Workshop on the Implementation of Global Strategy on Diet, Physical Activity and Health in Asian Countries, 10-13 October 2006, Manila, Philippines
A workshop on the Implementation of the Global Strategy on Diet, Physical Activity and Health (DPAS) in Asian Countries was held in Manila, Philippines from 10 to13 October 2006. This was the second workshop on the DPAS implementation in the Western Pacific Region.
The objectives of the workshop were:
(1) to review progress on the prevention of obesity, diabetes and related chronic diseases in Asian countries;
(2) to agree on priority actions for DPAS implementation at the national and local levels; and
(3) to propose priority areas for collaboration at a regional level.
All countries represented at the workshop had data on diet and physical activity patterns from recent surveys, such as STEPS, or had surveys underway or planned. Almost all countries had existing national plans related to the aims of DPAS, two thirds had dietary guidelines, and half had physical activity guidelines. The workshop examined the opportunities for improving nutrition and physical activity through policy, legislation and environmental change and then specifically examined opportunities presented by urban planning, community action, schools, workplaces and the health system. Country experiences in each of these areas were shared. The cross-cutting issues of situation analysis, population monitoring, programme evaluation, advocacy and communication, and mobilizing resources were also discussed, along with relevant country examples in each session.
Significant progress in nutrition and physical activity interventions was already underway in Australia and New Zealand, as well as in wealthier Asian countries in the Region, such as Japan, Singapore and the Republic of Korea. Some progress was also noted in countries such as China, the Philippines and Malaysia, whereas for countries such as Cambodia, the Lao People’s Democratic Republic and Viet Nam, noncommunicable disease control is not yet high enough up on the political and public agenda to make DPAS implementation a priority for those governments.
Each country worked on developing its own top three priorities for action and, for each area, objectives, evaluation indicators, next steps in the process, and the evidence needed to make the case were developed. This gave each country a tangible set of priority actions to work on to advance the DPAS agenda following the workshop.
Priority actions were also identified for the Region and recommendations were made for WHO, Member States, the private sector and civil society. The priority areas for technical support for nutrition action were in the development of policies and regulations on food labelling, food standards, and reducing food and beverage marketing to children. For physical activity, support was requested for the development and promotion of physical activity guidelines and the development of regional physical activity networks. For the cross-cutting areas, the priorities for support were for programme evaluation training, the establishment of health promotion foundations, and training in the effective use of advocacy and social marketing to support national policies and programmes.
Member States were urged to place a high priority on DPAS implementation by committing resources and creating the policies needed to make a difference. This is a fundamental investment for the health and economic well-being of citizens, as well as providing substantial savings on health care costs, personal costs and reduced productivity due to chronic diseases and disability. The private sector, including major food and beverage companies, were also urged to support national and regional efforts to harmonize nutrient labelling, set food nutrition standards and reduce marketing to children. The importance of the national and international advocacy efforts of civil society was stressed as a key driver for DPAS implementation.
Workshop participants strongly endorsed the DPAS principles for action and strategic directions and made the following recommendations for action in Asian countries.
(1) Recommendations for WHO
a. Health leadership and engaging partners
· Promote DPAS implementation as a high priority for Asian countries.
· Facilitate the use of an Asia-Pacific Physical Activity network and provide continued support for the Mobilization of Allies in Noncommunicable Disease (MOANA) network.
b. Standard-setting and prioritizing and monitoring implementation
· Work with Member States and the private sector to achieve harmonization of food standard setting and food labelling regulations across the Region.
· Lead further work on providing regulatory options for countries on reducing commercial promotion of food and beverages to children.
· Provide technical support on using STEPS and other data collection systems to assess diets, nutrition and physical activity in countries and monitor the implementation of DPAS.
c. Technical support for catalyzing change, building institutional capacity, and advocacy
· Provide technical support for developing plans and guidelines, especially for physical activity.
· Provide technical support for establishing health promotion foundations.
· Support capacity-building in the Region for key skill development in advocacy, leadership and programme evaluation.
· Provide technical guidance on effective and cost-effective ways of using social marketing to support DPAS policies and programmes.
(2) Recommendations for Member States
a. Implement DPAS as a high priority by adapting and enriching existing national plans, policies and activities where possible.
b. Allocate more public funding and human resources and advocate for more private funding to improve nutrition and physical activity as an excellent investment for the population’s future health and economic well-being.
c. Ensure that funding is allocated for DPAS activities to be evaluated as outlined in using the DPAS Framework to Monitor and Evaluate Implementation.
d. Provide sufficient funds and support for primary health care (including health professional training and review of curricula) to implement DPAS goals and activities.
e. Using the experience of tobacco and alcohol control, consider fiscal measures to promote physical activity and healthy food choices and to discourage unhealthy choices.
f. As a central strategy to create a healthy food environment for children, develop and implement regulations to reduce the commercial promotions of foods and beverages that target children.
g. Consider establishing health promotion foundations as a source of sustainable financing for DPAS implementation.
h. Ensure that DPAS implementation, while led by the health sector, collaborates with other sectors, such as agriculture, transportation, and education, and is linked with the promotion of healthy environments and preservation of natural resources.
i. Ensure that DPAS is implemented in a way that reduces health inequalities and considers differences in ethnicity, gender and age.
j. Ensure that social marketing is used in ways that are effective and cost-effective, linked to DPAS policies and programmes, and evaluated.
k. Implement DPAS activities throughout the government health sector so that it acts as a role model for wider DPAS implementation.
l. Identify a senior person as the focal point for DPAS implementation.
m. Identify and support high profile champions, such as prominent political or public figures, to promote healthy eating and physical activity.
n. Engage and establish relationships with the key national and international nongovernmental organizations (NGOs) on the prevention of chronic diseases.
(3) Recommendations for the private sector
a. Reformulate food and beverage products to reduce fats, saturated fat, trans-fatty acids, sugar and salt content wherever possible.
b. Support country and regional efforts to harmonize food labelling regulations.
c. Support country and regional efforts to provide healthy food environments for children, including reductions in commercial promotions that target children.
d. Provide healthy environments for diet and physical activity for employees.
e. Include the promotion of healthy eating and physical activity as part of corporate social responsibility efforts.
(4) Recommendations for civil society
a. Increase advocacy efforts for DPAS implementation as an urgent priority for population health and economic well-being.
b. Identify, support, and promote champions for DPAS actions.
c. Link with national, regional, and global coalitions and alliances (e.g. Global Prevention Alliance, Healthy Cities Alliance, Oxford Health Alliance, Global Alliance on Physical Activity) to advocate for DPAS implementation.
(5) Next steps for regional collaborations
a. WHO to convene a meeting with key food and beverage companies and related bodies in the Region and create a plan on harmonizing food standards and labelling and regulations on marketing of food and beverages to children.
b. WHO to work with the Global Alliance on Physical Activity on a set of resources to help countries develop and promote Physical Activity Guidelines.
c. WHO to work with the FAO and other agencies to produce and disseminate guides for the communication and use of dietary guidelines to promote the availability, accessibility, affordability and consumption of healthy foods.
d. WHO to provide support for the Asia-Pacific Physical Activity network and the MOANA network.