Preventing Chronic Disease: how does Australia score?

Australia’s health and wellbeing is at a tipping point, threatened by the burden of chronic disease, with the Australian Institute of Health and Welfare (AIHW) labelling it our nation’s greatest health challenge.

The two-yearly report card released by AIHW this week, Australia’s health 2018, further reinforced that Australia is trending in the wrong direction when it comes to tackling chronic health conditions.

Based on this, you may be surprised then to hear that our governments are still failing to put in place the necessary preventive health policies that will reduce the burden of disease, save lives, improve equity and increase the quality of life, health and wellbeing of all Australians.

This disappointing result is highlighted in the recently released Prevention 1st Scorecard – Preventing Chronic Disease: how does Australia score?

The Scorecard assesses Australian governments’ action on the World Health Organization’s (WHO) ‘Best buys’ and other recommended interventions for the prevention and control of non-communicable diseases (NCDs). These recommendations sit under the WHO Global Action Plan on NCDs and have been publicly endorsed and adopted by Australia as a member of both the UN General Assembly and World Health Assembly.

But as the results show, government action on the prevention and control of NCDs has been ad-hoc with inconsistent implementation of policies across the country. While there has been some progress to address the four modifiable risk factors – tobacco use, alcohol consumption, poor diet, and physical inactivity – we can and must do more.

Anti-smoking policies are ‘good’, yet efforts to address alcohol consumption, physical activity and nutrition all rate poorly.

Premature deaths from NCDs have become a major health and equity challenge for the world, leaving no country untouched.¹ In 2011, Australia joined with 197 other countries at the UN High-level Meeting on NCDs and pledged to tackle the global burden of chronic disease.

Yet, despite this goal being within our reach because we all know what needs to be done, we aren’t going to get there. What we really need is the political class to act. And until their commitments are turned into meaningful action, we will continue to see an increase in the burden of disease, increases in healthcare costs and increased pressure on the budget.

Prevention is more than disease management. Stopping these conditions from developing in the first instance means that governments avoid the costs to the healthcare budget of treating and managing these complex conditions later on. However, without coordinated action across all levels of government, the prevalence of chronic disease will continue to rise across Australia.

Australia needs national strategies on each of the four risk factors to make progress on reducing NCDs. We have been without a National Alcohol Strategy since 2011, without a National Nutrition Strategy since 2010 and we have never had a National Physical Activity Strategy.

The need for action is clear.

By preventing illness, Australians can experience better health and wellbeing and as a result live happier, longer and more productive lives. These are some of many actions that governments can take from the WHO Global Action Plan on NCDs to invigorate Australia’s preventive health efforts.

1. Renew mass media campaigns that are population-wide and engage effectively with disadvantaged groups.
2. Abolish the Wine Equalisation Tax (WET) and introduce a volumetric tax for wine and cider.
3. Legislate to implement time-based restrictions on exposure of children (under 16 years of age) to unhealthy food and drink marketing on free-to-air television until 9.30pm.
4. Implement a whole-of-school program that includes mandatory daily physical activity.

It is important that all Australian governments work together to implement the WHO-recommended interventions. Action in one jurisdiction is not enough. We are calling on all governments, political parties and politicians to make preventive health a national priority.

¹United Nations General Assembly resolutions 66/2 (paragraph 1), 68/300 (paragraph 2) and 69/313 (paragraph 32).