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Health Surveillance and Disease Prevention and Control / Chronic Diseases

Regional Strategy on an Integrated Approach to the Prevention and Control of Chronic Diseases Including Diet, Physical Activity, and Health

Regional Strategy on Chronic Diseases

new Full Text in PAHO publication format

The Regional Strategy on an Integrated Approach to the Prevention and Control of Chronic Diseases Including Diet, Physical Activity, and Health (CD47/17, September 2006), was approved by the PAHO Directing Council at their September meeting. Closely related strategies are the Regional Strategy and Plan of Action on Nutrition in Health and Development, 2006–2015 CD47-18 and the Regional Strategy on Health Promotion CD47-16. In the past year, two other WHO Regions—SEARO and EURO—have also approved chronic disease strategies, so that worldwide momentum is building up.

The Strategy is comprehensive, requiring a combination of interventions for the population and individuals. It is integrated, spanning prevention and control strategies focusing on the major chronic diseases and cross-cutting risk factors (especially diet, physical activity, tobacco, and alcohol). Finally, it is intersectoral, because most of the major determinants of the chronic-disease burden lie outside the health sector.

Consequently, the Strategy uses four lines of action:

  • surveillance,
  • advocacy & policy,
  • health promotion & disease prevention, and
  • integrated management of chronic diseases & risk factors.

In its implementation, the Strategy will mobilize and deepen a range of partnerships both inside and outside PAHO.

The Regional Strategy was developed through an intensive consultation process. The goal is to prevent and reduce the burden of chronic diseases and risk factors in the Americas. The target is a 2% annual reduction in death rates from the major chronic diseases, over and above current trends, which will result in the lives of over three million people being saved over the next 10 years, thus enabling them to discharge their social and work-related responsibilities. Globally, WHO has set the target of preventing 36 million deaths over the next 10 years.

It is intended that the CARMEN (Conjunto de Acciones para la Reduccion y Manejo de Enfermedades No Transmisibles) initiative will be a major vehicle for implementation of the regional strategy, bringing together Member Countries, the Secretariat, and partners. A CARMEN management committee meeting in March will consider a renewed vision and terms of reference for the initiative and network in the light of 10 years of CARMEN and the approved Regional Strategy, and make plans for a major CARMEN meeting to occur in autumn, which will develop national and subregional plans for the biennium 2008–2009. A Technical Advisory Group on chronic disease will be established to provide scientific guidance to the implementation of the Regional Chronic Disease Strategy. At the Program Secretariat at PAHO Headquarters, program implementation will be coordinated by an Interprogrammatic Working Group bringing together national, subregional, regional, and global levels of WHO.

The rationale for the Strategy is well known. Chronic diseases are the major cause of death in all our countries. They are commoner among the poor and, when they occur, push people and families into poverty. Worldwide, they cause 60% of all deaths; and over 35 million people will die from chronic diseases in 2006. The main problems—heart disease, stroke, cancer, diabetes, and chronic respiratory disease-are caused by hypertension, elevated blood sugar, hyperlipidemia, and overweight/obesity—which, in turn, are the result of unhealthy diets, physical inactivity, tobacco use and alcohol excess. These risk factors are largely socially determined and encompass knowledge, attitude, skills, and the social environment-culture, tobacco taxation, agriculture, education, mass-transportation policies, private-sector marketing, etc. At least 80% of all heart disease, stroke and Type 2 diabetes, as well as 40% of all cancer, can be prevented through a range of cost-effective interventions, many of which are inexpensive. Many costly complications can also be prevented by good health policies. Nonetheless, we must strike a new balance between prevention and control.

To promote and support implementation of the Strategy, a communication plan is under development. This plan will identify channels and vehicles to communicate the importance of taking action to promote health and prevent chronic disease. Spokespeople will be identified to promote the plan; key decision-makers will be identified and brought into dialogue; and messages will be designed for radio, television, and print. These messages will be tailored to various audiences including policy-makers, health professionals, PAHO employees, people living with chronic diseases, civil society, partners, and the media.

About the CARMEN Network   |   PAHO Chronic Disease Newsletter