CHRONIC DISEASE ALLIANCE

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• CHRONIC DISEASE ALLIANCE
• Taking on the collective social challenge of
  chronic non-communicable diseases

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Chronic Non-Communicable Diseases Account for 86
of Deaths in the EU
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The Chronic Disease Alliance Ten European
organisations
EASL - European Association for the Study of the
Liver ECCO - European CanCer Organisation EHN -
European Heart Network EKHA - European Kidney
Health Alliance ERS - European Respiratory
Society ESC - European Society of Cardiology ESH
- European Society of Hypertension ESMO -
European Society of Medical Oncology FEND -
Foundation of European Nurses in Diabetes IDF
Europe - International Diabetes Federation Europe
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The Chronic Disease Alliance Aims
Ten European organisations gt100,000 health
professionals Call for immediate political
action to reverse the alarming rise in chronic
non-communicable diseases which affects more than
a third of the population of Europe Over 100
million citizens.
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Prevention of chronic diseases Transprofessional
collaboration
The Chronic Disease Alliance
Key issues

• Impact on public health
• Economy in prevention
• The climate for
• collaborative efforts and
• political success

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Explaining the fall in coronary heart disease
deaths in England Wales 1981-2000
Risk Factors worse 13 Obesity (increase)
3.5 Diabetes (increase) 4.8 Physical
activity (less) 4.4 Risk Factors better
-71 Smoking -41 Cholesterol
-9 Population BP fall -9 Deprivation
-3 Other factors -8   Treatments
-42 AMI treatments -8 Secondary
prevention -11 Heart failure
-12 AnginaCABG PTCA -4 Angina Aspirin
etc -5 Hypertension therapies -3
68,230 fewer deaths in 2000
2000
1981
  Unal, Critchley Capewell Circulation 2004
109(9) 1101
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Explaining the CHD mortality fall in Sweden
1986-2002
Bjorck et al Eur Heart J 2009
Risk Factors worse 11 Obesity (increase)
3 Diabetes (increase) 8 Risk Factors
better -66 Cholesterol (diet) -39 Population
BP fall -9 Smoking -20 Physical
activity -13  Treatments -36 AMI
treatments -6 Unstable angina
-2 Secondary prevention -12 Heart failure
-7 AnginaCABG PTCA -3 Hypertension
therapies -4 Statins (primary prevention)
-2   Unexplained -9
13,180 fewer Deaths in 2002 ?
2002
1986
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The document June 10, 2010
Delivered to Health Commissioner John Dalli
Berlaymont
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The document Delivered June 10, 2010
Examples of the contents
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Chronic non-communicable diseases (CNCD) Some
important facts

• CNCD treatable - rarely curable
• Huge costs Treatment, Carers - Lost
  productivity
• Chronic ill-health traps people in poverty
• CNCD threatens the Europe 2020 targets

• DALYS attributable to

Shared risk factors 28 Adding obesity
overweight 35
(Aging report EC 2009 Lopez et al Lancet 2006
3671747 Allender et al EHN 2008)
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Chronic Disease Alliance The slogan and impact
Health is Wealth!!!

• Longer and healthier lifes
• Reduced health inequities
• Reversed negative labour force growth
• Improved European productivity

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Chronic disease alliance Health not only for
health departments

• Recommendations on
• Taxation
• Agriculture
• Food labelling
• Urban planning
• Education
• Sport and recreation
• Paramount legislative principal
• Health in all policies

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Policy recommendations

• Choice and information
• Incentives
• The default healthy option
• Safety science

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Prevention of chronic diseases Some examples -
tobacco
Choice and information Comprehensive disclosure
of physical, chemical and design characteristics
of all tobacco products made public Compulsory
cigarette packaging All branding elements removed
Pictorial health warnings cover 80 of the
packet front back
Front
Back
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Prevention of chronic diseases Some examples -
tobacco
Incentives Ensure taxation on tobacco and alcohol
is harmonised at a high level across EU
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Prevention of chronic diseases Some examples -
tobacco
Safety science Urge Member States
to implement and enforce smoke free
legislation
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Prevention of chronic diseases Some examples
food and alcohol
Choice and information Mandatory food labelling
on front and back including traffic light
colour coding to facilitate consumer
understanding
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Prevention of chronic diseases Some examples -
food
Incentives Promote measures to increase the
affordability of healthy food choices including
financial measures (subsidies)
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Prevention of chronic diseases Some examples -
food
Transfat content
(Stender et al Atherosclerosis 2006 Suppl 7 47)
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Prevention of chronic diseases Some examples -
food
The default healthy option Proceed with EU-wide
measures to prohibit all marketing of
unhealthy food to children through
television and non-broadcast media
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Prevention of chronic diseases Some examples
physical activity
Incentives Prioritise pedestrians and
cyclists in urban development and ensure easy
access to facilities encouraging physical
activity
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Prevention of chronic diseases Recommendations
at two levels
At EU level Intensify collection, analysis and
dissemination of information on effectiveness of
interventions in the area of physical
activities Monitor EU citizens participation
in physical activity through regular surveys
Proportion without moderate physical activity a
typical week in European countries
(Source European Commission 2006)
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Prevention of chronic diseases Recommendations
at two levels
At National level Set urban planning standards
prioritising non- motorized transport and for
recreational areas encouraging physical
activity Each school child to have access to
periods of physical activity each day at school,
and to be encouraged to after school physical
activity
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Prevention of chronic diseases Economical
benefits

• Revenue generating
• Taxation on alcohol tobacco
• Revenue neutral
• Marketing and advertising regulation
• Restriction on retail outlets for alcohol and
  tobacco
• Effective food, alcohol and tobacco labelling
• Setting urban planning standards
• Banning trans-fats
• Investment required
• Subsidies for healthy foods
• School activity/sport programmes
• School and community sport / physical recreation
  facilities
• Alcohol dependence programmes

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Chronic Disease Alliance

• Act Now
• To make European citizens safer and healthier
• To stop the escalating cost to society

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Chronic Disease in Europe United for Prevention
Oct 5th 2010

• Joint meeting of the following 4 MEP Groups
• MEP Heart Group
• MEP Group for Kidney Health
• EU Diabetes Working Group
• MEPs Against Cancer
• Statement has the support of the 4 Parliamentary
  Groups
• To be presented to the Belgian Council Presidency

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European Health Award 2010 The Chronic Disease
Alliance
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Thank You

• Chronic Disease Alliance