Earlier this year I had the privilege to participate in the Prince Mahidol Award Conference, an annual global health gathering sponsored by the Government of Thailand. This year’s theme – The political economy of NCDs: The whole of society approach – reinforced the importance of inclusivity and multistakeholder engagement in identifying and implementing solutions to non-communicable diseases such as cancer, cardiovascular disease, chronic respiratory diseases and diabetes.
NCDs account for the greatest share of deaths globally. In the Asia-Pacific region, for example, NCDs are now the most significant cause of death and disease burden. Most premature deaths from NCDs are associated with the main modifiable risk factors, namely tobacco use, unhealthy diets, physical inactivity, harmful use of alcohol and air pollution.
Air pollution and low physical activity risk factors present opportunities to target policy action to improve the environment and to improve human health. During the week of PMAC, Bangkok was experiencing one of its worst air quality episodes in recent years. A combination of factors was responsible – air emissions from industry, motor vehicle use, burning of sugar cane and dry weather conditions. Conference goers and locals alike found themselves using apps for PM2.5 real-time readings and looked to buy air quality masks.
A session on the first day of the conference highlighted available science-based tools which could be used to address environmental risk factors of NCDs. I was privileged to be in the company of experts who work in scientific research and who have deep experience in applying scientific knowledge to inform policy decisions. We represented academia (University of Sydney, University of Oxford), government (Ministry of Health and Sports of Myanmar, US National Institute for Environmental Health Sciences), multilateral organizations (OECD) and multilateral funding entities (Green Climate Fund).
We shared tools which are aimed at specific policy uses. The OECD’s work on a simulation modeling tool estimates NCD prevalence and informs cost-effectiveness analysis and takes into account the costs of human health effects, labour productivity and aggregate GDP. These can support country-level investment decisions such as on infrastructure, which could promote healthy lifestyles and reduce NCD risk.
The use of the Health Impact Assessment (HIA) tool can be adapted to help identify win-win solutions to improve health while also reducing the ecological footprint across such areas as transport, land use and health.
From the country perspective, Myanmar’s Permanent Secretary of the Ministry of Health and Sports presented on NCD threats facing the country, particularly diabetes. Myanmar is also concerned about climate change and health and well-being, especially the effects of extreme events like cyclones. Climate change is expected to exacerbate the human health effects of other environmental stressors such as water contamination. As a result, there is increasing worry about displaced communities and scarcity of resources.
Participants at the conference were also interested in learning about additional tools to help address the environmental risk factors of NCDs. Other points raised included the need for HIA to be more systematic and less procedural, and should be made more meaningful to address linked environment health issues. Data integration is key for improved assessment and monitoring of health outcomes over changing environmental conditions. This requires interoperable environmental and health data platforms to facilitate interpretation and analysis to directly inform policy.
We know that policy action on NCDs has to come from health and non-health sectors. Highlighting existing tools and how they can be enhanced based on increasing understanding of environment-NCD relationships puts us on good course towards a practice of multi-sectoral policy collaboration.
By Montira Pongsiri, Senior Science Policy Adviser, Secretariat of the Rockefeller Foundation Economic Council on Planetary Health