Sustainable partnerships for NCD prevention: implications for public health

Excerpt

While largely preventable, the global burden of non-communicable diseases (NCDs) remains overwhelming, calling for collaboration across public and private sectors. Globally, 70% of all deaths are attributable to non-communicable diseases (NCDs). NCDs disproportionately affect people in developing countries where three-quarters of these deaths occur (World Health Organization 2017a). Concerted action is required to tackle the multiple risk factors of NCDs particularly unhealthy diets and their social, cultural, economic, commercial and environmental determinants. Buse and Hawkes (2015) argue that only a paradigm shift in global health efforts can support the prevention of NCDs and contribute meaningful progress towards the Post-2015 Development Agenda. They identify five challenges, including shifting the focus from treatment towards prevention, enhancing intersectoral and coordinated leadership that acts on the socioeconomic, political and legal drivers of health, and implementing effective means to tackle the commercial determinants of health. While the 17 Sustainable Development Goals (SDGs) reflect a more holistic view of health compared to their predecessor, the Millennium Development Goals, they also reveal several inherent tensions. For example, SDG3 on health and well-being includes as a target the reduction of one-third premature mortality from NCDs, while SDG17 encourages partnerships between academic, public, private and civil society actors to achieve these goals (United Nations 2016). This encouragement to partner may lend legitimacy to public/private partnerships, without recognizing that these efforts can also compromise and conflict with public health goals, especially when involving industries that directly or indirectly profit from the consumption of products shown to contribute to NCDs (e.g. tobacco, alcohol, unhealthy foods) (Kickbusch et al. 2016). The constant push and pull for multi-stakeholder partnerships that include the commercial sector raises a number of challenges for researchers, practitioners and policy-makers whose mandate is to protect and promote population health, despite potentially lucrative opportunities to expand programs. These challenges relate to issues of governance, transparency, accountability and conflicts of interest. …