From Clinic to Food Production to City Planning: Building primary prevention of NCDs into Universal Health Systems in the Americas

Four underlying risk factors, unhealthy diet, tobacco use, harmful use of alcohol and physical inactivity underlie more than two thirds of all new cases of NCDs globally, and aggravate conditions of those already ill.  In Latin America and the Caribbean it has been estimated that annual mortality due to these risk factors exceeds a million attributable deaths annually.  These risks arise from changing patterns of production, consumption and behavior that result from transformations in our communities. The consequent burden of disease, in addition to causing enormous human suffering, poses major operational and financial challenges for assuring universal health care. Innovative approaches to addressing these risk factors, from incorporation into primary care to development of multi-sectoral policies and practices, are growing in the Americas. These range from advising patients on salt or supporting tobacco cessation in clinics to national regulatory approaches to salt reduction in Argentina and innovative dietary guidelines addressing processed food in Brazil. The Pan American Health Organization, with  a wide range of other partners, is working to strengthen systematic cooperation in the Americas on integration of primary prevention policy and practice on these four risk factors, into the design of national health systems, and their approach to noncommunicable disease. This presentation will seek to describe systematic approaches to integration and strengthening of stewardship and governance  capacity required to create the physical and social environments amenable to healthy choices.