| Hakim Hayat |
AS NON-COMMUNICABLE diseases (NCDs) present a large and rising threat to many developing countries today including Brunei Darussalam, addressing the issue requires a different set of institutional competencies and multi-sectoral approaches, said World Health Organization (WHO) Director-General nominee, Dr Sania Nishtar yesterday.
Dr Sania, who has been a strong advocate of NCD prevention and control since the beginning of her career, hails from the Islamic Republic of Pakistan and has been officially elected by the WHO Executive Board as one of the three nominees earlier this year. She is in the country to meet with top health and foreign ministry officials here to campaign for the top coveted position.
The rising incidence of NCDs such as diabetes, heart diseases and obesity is placing an increasing burden on the Sultanate’s health care system and economy each year and has been the main cause of death here for more than 30 years, with a shift away from traditional lifestyles and dietary patterns seen as the underlying cause, according to the Ministry of Health (MoH) in a recent report.
Responding to a question on the matter during an interview session with the Weekend Bulletin, Dr Sania said that addressing NCDs requires an additional set of institutional competencies and policies compared to what is needed for communicable disease control, highlighting that a multi-sectoral approach to public policy as one of the main solutions.
She cited the examples of promoting physical activities in urban settings by working with city councils to provide more spaces and also working with finance and trade ministries to control tobacco use and import of unhealthy food as well as encourage healthier food choices that are cheaper-to-access.
![Dr Sania Nishtar, World Health Organization (WHO) Director-General nominee, speaking to the Weekend Bulletin. - DEAN KASSIM]()
Dr Sania Nishtar, World Health Organization (WHO) Director-General nominee, speaking to the Weekend Bulletin. – DEAN KASSIM
“For instance, in many countries, to reduce reliance on revenue generated from tobacco, the health sector has to work with the ministries of finance, agriculture and other sectors for agro-industrial diversification,” she added.
Dr Sania, who also led Pakistan’s integrated national plan of action for NCDs back then, also highlighted that another dimension in addressing the issue is the need to influence individuals to change their lifestyles. “A lot of times, people have heart diseases, diabetes and high blood pressure because they eat unhealthy, smoke, don’t exercise and have lots of fat and sugar,” she said.
Dr Sania also highlighted that the policy environment is also central in combating this issue, through the re-orientation of health systems.
“In many parts of the world, health systems are tuned to catering for acute infectious diseases. However, in order to provide healthcare for diseases such as heart diseases, diabetes and cancer, you require health systems that can follow up individuals for a long period of time and can provide chronic care,” she highlighted.
She recommended three levels that countries must work to address NCDs – reorient health systems, prevent people from falling sick by influencing the change of their personal lifestyles and also public policy outside of the health sector through multisectoral action. “As I said, the prices of food, cultural practices, spaces for physical activity, policies of trade and finance ministries, the agriculture and food systems.. all of these impact NCDs, so it requires societal change,” she added.
The prevalence of NCDs, she said is a very urgent call for WHO because it is not just a health issue but also detrimental for economies because healthcare costs as a result of NCDs have escalated so much that they are threatening economies.
She commented that as countries develop rapidly, they become the victims of their own success because people start living longer. “This cannot be fixed by training more doctors and by having more hospital beds.. it is about lifestyles – how societies function and how and what kind of choices people make for themselves and families and what you feed your children,” she added.
She said that in affluent populations such as Brunei these days, obesity and diabetes are the biggest problems, in addition to communicable diseases and pandemics.
A physician, former federal minister, co-chair of the WHO Commission on Ending Childhood Obesity and civil society leader in health, and global accountability champion, Dr Sania has been involved with many international agencies in various capacities and is described by the WHO as a widely respected global health expert.
Her vision for the WHO is the one in which it reclaims its primacy and earns the world’s trust as its lead health agency, and has the ability to foster and sustain partnerships to achieve the vision for health – universal attainment of the highest possible level of health and well-being.
Under her leadership, she said that the WHO will demonstrate and deliver 10 pledges which are: Transparency and accountability in all areas of its work; Leadership for action; Operational readiness in outbreaks and emergencies: Country-relevant support to achieve the Sustainable Development Goals (SDGs); Strengthened action on global public goods; focus on health-climate interaction; accelerated pace of reforms: management for results: a culture of partnerships and new models for financing.
As WHO is an important organisation, she said it is also very important for member states to pick the best candidates for the crucial position.
“According to the code of the election, WHO regions that have not had director generals should be given preference and I come from one of those regions.. I think overall the candidates’ ability is very important and what the candidate delivered in the past should be taken into consideration. So I look forward to having Brunei’s support,” she said.
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