language other than English and before 2000; focused on specific chronic diseases and/or risk factors and not CDP broadly; concentrated on the health care sector and clinical services and/or health status and surveillance data; and described evaluations of setting specific actions such as policies, programs, interventions, approaches, projects, laws, or regulations. Selected literature (n = 141) was coded in terms of the extent to which the research questions and the working definition of systems for CDP were addressed. Data was then analysed and synthesized to determine key themes. RESULTS A revised definition of systems for CDP and seven attributes of effective systems for CDP are reported (collaborative capacity, health equity paradigm, leadership and governance, resources, implementation of desired actions, information and complex systems paradigm). A framework was developed to provide a foundation for describing, assessing and strengthening systems for CDP. CONCLUSIONS The results of this literature review provide a strong foundation for a framework to help strengthen systems for CDP. The framework consolidates not only well-established attributes of effective CDP but also highlights theoretical and practical insights from complex systems perspectives.
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Affiliation(s)
- Lori Baugh Littlejohns
- Menzies Centre for Health Policy, The Australian Prevention Partnership Centre, D17 Charles Perkins Centre, University of Sydney, Sydney, NSW 2006 Australia
| | - Andrew Wilson
- Menzies Centre for Health Policy, The Australian Prevention Partnership Centre, D17 Charles Perkins Centre, University of Sydney, Sydney, NSW 2006 Australia
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Gostin LO, Magnusson RS, Krech R, Patterson DW, Solomon SA, Walton D, Burci GL, Cathaoir KÓ, Roache SA, Kieny MP. Advancing the Right to Health-The Vital Role of Law. Am J Public Health 2019; 107:1755-1756. [PMID: 29019787 DOI: 10.2105/ajph.2017.304077] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Lawrence O Gostin
- Lawrence O. Gostin, Katharina Ó Cathaoir, and Sarah A. Roache are with the O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Roger S. Magnusson is with the Sydney Law School, University of Sydney, Sydney, Australia. Rüdiger Krech, Steven A. Solomon, and Derek Walton are with the World Health Organization, Geneva, Switzerland. Marie-Paule Kieny is with the World Health Organization, Inserm, France. David W. Patterson is with the International Development Law Organization, The Hague, The Netherlands. Gian Luca Burci is with the Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Roger S Magnusson
- Lawrence O. Gostin, Katharina Ó Cathaoir, and Sarah A. Roache are with the O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Roger S. Magnusson is with the Sydney Law School, University of Sydney, Sydney, Australia. Rüdiger Krech, Steven A. Solomon, and Derek Walton are with the World Health Organization, Geneva, Switzerland. Marie-Paule Kieny is with the World Health Organization, Inserm, France. David W. Patterson is with the International Development Law Organization, The Hague, The Netherlands. Gian Luca Burci is with the Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Rüdiger Krech
- Lawrence O. Gostin, Katharina Ó Cathaoir, and Sarah A. Roache are with the O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Roger S. Magnusson is with the Sydney Law School, University of Sydney, Sydney, Australia. Rüdiger Krech, Steven A. Solomon, and Derek Walton are with the World Health Organization, Geneva, Switzerland. Marie-Paule Kieny is with the World Health Organization, Inserm, France. David W. Patterson is with the International Development Law Organization, The Hague, The Netherlands. Gian Luca Burci is with the Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - David W Patterson
- Lawrence O. Gostin, Katharina Ó Cathaoir, and Sarah A. Roache are with the O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Roger S. Magnusson is with the Sydney Law School, University of Sydney, Sydney, Australia. Rüdiger Krech, Steven A. Solomon, and Derek Walton are with the World Health Organization, Geneva, Switzerland. Marie-Paule Kieny is with the World Health Organization, Inserm, France. David W. Patterson is with the International Development Law Organization, The Hague, The Netherlands. Gian Luca Burci is with the Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Steven A Solomon
- Lawrence O. Gostin, Katharina Ó Cathaoir, and Sarah A. Roache are with the O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Roger S. Magnusson is with the Sydney Law School, University of Sydney, Sydney, Australia. Rüdiger Krech, Steven A. Solomon, and Derek Walton are with the World Health Organization, Geneva, Switzerland. Marie-Paule Kieny is with the World Health Organization, Inserm, France. David W. Patterson is with the International Development Law Organization, The Hague, The Netherlands. Gian Luca Burci is with the Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Derek Walton
