Countries recovering from war are at risk of being left to their own devices in tackling non communicable diseases, leaving an "open door" for exploitation by alcohol, tobacco and food companies, health experts warn.
Writing in the Bulletin of the World Health Organization, Bayard Roberts and Martin McKee, of the London School of Hygiene & Tropical Medicine, and Preeti Patel, of King's College London, argue that the post-conflict environment risks increases of mental health problems and other NCDs, such as high blood pressure, diabetes and cancer.
After exposure to violent and traumatic events, people may be prone to developing harmful health behaviours, such as excessive drinking and smoking, which exacerbate the problem of NCDs in the long-term. This is why the lack of a strong will from the authorities to restore the health system leaves an open door for commercial ventures to influence health policy to their advantage.
The authors write: "This toxic combination of stress, harmful health behaviours and aggressive marketing by multinational companies in transitional settings requires an effective policy response but often the state has limited capacity to do this."
Afghanistan has no national policy or strategy towards NCDs and, apart from the European Commission, none of its partners has given priority to introduce and support them. High blood pressure is largely untreated in Iraq, three times as many people die prematurely from NCDs in Libya than from infectious diseases and similar patterns can be found in other countries recovering from conflict.
"This policy vacuum provides an open door for multinational companies to influence policies in ways that undermine efforts to control tobacco and alcohol use or improve unhealthy diets in transitional countries," the experts say.
Little attention is paid in reconstruction and humanitarian efforts to helping countries emerging from conflict deal with their present or future burden of NCDs - with the topic virtually ignored during the United Nations high-level meeting on NCDs in September 2011. The authors argue that this gap must be filled, pointing out that the post-conflict period can provide an opportunity to completely rewrite strategies and undertake reforms to better address the health needs of a population and lay the foundations for a more efficient health system.
Dr Roberts, a lecturer in the European Centre on Health of Societies in Transition at LSHTM, says: "While great attention is rightly paid to infectious diseases, noncommunicable diseases should also be given attention -especially as the post-conflict environment can provide the perfect breeding ground for unhealthy activities like smoking, drinking and poor diet. We are making the argument that if the authorities do not step up to lead the way in developing policies which will benefit public health, then they leave the route clear for companies to step in and serve their own interests."
Notes to Editors
1. Reference: Noncommunicable diseases and post-conflict countries - Bulletin of the World Health Organization, January 2012
2. The London School of Hygiene & Tropical Medicine (LSHTM) is a renowned research-led postgraduate institution of public health and global health. Its mission is to improve health in the UK and worldwide through the pursuit of excellence in research, postgraduate teaching and advanced training in national and international public health and tropical medicine, and through informing policy and practice in these areas. Part of the University of London, the School is the largest institution of its kind in Europe with a remarkable depth and breadth of expertise encompassing many disciplines associated with public health. http://www.
3. King's College London is one of the top 30 universities in the world (2011/12 QS international world rankings), and was The Sunday Times 'University of the Year 2010/11', and the fourth oldest in England. A research-led university based in the heart of London, King's has nearly 23,500 students (of whom more than 9,000 are graduate students) from nearly 140 countries, and some 6,000 employees. King's is in the second phase of a £1 billion redevelopment programme which is transforming its estate. King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs.