Low-and middle-income countries need to prioritize noncommunicable disease prevention

Nine years after the World Health Organization adopted a global strategy on diet, physical activity, and health to address risk factors for chronic diseases such as heart disease and diabetes (referred to internationally as noncommunicable diseases), only a few low-and middle-income countries have implemented robust national policies to help prevent such diseases, according to a study by international researchers published in this week's PLOS Medicine.

These findings are important as they suggest that the majority of the world's low- and middle-income countries are not prioritizing the prevention of noncommunicable diseases through evidence-based actions, such as reducing fat and salt intake.

The researchers, led by Patrick Kolsteren from the Institute of Tropical Medicine in Antwerp, Belgium, reached these conclusions by reviewing relevant policies from all 140 low- and middle-income countries but were only able to find any such policies in 116 countries.

The authors found that less than half of the 116 countries (47% or 54/116) had any strategies relating to noncommunicable diseases and that only a small proportion of these strategies proposed actions to promote healthier diets and physical activity. Furthermore, only 14 countries (12%) proposed a policy that addressed all main risk factors (reducing salt and fat intake, and promoting fruit and vegetable intake and physical activity) and 29 (25%) addressed only one risk factor.

The authors say: "The present review shows that the policy response to address current [noncommunicable diseases] challenges through diet and physical inactivity in [low- and middle-income countries] is inadequate since endorsement of the Global Strategy on Diet, Physical Activity and Health."

They continue: "[Low- and middle-income countries] urgently need to scale up interventions and develop integrated policies that address various risk factors for [noncommunicable diseases] prevention through multi-stakeholder collaboration and cross-sector involvement."

In an accompanying Perspective article, David Stuckler from the University of Oxford and Sanjay Basu from Stanford University (uninvolved in the study) say: "Two key features of the study underscore some reasons for the malignant neglect of [non-communicable diseases]. First, there is virtually no serious response to potential conflicts of interest with industries that manufacture and market the products directly attributable for rising [non-communicable diseases]." "Second, there is a vast divide between resources available to the public and those used to construct policy."

Stuckler and Basu continue: "People around the world deserve to know which policies they are (or are not) being exposed to and what impact these policies have on them."