- Lawrence O. Gostin, Katharina Ó Cathaoir, and Sarah A. Roache are with the O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Roger S. Magnusson is with the Sydney Law School, University of Sydney, Sydney, Australia. Rüdiger Krech, Steven A. Solomon, and Derek Walton are with the World Health Organization, Geneva, Switzerland. Marie-Paule Kieny is with the World Health Organization, Inserm, France. David W. Patterson is with the International Development Law Organization, The Hague, The Netherlands. Gian Luca Burci is with the Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Gian Luca Burci
- Lawrence O. Gostin, Katharina Ó Cathaoir, and Sarah A. Roache are with the O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Roger S. Magnusson is with the Sydney Law School, University of Sydney, Sydney, Australia. Rüdiger Krech, Steven A. Solomon, and Derek Walton are with the World Health Organization, Geneva, Switzerland. Marie-Paule Kieny is with the World Health Organization, Inserm, France. David W. Patterson is with the International Development Law Organization, The Hague, The Netherlands. Gian Luca Burci is with the Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Katharina Ó Cathaoir
- Lawrence O. Gostin, Katharina Ó Cathaoir, and Sarah A. Roache are with the O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Roger S. Magnusson is with the Sydney Law School, University of Sydney, Sydney, Australia. Rüdiger Krech, Steven A. Solomon, and Derek Walton are with the World Health Organization, Geneva, Switzerland. Marie-Paule Kieny is with the World Health Organization, Inserm, France. David W. Patterson is with the International Development Law Organization, The Hague, The Netherlands. Gian Luca Burci is with the Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Sarah A Roache
- Lawrence O. Gostin, Katharina Ó Cathaoir, and Sarah A. Roache are with the O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Roger S. Magnusson is with the Sydney Law School, University of Sydney, Sydney, Australia. Rüdiger Krech, Steven A. Solomon, and Derek Walton are with the World Health Organization, Geneva, Switzerland. Marie-Paule Kieny is with the World Health Organization, Inserm, France. David W. Patterson is with the International Development Law Organization, The Hague, The Netherlands. Gian Luca Burci is with the Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Marie-Paule Kieny
- Lawrence O. Gostin, Katharina Ó Cathaoir, and Sarah A. Roache are with the O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC. Roger S. Magnusson is with the Sydney Law School, University of Sydney, Sydney, Australia. Rüdiger Krech, Steven A. Solomon, and Derek Walton are with the World Health Organization, Geneva, Switzerland. Marie-Paule Kieny is with the World Health Organization, Inserm, France. David W. Patterson is with the International Development Law Organization, The Hague, The Netherlands. Gian Luca Burci is with the Graduate Institute of International and Development Studies, Geneva, Switzerland
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Magnusson RS, McGrady B, Gostin L, Patterson D, Abou Taleb H. Legal capacities required for prevention and control of noncommunicable diseases. Bull World Health Organ 2019; 97:108-117. [PMID: 30728617 PMCID: PMC6357565 DOI: 10.2471/blt.18.213777] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 10/14/2018] [Accepted: 10/23/2018] [Indexed: 12/14/2022] Open
Abstract
Law lies at the centre of successful national strategies for prevention and control of noncommunicable diseases. By law we mean international agreements, national and subnational legislation, regulations and other executive instruments, and decisions of courts and tribunals. However, the vital role of law in global health development is often poorly understood, and eclipsed by other disciplines such as medicine, public health and economics. This paper identifies key areas of intersection between law and noncommunicable diseases, beginning with the role of law as a tool for implementing policies for prevention and control of leading risk factors. We identify actions that the World Health Organization and its partners could take to mobilize the legal workforce, strengthen legal capacity and support effective use of law at the national level. Legal and regulatory actions must move to the centre of national noncommunicable disease action plans. This requires high-level leadership from global and national leaders, enacting evidence-based legislation and building legal capacities.
