Sweet Resolution recently conducted an interview with Dr. Derek Yach, a former executive director at the World Health Organization. Dr. Yach has been largely instrumental in global health issues, with a focus on non-communicable diseases. Working at the World Health Organization from 1995-2004, Dr. Yach was responsible for developing the Health for All policy, adopted by all governments in 1998. He established the Tobacco Free Initiative and ensured that the Framework Convention for Tobacco Control was accepted by governments, as well as placed chronic diseases and injuries higher on the agenda of governments, non-governmental organizations and the private sector. Dr. Yach also directed the Global Health department at Yale University, where he worked to initiate new courses and research related to global aspects of chronic disease control as well as the governance of health. Most recently, Dr. Yach is director of the global health program at the Rockefeller Foundation in New York City, and is on the Board of Directors of the Oxford Health Alliance, a London-based alliance to prevent chronic disease.
Sweet Resolution (SR): Dr. Yach, thank you for taking the time to answer some important questions. To start, can you tell readers a bit about how you got to where you are now – what first made you see chronic disease as an enormous global health priority and why take the approach you do (public-private partnerships) to achieve your goals?
Derek Yach (DY): Way back when I headed the South African Center for Epidemiological Research in the mid 1980s it was becoming clear that chronic diseases would dominate all other causes in time. Nutrition transition was well underway with obesity rates rising in black South Africans while underweight remained a problem; tobacco was then a major health concern – yet policy makers refused to act. Twenty years later, and having spent ten years at the World Health Organization, I continue to be concerned about the lack of attention to the problem – despite solid evidence that it is indeed the world’s greatest public health problem, and one that remains largely neglected.
The Millenium Development Goals do not explicitly address chronic diseases. They guide donor and Foundation priority spending in health. And will continue to do so for a decade or so. Unlike infectious diseases and hunger, chronic disease prevention and control lend themselves to innovative private-public partnerships and the greater use of market forces.
SR: Why should people not directly affected by diabetes care about it?
DY: Diabetes represents a failure of prevention at a societal level and an indicator of health system failure across many related chronic diseases. Thus a focus on diabetes would draw attention to the need for more effective primary and secondary prevention. Further, in many developing countries, diabetes and related chronic diseases lead to reduced worker productivity and thereby, undermine national economies and could reduce profits of multinationals.
SR: What do you think is the largest obstacle right now to chronic disease control and prevention? Why don’t chronic diseases received the funding and attention they deserve, and how can the UNR fix this?
DY: [The main problems are] a lack of knowledge about the size of the problem in developing countries, and lack of acceptance of what this means for resource allocation. Also, a continued belief that diabetes is merely an issue of failed personal responsibility – and that governments have little role to play. A UNR could counter these myths – provide high level data and hope!
SR: With tobacco, we saw that as soon as companies were restricted in developed countries, they shifted their focus to emerging market countries. Do you think the same will happen as a result of recent developments in the US, for example the Clinton Foundation agreement with five major snack food companies to reformulate products for US schools? Couldn’t companies just take the unhealthier versions of their products and sell them in other countries if the healthier versions aren’t as profitable? If so, how can a UNR help offset potential damage to health in these countries?
DY: Companies do not wait for developed markets to become saturated before they move elsewhere! They are already doing what most major multinationals do – seeking opportunities for growth worldwide. And increasingly, the more progressive food companies have committed themselves to adapting the notion of corporate social responsibility to their products and marketing: wherever they operate! In a globalized world, they know that double or triple standards simply are not acceptable (or desirable) from the longterm perspective. The leading food companies have seen that this is a sensible future-oriented business model and are investing big time to ways of bring profitability and improved health together.
Posted by siegelbug 
Posted by siegelbug 
Posted by siegelbug 
In response to rising rates of childhood obesity and diabetes, Disney has announced that it will begin to serve and promote healthier meal options in its theme parks! Furthermore, Disney cartoon characters will now be used to encourage consumption of foods lower in fat, sugar and calories over the next two years, and the company will cut back on trans-fat in its licensed foods.
