Gender and Development

The New Narrative in NCD Prevention

Noncommmunicable diseases (NCDs) have finally been placed in the spotlight, with this year's UN General Assembly finally putting it at the forefront. Ana Zhelyazkova outlines the preventive measures the international community is looking to take, as well as gaps in their current strategy.


On the agenda of this year’s United Nations General Assembly (UNGA) High-Level week, global health issues were bestowed with the same quantity and quality of attention as  topics of international security and multilateral cooperation. Several high-level meetings on health issues dominated the program along with calls for action and political commitment.

While progress and reconfirmed pledges in ending Tuberculosis commenced a perceived final chapter in the fight against preventable infections, global stakeholders finally took the decisive steps towards collaborating for monitoring, controlling and preventing the epidemic of noncommunicable diseases (NCDs). Placing the spotlight on NCDs is a long-awaited attempt to adopt a solution mindset aligned to the nature of the problem. Yet, the new global NCDs approach appears to be designed to be on the opposing side to the previously established notion of individual responsibility. Thus, the continuum of prevention concepts in regard to NCDs is currently facing a sharp drift by shifting the complete burden from the individual to the stakeholders shaping the physical and dietary environment.

From Responsibility to Accountability

In the past few months, the global health agenda has been embracing a new narrative with regard to the accelerating prevalence and negative impact of NCDs. An observable shift from personal responsibility to public accountability was set off with the launch of the REPLACE guide by the World Health Organization (WHO). REPLACE aims to facilitate political action towards eliminating trans fatty acids – an ingredient established in the Fast-moving consumer goods (FMCG) industry that is among the main health risk factors for cardiovascular diseases and leading approx. 500,000 additional deaths worldwide. Soon after, the Global Action Plan on Physical Activity 2018-2030 set a much anticipated framework for policy-makers to facilitate the development of health-promoting legislation.

Following the pursuit for political action in reducing health-risk specific mortality, NCD Alliance, Imperial College London, The Lancet and WHO developed the first accountability mechanism for monitoring the progress towards achieving the 2030 goal for SDG 3.4 – a 30% reduction of premature mortality from NCDs. The increasingly visible recognition of the individual, societal and economic burden of NCDs was crowned with the Time to Deliver political declaration, adopted during the 73rd session of the UNGA. It essentially established the commitment of Member States to accelerate the short- and long-term response to the NCDs epidemic.

The upsurge in international stakeholder commitment marks a sharp and long-awaited turn in the rhetoric on and investments in NCD prevention. The broader consideration of risk factors, such as availability and accessibility of healthy foodstuff options and health-promoting measures, diminishes the entrenched perception of unconfounded causality in the notion that merely unhealthy behavior causes an unhealthy state of the individual. Rather than the sole personal responsibility for one’s dietary manners and subsequent self-driven ill-health, global health stakeholders have finally identified the catalytic impact of the food environment in that process and taken account of legislative and regulatory actions as a means to reduce NCD-prevalence.

From Consumers to Populations at Risk

On the continuum of approaches in NCDs prevention, the recent global stakeholder activities serve as an impetus for decision-making processes to move away from the sole target of increasing individual awareness about diet, nutrition and healthy lifestyle to a rather collaborative, legislative and regulatory solution-oriented manner. Indeed, the rhetoric of NCD-related discussions has been largely building around the idea of multi-sectoral and multi-stakeholder sustainable collaboration – one that drifts away from the micro-responsibility of the individual, focusing on the macro-level of food systems transformation. For individuals, this shift represents an essential positive development in confronting the Public Health problem of perpetuated NCD-biased discrimination, especially weight and obesity stigma as well as mental health stigma and discrimination. For stakeholders, the new series of strategic actions serve as a trigger to drive away from established top-down regulatory solutions and promises to not only facilitate the Health in All Policies framework but to also institute a Sustainability in All Policies mindset.

Nonetheless, although largely positive and promising, the NCD-shift highlights the divergence between stakeholders in their broad role of health providers and populations as beneficiaries from the projected multilevel policies. While policy, industry and civil society actors are building the new NCD-narrative through their newly recognized accountability for structuring health-promoting environments, empowering the populations and considering them as stakeholders in these environments appears to only be partially included. Still, for the mindset of Health & Sustainability in All Policies to be truly adopted, global health stakeholders need to be more embracing of the most dynamic facet of the physical and dietary environments – namely, the populations living with, because and despite of those. The new NCD narrative is a reassuring development in the overall global health agenda and recognition of health as a global political issue. For the new rhetoric to effectively translate into action and outcomes, empowering populations is key.

Ana Zhelyazkova holds a Master’s Degree in Public Health and Bachelor’s Degree in Communication studies and Political Science. She currently works as a Research Associate at the Pettenkofer School of Public Health, LMU Munich, with focus on Health Communication and Policy. She also serves as Public Information Officer for the Association for UN Interns (AUNI), New York.

Please note that opinions expressed in this article are solely those of our contributors, not of Political Insights, which takes no institutional positions.

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