Prevention of non-communicable diseases and environmental risks to health

Non-communicable diseases (NCDs)

Non-communicable diseases (NCDs), mainly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes, account for two-thirds of deaths worldwide.

Due to a dual demographic and epidemiologic transition, non-communicable diseases are a growing burden for health care systems, including in developing countries. Health promotion, in conjunction with better awareness of social and environmental factors (pollution, etc.) affecting health, are key to an effective and long-lasting response to these diseases.

Recognizing the dominance of NCDs on a global scale, in 2011 the UN General Assembly adopted a political declaration on the prevention and control of non-communicable diseases (Resolution A/66/2). This is the second public health issue to be the subject of a high-level General Assembly Meeting, ten years after the one focusing on HIV/AIDS. This text highlights the need to adopt a coordinated, multisectoral approach in order to reduce the impact of the common non-communicable disease risk factors, namely tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity.

The World Health Organization (WHO) has been given the task of creating an NCD Global Monitoring Framework, together with a Multisectoral Action Plan by 2025. Adopted in 2012, this framework sets a target of a 25% reduction in premature mortality from NCDs by 2025, and includes eight other voluntary global targets based on the various risk factors, and 25 monitoring indicators. In 2013, a special UN team was created to coordinate the work of agencies in the fight against NCDs. In addition, a global coordination mechanism will bring together non-state partners in the fight against NCDs, by ensuring that the objective of public health is preserved from any conflict of interests.

Mental disorders

Mental disorders are the second cause of invalidity and premature death. They represent 14% of the global morbidity burden.

One person in four is exposed to mental disorders during their lifetime. The total cost of mental diseases, including foregone economic productivity, was estimated at US$2,500 billion in 2010. It could reach US$6,000 billion by 2030. France supports the implementation of the Global Mental Health Action Plan 2013-2020, particularly through the WHO collaborating centre in Lille for research and training in mental health. In addition, the French Development Agency, operator for the French Ministry of Foreign Affairs and International Development, supports psycho-social care and community mental health, particularly in post-conflict countries.

Action concerning environmental factors affecting health

According to WHO, 24% of the morbidity burden (healthy life years lost) and 23% of all deaths (premature mortality) are caused by environmental factors. In children aged 0-14 years, 36% of deaths are caused by environmental factors.

Although environmental issues are being extensively discussed today at global level, their effect on health is still not sufficiently taken into account. The most urgent issues feature climate change, the non-sustainable management of water resources, known to be of insufficient quantity and quality in developing countries, the need to develop large-scale sanitation networks, and management of all types of waste that pollutes water, air, but also food. A cleaner environment would help avoid 13 million deaths each year if we were to act on environmental factors such as safe drinking water or air pollution.

Twenty years after the first Rio Declaration in 1992, the international community renewed its commitment towards environmentally sound development in the Rio+20 Declaration, adopted in June 2012 during the United Nations Conference on Sustainable Development. Health is recognized as being a prerequisite, a result and an indicator of the three pillars of sustainable development. A green economy that reduces risks linked to air and water pollution and that aims to improve access to healthy food and nutrition, and to reduce climate change will lead to better health for all, while contributing to sustainable development.

The health and environment issue is a key area of France’s work at global level. It is part of the Protocol on Water and Health to the 1992 Convention on the Protection and Use of Trans-boundary Watercourses and International Lakes of the United Nations Economic Commission for Europe (UNECE). France piloted a Working Group on Water and Health focusing on access to safe drinking water and sanitation. Adopted by the World Health Assembly (WHA) in May 2011, the “water, sanitation and health” resolution, proposed by France, was hailed as important progress through its cross-cutting dimension involving the sectors of water, environmental health and human rights. A new WHO strategy for the water/sanitation/health sector was presented to the WHA in May 2013. In March 2012, France organized the World Water Forum in Marseille. In 2009, the WHA endorsed a new WHO work plan on climate change and health.

Although no region in the world is spared, Africa is the main continent concerned by all these risk factors. The First Inter-Ministerial Conference on Health and Environment in Africa, on the theme “Health Security through Healthy Environments” was organized in Libreville, in August 2008 with the support of France, followed by a conference in Luanda in 2010 on the effects of climate change on health.

May 2014