Could Australia do more to tackle chronic disease? Yes, says the WHO

The research focused on the implementation of 18 World Health Organization (WHO)-backed policies targeting non-communicable disease (NCD) across 151 countries.
 
Australia ranked 36th in terms of policy implementation with 63% of policies introduced, in front of New Zealand (58%) but far behind Iran and Costa Rica (87%).
 
While implementation is slowly improving globally, slightly less than half of the policies have been adopted on average, the research found.
 
GP and Executive Dean of Health Sciences and Medicine at Bond University Professor Nick Zwar told newsGP while Australia is performing well in areas such as tobacco control and cardiovascular health, there is room for improvement.
 
‘We should be concerned because there are some areas where our policy does lag behind some other countries or isn’t as health-focused,’ he said.
 
‘We’re much less strict on alcohol advertising than we are on tobacco, but alcohol does quite a lot of harms. That’s an area where further regulation could be enacted.
 
‘[Another] that sprang to my mind was nutritional food and food labelling. We don’t have a simple, easy to understand consumer food labelling system that helps people to make healthy choices about what they eat.’
 
Professor Zwar said there are a number of potential reasons for why Australia hasn’t adopted all of the recommended WHO policies, including cultural factors.
 
But he believes politics plays a key role.
 
‘There doesn’t always seem to be the political will to do it, and whether that’s because of lobbying or because of a view that these are free choices that people make – and certainly you hear politicians say those sorts of things – [I don’t know],’ he said.
 
‘Clearly there has to be some personal responsibility [as well]. But it’s a kind of political mindset that sees some of the public health issues as not aligning with the ideology of the political party.
 
‘This is a benchmarking exercise and we need to ask ourselves why, and where the areas are that we could do better.’
 
On average, global implementation improved for 14 out of 18 policies. The most commonly implemented were the introduction of clinical guidelines, graphic warnings on tobacco packaging, and surveys on national NCD risk factors.
 
The least widely implemented were market-related policies, including tobacco taxation, tobacco mass-media campaigns and alcohol advertising bans, as well as providing cardiovascular drug therapy.
 
Dr Marguerite Tracy, Senior Lecturer at the University of Sydney’s School of Public Health and RACGP Expert Committee – Quality Care (REC– QC) member, told newsGP that NCD policies could not solve public health issues in isolation.
 
‘We can always do more to combat non-communicable diseases. [But] this needs effort from all sectors, not just health. The social determinants of health are a dominant predictor of NCDs, [and] long-term, sustained funding of programs with evaluation is important,’ she said.
 
Dr Tracy also pointed out that not all policies are equally effective at combating NCDs, with the aggregate scores produced by the study measuring breadth of policies only, rather than effectiveness.
 
Despite this, she said she would not want to see Australia continue to slide down the table.
 
‘We have been aware of the growing burden of NCDs in Australia for a long time now, which is increased by our ageing population and also our successful management of so many other life-limiting conditions,’ she said.
 
‘Preventive healthcare to reduce the NCDs is core work in primary care. National policies to support improvements in social determinants of health and equitable policies to reduce risk factors for NCDs is vital.’
 
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