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Affiliation(s)
- Roger S Magnusson
- Sydney Law School, University of Sydney, New South Wales, 2006, Australia
| | - Benn McGrady
- Prevention of Noncommunicable Diseases Department, World Health Organization, Geneva, Switzerland
| | - Lawrence Gostin
- WHO Collaborating Center for National & Global Health Law, Georgetown University, Washington, United States of America
| | - David Patterson
- Health, Law and Development Consultants (HLDC), The Hague, Netherlands
| | - Hala Abou Taleb
- Health Systems Development Department, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
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18
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Gostin LO. Tackling Obesity and Disease: The Culprit Is Sugar; the Response Is Legal Regulation. Hastings Cent Rep 2018; 48:5-7. [PMID: 29457232 DOI: 10.1002/hast.804] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
It is staggering to observe the new normal in America: 37.9 percent of adults are obese, and 70.7 percent are either obese or overweight. One out of every five minors is obese. The real tragedy, of course, is the disability, suffering, and early death that devastates families and communities. But all of society pays, with the annual medical cost estimated at $147 billion. The causal pathways are complex, but if we drill down, sugar is a deeply consequential pathway to obesity, and the single greatest dietary source is sugar-sweetened beverages (SSBs). The copious amount of sugar in the American diet is no accident. Industry practices and regulatory failures have fueled this explosion. Yet there are sensible, effective interventions that would create the conditions for healthier behaviors. What are the key interventions, and how can we overcome the social, political, and constitutional roadblocks? Tobacco control offers a powerful model, suggesting that success requires a suite of interventions working in concert: labeling, warnings, taxation, portion sizes, product formulation, marketing restrictions, and bans in high-risk settings such as schools and hospitals. Each intervention deserves detailed analysis, but I'm kick-starting scholarly and policy conversation by systematically laying out the major legal tools.
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19
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Roache SA, Gostin LO. Tapping the Power of Soda Taxes: A Call for Multidisciplinary Research and Broad-Based Advocacy Coalitions - A Response to the Recent Commentaries. Int J Health Policy Manag 2018; 7:674-676. [PMID: 29996590 PMCID: PMC6037498 DOI: 10.15171/ijhpm.2018.30] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 03/25/2018] [Indexed: 12/02/2022] Open
Affiliation(s)
- Sarah A. Roache
- O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA
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20
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Baker P, Jones A, Thow AM. Accelerating the Worldwide Adoption of Sugar-Sweetened Beverage Taxes: Strengthening Commitment and Capacity Comment on "The Untapped Power of Soda Taxes: Incentivizing Consumers, Generating Revenue, and Altering Corporate Behavior". Int J Health Policy Manag 2018; 7:474-478. [PMID: 29764114 PMCID: PMC5953533 DOI: 10.15171/ijhpm.2017.127] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 10/15/2017] [Indexed: 11/28/2022] Open
Abstract
In their recent article Roache and Gostin outline why governments and public health advocates should embrace soda taxes. The evidence is strong and continues to grow: such taxes can change consumer behavior, generate significant revenue and incentivize product reformulation. In essence, such taxes are an important and now well-established instrument of fiscal and public health policy. In this commentary we expand on their arguments by considering how the worldwide adoption of such taxes might be further accelerated. First, we identify where in the world taxes have been implemented to date and where the untapped potential remains greatest. Second, drawing upon recent case study research on country experiences we describe several conditions under which governments may be more likely to make taxation a political priority in the future. Third, we consider how to help strengthen the technical and legal capacities of governments to design and effectively administer taxes, with emphasis on low- and middle-income countries. We expect the findings to be most useful to public health advocates and policy-makers seeking to promote healthier diets and good nutrition.
