'On 23-24 March 2009, the Pan American Health Organization (PAHO) organised a workshop to think about how to set up a multi-stakeholder forum where governments, civil society organisations and industry should come together to fight chronic non-communicable diseases (CNDCs). Among governments and civil organisations, Consumers International was also invited.
These diseases, like diabetes type 2, hypertension, obesity, cardiovascular diseases, some types of cancer and osteoporosis, are the main causes of premature deaths, 80% of which occur in low and middle income countries. Physical inactivity, an unhealthy diet with too much sugar, salt and fat, smoking and abuse of alcohol are the main causes of CNDCs, affecting more and more the poor people.
And what is worse, these diseases can be prevented in many cases. Lowering the salt consumption with 2 to 5 grams each day and smoking less can prevent globally 13,8 million deaths in the coming 10 years! With some other measures, like extra physical activities, etc. this number can be still higher.
Now to be able to achieve that, large changes are necessary which no one party, be it government, industry or civil society, can accomplish by itself. So there is a strong need to bring these parties together to fight the epidemic of CNDCs. What we, governments and NGOs, tried to envision in the two days of brainstorming and work lunches was how to involve the industry without generating conflicts of interest.
Listening to previous experiences of creating alliances and projects, one can see that there are many things going on but these are not aligned. They work locally or nationally or treat specific diseases. The new forum that PAHO is setting up should comprise all CNDCs and all countries in South and North America. A huge task but this is where the transnational companies, selling their sometimes not so healthy food in almost all the North and South American countries, come in.
There is mistrust between NGOs and large corporations. What happens if a company, willing to sponsor a PAHO project, earns money selling unhealthy products (alcohol, tobacco, unhealthy foods and drinks)? Well, the companies related to alcohol or tobacco or guns will never be allowed to do so. Industry with product or services damaging (public) health cannot either. Moreover, companies with a bad corporate social responsibility record are also not considered. PAHO has very strict rules to scrutinise companies and deciding whether they can form part of the platform. Its reputation is at stake and cannot be compromised.
On the other hand, we know that industry is very interested in participating. Maybe because this way they hope to get recognition for their self regulation programs. The food industry got together to start removing trans fats from food stuff. Something which could serve as an example for lowering levels of salt, even though from experience, we know that self regulation alone is not sufficient.
It is interesting and dramatic at the same time to see that many governments are spending their health care money on curing diseases, while they could spend it much more efficiently on preventing people from getting sick in the first place. Doctors are educated in treating patients, not really in preventing people from contracting a disease. The CNDCs will grow in such a pace that the costs involved will explode and be unsustainable soon. Changes have to be made, nationally but also internationally. Even the WHO needs to do so.
Talking about this, we agreed quite quickly and we discussed the next steps that should be taken. And now it is time to stop talking and start doing things. We need to go back to our workplaces, organisations, etc. and figure out how to move forward. In the months to come meetings will be held where industry shall be invited together with other civil organisations. Governments of all countries in the region will be invited too. The plan is to create an alliance with clear roles and criteria for all participating sectors and launch it at the end of 2009. WHO is planning to do so in other regions as well.'
 The Lancet, Volume 370, Issue 9604, Pages 2044 - 2053, 15 December 2007 Chronic disease prevention: health effects and financial costs of strategies to reduce salt intake and control tobacco use Perviz Asaria MPH, Dr Dan Chisholm PhD, Colin Mathers PhD, Majid Ezzati PhD, Robert Beaglehole DSc