Obesity Connect: Policy Briefing

Obesity Connect: Policy Briefing

The World Health Organisation's Executive Board is in session this week; the output includes a major milestone for the obesity policy community.

We met up with our EASO Policy Lead, Jacqueline Bowman-Busato to find out more about the context and why this meeting is so important for Europe Region.

Obesity Connect (OC): For the first time in recent history, The WHO Executive Board is discussing the prospect of a Resolution which would place obesity squarely within the NCD (noncommunicable diseases) framework as an NCD in its own right. How has this come about?

Jacqueline Bowman-Busato (JBB): This has been a long time in the making! And indeed, we are all extremely encouraged by developments.

Last year, when the European Commission produced their brief which categorised obesity as a noncommunicable disease (NCD) in its own right, we were hopeful that all policy-makers across Europe and beyond would follow suit and align with the overwhelming scientific evidence and consensus.

This was not to be! Policy can take significantly longer to align across political visions and national environments. As a result, the European obesity policy advocacy community has been really encouraged by the work of WOF (World Obesity Federation) to secure Political Good Will at global level and at least have obesity prioritised across the disease continuum.

OC: You mention “Political Good Will”, could you expand on that for us?

JBB: You can compare the concept of Political Good Will” to reaching a common scientific consensus that a particular approach or question needs to be addressed. We go through the same intellectual processes. Establishing the Problem Statement. Investigating the underlying causes and what is currently being done to address the root causes as perceived/ identified and then working on various solutions.

The major challenge with obesity is that policies have somewhat lagged behind the evolution of science over the years.

So whereas for some time, we have known that there are different types of obesity and that at its core, the chronic disease of obesity is about abnormally functioning adipose tissue and/ or excessive adipose tissue, that it is a chronic relapsing disease with over 230 medical complications.

Even though we have the evidence widely published on the fact that treating obesity as a chronic disease will prevent up to 20% of adult cancers as well as up to 80% of type 2 Diabetes and 35% of cardiovascular diseases, policies mainly continue to only focus on primary prevention and very generalised policy interventions around nutrition and physical exercise.

So to have Political Will to prioritise obesity and to address it using the NCD framework (or at leas see how this can be done), is a major step in the right direction globally and most definitely for the Europe Region.

OC: And what might this mean for European Region?

JBB: From a policy perspective, here is where it becomes a little more complex. The EASO membership footprint spans WHO Europe Region. We have member associations in 36 of the 53 WHO Europe Region countries.

However, 27 of those countries are part of the European Union, which for policy purposes, also forms its own bloc with some policies and legislative packages taking direct effect at national level and others only being a “guiding light”.

Notably, the EU also holds a seat on the WHO Executive Board as a State Actor in its own right. So do other EU Member States individually. These are currently, Austria, Denmark, France and Slovenia. The other Executive Board European Members are currently Belarus, Russian Federation, Tajikistan and the UK.

If you also take into account the current review of NCD National Plans at country level across the EU as well as pivotally the European Commission’s new initiative on creating an NCD Plan Roadmap for specific chronic diseases, it means that having Political Good Will from WHO Executive Board is extremely helpful for our work across the EU and wider WHO Europe Region moving forwards.

OC: Tell us more about the European Commission’s Healthier Together Initiative.

JBB: As you know, Health policies are considered a National Competence by the European Union. However, this does not stop the European Institutions and particularly the European Commission, from providing harmonised frameworks on key policies related to healthcare; particularly when they can involve cross-border elements.

Notably, when EU Member States first implemented NCD National Plans (Cancer Diabetes, Cardiovascular and Rare Diseases), the “template” was collaboratively designed at EU level with working groups from National Member States along with the European Commission.

The same principle is being adopted this time around as well. The European Commission is consulting with EU Member States via its Steering Group on Health Promotion, disease prevention and management of Non-Communicable Diseases.

It will be up to that group to decide priorities for NCD Plans for the final specific list of NCDs to be addressed along with the scope for the template.

OC: How can the wider EASO community support this effort?

JBB: I’ll be honest, moral support up this mountain is very much appreciated! But most importantly, it is how we can support each other from an EASO community in key countries and the Policy Team within the EASO Secretariat.

We have a specific timeline to inform and encourage our national policy-making representatives on the EU High Level Steering Group – Subcommittee on Noncommunicable Diseases Roadmap to raise the question of why obesity has not been addressed as an NCD so far in the discussions despite clear evidence to that effect and all of the above! The final list to be addressed will be made in June this year by the European Commission and so it is extremely important that we support our EASO policy changemaking community in practical ways.

The same goes for supporting the passing of the WHO Global Resolution on obesity. The next milestone will be in May 2022.

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