Policy and advocacy for healthier lifestyles – the challenges and opportunities

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Sir Trevor HassellSir Trevor Hassell is President of the Healthy Caribbean Coalition.

As cancer and non-communicable disease (NCD) organisations gather in Paris for the 2016 World Cancer Congress I am pleased to be moderating a discussion panel jointly co-organised by 13 cancer societies. The organisations have come together in recognition of the challenges and opportunities which exist for those wishing to develop, or further advance, their cancer prevention and control strategies in unhealthy eating, physical inactivity, consumption of alcohol and overweight & obesity.

Unhealthy eating, physical inactivity, drinking alcohol, and being overweight or obese, contribute to the worldwide epidemic of NCDs. In fact, 7 in 10 deaths are due to NCDs worldwide, with more than 40% of deaths occurring before the age of 70. Prevention and control of NCDs and their risk factors require policies and programmes to create environments that encourage healthy eating, increased physical activity, and reduced consumption of alcohol as the “easy and preferred choices”.

Internal and external challenges

In developing policy positions and advocacy actions aimed at creating and contributing to healthier environments, civil society organisations (CSOs) are often challenged by internal factors within organisations as well as external factors.

Some of the internal challenges faced directly by CSOs include: limited human and financial resources, underappreciation of the importance of civil society advocacy and the absence of a tradition of working with other health CSOs – only to name a few.

External challenges arise from failure of the non-health sector to appreciate that NCD prevention and control extends well beyond health and is influenced significantly by non-health issues. Additionally, policy makers sometimes view CSOs with suspicion and have therefore had difficulties partnering with these organisations in the development of policies and programme implementation. Finally, many challenges exist in the private business sector, whose interests are often at odds with those of CSOs.

There is also inadequate public and political awareness of NCDs as well as a lack of  understanding of the vital role society can play. These challenges are often compounded by a lack of supporting regulations and laws, lack of data, use of evidence, target setting and monitoring.

Unique role of CSOs

Despite the challenges, significant opportunities exist for CSOs  to effectively advocate and influence policy. The United Nations Sustainable Development Goal 17 explicitly calls for the encouragement and promotion of effective public, public-private and civil society partnerships, which can lead to better NCD prevention and control.

I believe that many of the challenges can be overcome by CSOs using their unique ability to influence individual behaviour, increase public awareness and representing public health and consumer interests. This allows them to make valuable contributions to the delivery of prevention programmes.

An economic and social justice issue

As CSOs develop policy positions and advocacy initiatives they should be guided by overarching perspectives that include a recognition that the prevention and control of NCDs is both an economic and social justice issue impacting on human development.

NCDs, and the lifestyles contributing to them, should be seen first and foremost as issues of the young. They must be addressed over the life course, recognising that influences in the antenatal period and the first 3 months of life often determine outcomes throughout life. CSOs need to understand that support for policies and activities is more likely if these are aligned with WHO Global Targets and the Sustainable Development Goals.

Cancer and other NCD organisations have important roles to play in the development of policies and programmes aimed at risk factor reduction and NCD prevention and control. These organisations are well positioned to assist empowered people in their determination to improve life conditions and ways of living.