To mark World Health Day on April 7, 2013, IDLO Head of Social Development David Patterson issued a call to action.
Heart disease.
You don’t catch it from a toilet seat.
Cancer: it doesn’t spread through sneezing.
And diabetes? Well, no, you won’t pick it up on the subway.
Which does not make it, or any of the other unpleasant things I’ve mentioned, any less insidious.
Non-communicable diseases, in fact, kill far more people than their infectious counterparts. World Health Organization figures say NCDs accounted for nearly two-thirds of the 57 million deaths that occurred in 2008. The next set of numbers, when it comes out, will be even worse.
Yes, we all have to die of something. But we don’t have to die prematurely. We don’t have to have our limbs amputated in our fifties, because of all the wrong stuff clogging our insides. You know what I’m talking about: tobacco; alcohol; the time we spend wolfing down the stuff that we know we shouldn’t. Individual choice, you say? If by this you mean consumer choice, then this only exists in the most mechanistic sense. In practice, consumer choice is shaped by industry. Specifically, by global food and drink companies.
Nanny state, you say? Let me ask you in turn: would you like your twelve-year-old to weigh twice as much as you do? Would you like them to die decades before you do? Can you really control what they eat, how much they exercise?
In Indonesia, six-year-olds are known to smoke. Two-hundred thousand of that country’s citizens die of tobacco-related diseases every year. And every year, $200 million is spent on tobacco advertising. Spotted the link yet?
So tell me now: if the public authorities won’t stub out that cigarette; if they won’t take that packet of salt and fat out of our children’s hands – then who will?
My point is this: we need tough legal frameworks that will drastically curb non-communicable diseases and their impact.
The WHO has put together a Global Action Plan for the Prevention and Control of NCDs. It covers the seven years ahead; it is being firmly linked to the post-2015 development agenda; it cannot be accused of underestimating the problem. But the WHO’s indicators are largely designed to measure individual behavior, not government action. This focus must shift. Only governments can lay down red lines for the private sector and help combat NCDs. At the International Development Law Organization (IDLO), we strongly believe in the transformative power of the law – including in matters of public health. Whether it is anti-smoking legislation, New York’s trans-fat ban, or the UK’s crack down on junk food in schools, the law has shown the way forward. These must not be isolated gestures. We urgently need a global monitoring system for government action on non-communicable diseases. There should be constant sharing of best practice at the international level. And when needed, there should be naming and shaming.
Health, lest we forget, is a right. And to uphold this right, we must legally restrict a whole bunch of things.
I know this all sounds rather contradictory. I know we don’t normally speak of rights and bans in the same breath. I know that’s not how we think. But trust me.
I’m a lawyer.