Healthy Living Needs Global Governance

It may seem counter-intuitive, but the same factors that drive the spread of infectious diseases also contribute to the dominance of non-communicable diseases (NCDs) in the global burden of disease—urbanization, global markets and harmonized cultures. NCDs have overtaken infectious diseases as the leading cause of morbidity and premature mortality worldwide, with deaths concentrated among the poor due to the growing availability and affordability of highly-processed, unhealthy foods, alcohol and tobacco. The global response to NCDs has been slow and fractured, with the World Health Organization dedicating scant funding and the United Nations waiting until September 2011 to hold a high-level summit on prevention—despite previously holding three summits on HIV/AIDS. Yet, researchers have identified a suite of cost-effective NCD prevention measures. While tobacco control provides a model for international and national regulation of NCD risk factors, there are significant barriers to further action in prevention, including industry lobbying against strong government regulation, philanthropic action favoring swift wins in infectious disease control, and the framing of NCDs as an individual rather than collective problem. Stronger global governance could spur national action by providing funding, creating stronger norms and holding states accountable. The UN’s comprehensive review on progress in NCD prevention, held in July 2014, offered an opportunity for the international community to take concrete steps in strengthening global prevention efforts. This article proposes four concrete steps for a long-term solution: creating a dedicated fund for NCD control and prevention; regulating industry to improve nutrition and restrict alcohol and tobacco marketing; altering the built environment to promote physical activity; and prioritizing prevention in all sectors of government and in the global regimes that govern NCD risk factors. Only through these steps can we ensure healthy, more vigorous lives for the entire global community