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Affiliation(s)
- Phillip Baker
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,The Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Anne Marie Thow
- Menzies Centre for Health Policy, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
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21
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Uddin R, Khan A, Burton NW. Prevalence and sociodemographic patterns of physical activity among Bangladeshi young adults. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2017; 36:31. [PMID: 28709469 PMCID: PMC5512845 DOI: 10.1186/s41043-017-0108-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 06/29/2017] [Indexed: 05/16/2023]
Abstract
BACKGROUND Physical activity offers physical and psychosocial health benefits that are important during young adulthood and later in life. However, little is known about the physical activity of young adults in low- and middle-income countries. The purpose of this study was to estimate the participation of physical activity in Bangladeshi young adults and to assess differences by gender, age and family income. METHODS This cross-sectional study with a self-administered survey used a convenience sample of 573 young adults aged 18-24 years from six purposively selected universities in Dhaka City, Bangladesh. Data were collected during September-November 2015. Medians and their interquartile ranges of weekly time spent in total physical activity, and in different domains of physical activity, were computed. Non-parametric equality of medians test was used to examine gender differences in the median values. Chi-square test and Fisher's exact test were used to examine gender differences in the prevalence of meeting physical activity recommendations and frequency of participation in different leisure-time physical activities, and differences in meeting the activity recommendations by age and family income. RESULTS Seventeen percent of the participants were meeting moderate-to-vigorous physical activity (MVPA) recommendations with a significantly higher proportion of males than females (27 vs. 6%, p < .0001). Median duration of MVPA was significantly higher (p < .0001) for males [120 min/week (80, 190)] than females [90 min/week (50, 120)]. Jogging/running was the most commonly reported leisure-time physical activity, with 20% of males and 12% of females doing this at least once a week. Age and family income were not significantly associated with meeting MVPA recommendations. CONCLUSIONS Four out of five young adults in Dhaka City did not meet the physical activity recommendations. Additional population-based studies, including regional and metropolitan areas, and using objective measurement, are needed to understand the physical activity patterns of Bangladeshi young adults.
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Affiliation(s)
- Riaz Uddin
- Department of Pharmacy, Stamford University Bangladesh, Dhaka, 1217 Bangladesh
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, QLD 4072 Australia
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, QLD 4072 Australia
| | - Nicola W Burton
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, QLD 4072 Australia
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Gostin LO, Friedman EA. Reimagining WHO: leadership and action for a new Director-General. Lancet 2017; 389:755-759. [PMID: 28139256 DOI: 10.1016/s0140-6736(17)30203-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 01/25/2017] [Accepted: 01/25/2017] [Indexed: 12/18/2022]
Abstract
Three candidates to be the next WHO Director-General remain: Tedros Adhanom Ghebreyesus, David Nabarro, and Sania Nishtar. The World Health Assembly's ultimate choice will lead an organisation facing daunting internal and external challenges, from its own funding shortfalls to antimicrobial resistance and immense health inequities. The new Director-General must transform WHO into a 21st century institution guided by the right to health. Topping the incoming Director-General's agenda will be a host of growing threats-risks to global health security, antimicrobial resistance, non-communicable diseases, and climate change-but also the transformative potential of the Sustainable Development Goals, including their universal health coverage target. Throughout, the next Director-General should emphasise equality, including through national health equity strategies and, more boldly still, advancing the Framework Convention on Global Health. Success in these areas will require a reinvigorated WHO, with sustainable financing, greater multisector engagement, enhanced accountability and transparency, and strengthened normative leadership. WHO must also evolve its governance to become far more welcoming of civil society and communities. To create the foundation for these transformative changes, the Director-General will need to focus first on gaining political support. This entails improving accountability and transparency to gain member state trust, and enabling meaningful civil society participation in WHO's governance and standing up for the right to health to gain civil society support. Ultimately, in the face of a global environment marked by heightened nationalism and xenophobia, member states must empower the next Director-General to enable WHO to be a bulwark for health and human rights, serving as an inspiring contra-example to today's destructive politics, demonstrating that the community of nations are indeed stronger together.
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Affiliation(s)
- Lawrence O Gostin
- O'Neill Institute for National and Global Health Law, Georgetown University, Washington, DC, USA.
| | - Eric A Friedman
- O'Neill Institute for National and Global Health Law, Georgetown University, Washington, DC, USA
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