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Consumer Organisations and the WHO Global Strategy on Diet, Physical Activity and Health Transatlantic Consumers Dialogue Meeting Brussels, 3 February 2004,Amalia Waxman Project Manager, Global Strategy on Diet, Physical Activity and Health World Health Organization,Epidemiological: NCD overriding CD, & double burden of diseases in many developing countries. Nutritional: Diets are rapidly changing, physical activity reduced. Demographic: Population ageing. Globalization: Increasing global influences.,World Health is in Transition,Death, by broad cause group estimates for 2002,Injuries (9.1%),Noncommunicable conditions (58.6%) of which 50% are due to CVD,Communicable diseases, maternal and perinatal conditions and nutritional deficiencies (32.3%),Total deaths: 57,027,000,Source:WHO, WHR, 2003,Leading causes of mortality for adults, 2002,5823 4692 2399 1398 929 754 735 606 496 478,HIV/AIDS Ischaemic heart disease Tuberculosis Road traffic accidents Cerebrovascular disease Self-inflicted injuries Violence Cirrhosis of the liver Lower respiratory infections Chronic obstruc. pulmonary disease,Ischaemic heart disease Cerebrovascular disease Chronic obstruc. pulmonary disease Lower respiratory infections Trachea, bronchus, lung cancers Diabetes mellitus Hypertensive heart disease Stomach cancer Tuberculosis Colon and rectal cancers,1559,60 and over,Source: WHO, WHR, 2003,Leading causes of disease burden (DALYs) Persons aged 15 and over, worldwide, 2002,Heart disease HIV/AIDS Cerebrovascular disease Tuberculosis Chron. obstruc. pulmon. disease Unipolar depressive disorders Hearing loss, adult onset Road traffic accidents Cataracts Alcohol use disorders,Unipolar depressive disorders HIV/AIDS Maternal conditions Ischaemic Heart disease Cerebrovascular disease Cataracts Hearing loss, adult onset Chron. obstruc. pulm. disease Tuberculosis Osteoarthritis,MALES,FEMALES,Source: WHO, WHR, 2003,Global prevalence of underweight and obesity in adults for year 2000 by level of development,Prevalence (%),BMI = Body Mass Index,Source: WHO, SDE/NHD, 2000,Trends of overweight in children,Mexico,Tunisia,Nigeria,India,Mali,Source: de Onis and Blssner. Am J Clin Nutr 2000;72:1032-9.,1990,2000,1998,1994,Obesity USA: BMI 30, or 30 lbs overweight for 54” woman,No data, 10%,10 - 14%,15 - 19%, 20%,Trends in mean total cholesterol; Beijing China, 25-64,Source: WHO MONICA survey, Beijing,Mean total cholesterol mmol/l,Number of persons with diabetes: trends in developed vs. developing countries,Deaths attributable to 16 leading risk factors: all countries, 2001,3000,6000,7000,8000,0,1000,2000,Deaths (000),Blood pressure Tobacco Use Cholesterol Underweight Unsafe sex Fruit & vegetable intake High Body Mass Index Physical inactivity Alcohol Unsafe water, hygiene Indoor smoke from fuels Iron deficiency Urban air pollution Zinc deficiency Vitamin A deficiency Unsafe health care injections,4000,5000,Low mortality Developing countries,High mortality Developing countries,Developed countries,Source: WHO, WHR, 2003,You Can Change Your Risk of Chronic Disease by Changing One of These Three Things.,Mother,Father,Diet and Physical Activity,The Big Picture,The Global Strategy on Diet, Physical Activity and Health - next steps,EB approved Resolution with condition: comment period for countries until 29 Feb 04 WHO to collect and publicise comments GS ready by mid-March 04 - publicly available GS and Resolution presented to WHA for approval, 17-24 May 04, Geneva,Controversies,Scientific basis - TRS 916 and more Marketing Evidence for interventions Codex Alimentarius Personal responsibility,An example: Personal Responsibility, refers to the idea that people should make healthy choices for themselves, without intervention from government or others. This idea assumes: an environment that allows and promotes informed, un-coerced choice, an environment in which healthy choices are accessible, affordable and encouraged for everyone.,Individual behaviour,Change in environment,Puska 2001,The reality,The unhealthy choices are the easy choices, Unsupportive cultural and physical environments, Access and affordability are significant issues, Large marketing budgets for unhealthy food,What can consumer groups do?,Report to countries on the GS, the process for producing it, and its menu-like content Inform countries of the short comment period Encourage countries to send comments Urge coun