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The ‘O Generation':
tackling the childhood obesity epidemic

Mirta Roses-Periago, director, Pan American Health Organization

Measures are in place to confront the problem of poor diet and reverse a health trend that holds deep economic implications for future generations

From "The G8 Camp David Summit 2012: The Road to Recovery," edited by John Kirton and Madeline Koch,
published by Newsdesk Media Group and the G8 Research Group, 2012
To download a low-resolution pdf, click here.

With childhood obesity rates doubling or even tripling over the past 20-30 years in most countries, the next generation could become the ‘O Generation'. Many gains in child health would be reversed if present trends continue. Paradoxically, this overweight and obesity phenomenon is often accompanied by micronutrient deficiencies and anaemia from diets that are dense in calories but poor in nutrients, combined with lower levels of physical activity. This situation holds deep economic implications, in addition to the health problem: if the next generation is more overweight, less fit and less healthy, it will not learn as well and will incur higher healthcare costs over a lifetime, in turn affecting productivity and efforts to achieve fiscal consolidation. The Region of the Americas is already the world's most overweight. The Let's Move! campaign launched in the United States by First Lady Michelle Obama aims to reverse the epidemic of childhood obesity in a single generation through joint action across government departments, the business community and civil society. This is an example of political leadership to safeguard the next generation. But the problem extends well beyond the United States: most countries in Latin America and the Caribbean, and indeed in much of the world, are also experiencing upward trends in childhood and adult overweight and obesity, which are increasingly concentrated among the poor and less educated population sectors and thus are deepening social inequality. Obesity is simply a subset of a much bigger problem, the largely silent epidemic of noncommunicable diseases (NCDs) – namely, cancer, diabetes, heart disease and stroke, and chronic respiratory disease. Fortunately, the world is now rising to the challenge. The historic United Nations High-Level Meeting (UNHLM) held in New York in September 2011 placed NCDs on the development and economic agenda for all countries.

While the most rapid increases in these diseases are taking place in the low- and middle-income countries, those countries that are members of the Organisation for Economic Co-operation and Development (OECD) also face a heavy burden of NCDs and an ageing population with increasing health costs, which will serve to undermine their fiscal consolidation agendas.

A crucial step forward

The UNHLM declaration sets out objectives for NCD prevention and control, including:

Having an accountability architecture is key to the success of summits, by providing metrics and setting responsibilities for action.

Thus, the process that WHO is leading to develop an effective global monitoring framework that includes goals and targets that countries are able to realistically adopt, is a crucial step forward.

The current global monitoring framework includes measures of changes in outcomes and exposures and the national response. Proposed voluntary targets to be achieved by 2025 and currently under consultation with WHO members include a 25 per cent reduction in mortality between the ages of 30 and 70 due to cardiovascular disease, cancer, diabetes and chronic respiratory disease; reductions in risk factors such as hypertension (25 per cent), tobacco (30 per cent), salt consumption (30 per cent) and physical inactivity (10 per cent); and disaggregating all indicators by gender, age, socioeconomic position and other relevant stratifiers.

Preventive treatment

Given the need for a multisectoral response to NCDs, a clear corollary of the UNHLM declaration is that achieving these targets will demand ‘all-of-government' and ‘whole-ofsociety' approaches that confront head on the enormous health and economic challenges

In many parts of the world, countries are experiencing upward trends in childhood and adult obesity, which are concentrated among the poor

involved. Governments bring to the table their stewardship and responsibility for public policy, regulation and taxation, both at national and at local/municipal levels. Civil society brings its local know-how, legitimacy, networking, advocacy and community education efforts. The business sector brings products and services, technical knowledge and capacity, as well as obligations for social responsibility. Media outlets bring their ability to create awareness and mobilise.

The international financial institutions have a responsibility for contributing to support development, and NCDs are an undeniable obstacle to the continued development that they all want.

So, all hands are needed on deck to succeed in translating the UNHLM declaration into action in order to confront the NCDs epidemic. That is why the Pan American Health Organization has launched the Pan American Forum for Action on NCDs, with the participation of core partners such as the Public Health Agency of Canada, the World Economic Forum, the Spanish Agency for International Development Corporation, as well as other organisations.

The forum brings together government entities, the scientific and academic community, the business sector, international organisations and civil society – including faith-based organisations. Together they will raise awareness, help to promote innovative initiatives and scale up successful practices for NCDs prevention and control, as well as promote health at all levels, whether local, national or hemispheric. This strategy is relevant to each and every country's ability to intensify action on NCDs.

The forum will serve as an example of multi-stakeholder responses to the epidemic, called for by the UNHLM, and will work to raise NCDs to the highest level of political attention nationally and regionally.

It will also build capacity for mobilising partners and resources and will develop strategic alliances to support effective NCDs prevention and control measures and the promotion of healthy living and well-being.

Taking into account a core set of low-cost, high-impact NCD ‘best-buy' interventions identified by WHO, the forum's initial focus will include: communication and advocacy, dietary salt reduction and healthy nutrition, the scaling up of cardiovascular disease preventive treatment, the control and prevention of cervical cancer, and promoting physical activity and healthy workplaces.

The world can no longer afford a ‘business as usual' mentality regarding NCDs. Inaction would have a staggering cost. Over the next two decades, the toll from NCDs will exceed $30 trillion in healthcare costs, lost productivity and personal medical expenses.

Time to act decisively

Tackling this challenge is, therefore, fundamental to fostering the well-being of every country's populations, alleviating fiscal pressures caused by rising healthcare costs, and preserving and stimulating the nation's productivity. The time has come for G8 members, and indeed, all world leaders, to take advantage of this opportunity to act decisively now, by promoting and adopting an all-inclusive multisectoral approach to the problem, one which will succeed in dealing with the silent epidemic of NCDs.

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