The chain is expanding on the continent.

By Sania Nishtar
October 11, 2017
Ghana’s obesity epidemic was in the spotlight this week, with a hard-hitting long-read in the New York Times on the changing food culture there, highlighted by the popularity of fried chicken chain KFC. This trend is leading to expanded waistlines and driving an epidemic of diabetes and heart disease that threatens to overwhelm Ghana’s already fragile health system.

As globalization has accelerated, an emerging middle class has embraced sedentary lifestyles and Western fast food diets. Year after year, new data reconfirms the growing scale of the obesity crisis in every country of the world, and yet political action has been muted.

It is easy to blame the private sector for this, but should the public health community be exonerated? In the past, it has traditionally responded to major public health crises with relatively fitting solutions. To halt millions of children dying from preventable disease every year, a children’s vaccine initiative was set up in the 1990s. Later on Gavi, the Vaccine Alliance was established, aspiring to make lifesaving vaccines ubiquitous for children. And as the HIV epidemic spread, the world responded by setting up a United Nations agency solely dedicated to tackling the disease and a new Global Fund to marshal new resources.

But when it comes to the world’s biggest killer diseases—heart disease and diabetes—brought on by obesity, no commensurate action is taken. This is particularly disappointing given that ministers of health—as I learned from my interactions with 191 delegations as one of the finalists for director general of the World Health Organization (WHO)—are willing and ready to act, and seem to be held back by the lack of an international impetus.

Recent data from the Global Burden of Disease in The Lancet shows that poor diet is a factor in one in five deaths around the world. People may be living longer, but they are also spending more time in ill health. Ensuring that people can access quality and nutritious local food is critical, but it’s equally critical to help people make the right food decisions for themselves and their families when it’s already available.

Fixing the obesity epidemic means harnessing the strength of all stakeholders to address the problem. As former co-chair of the WHO Commission on Ending Childhood Obesity, I witnessed the progress that can be made by bringing stakeholders together, building trust, and jointly working through challenges.

Private companies like Yum Brands, which owns KFC, Taco Bell, and Pizza Hut, need to be part of the solution to tackling obesity. This means the government must work with the private sector to encourage more locally sourced, healthy, and nutritious products. As I wrote in a recent piece in The Lancet, a new independent agency should be established to help make markets in low- and middle-income countries more encouraging for healthy foods and medical treatments.

Ensuring public-private investment should also be a top priority for this agency. To drive new money, governments and the private sector must do their part. This may include improving diversification of crops to ensure the availability of more nutritious foods or offering tax incentives to better pool research funding into collaborative approaches to addressing obesity.

Ghana is a bellwether for the health problems all low- and middle-income countries have to tackle. Oct. 11 marks World Obesity Day, an opportune time to reflect on the stark choice the world must make: reform quickly or prepare for a public health crisis that decimates already fragile health systems.

Sania Nishtar co-chaired the WHO Commission on Ending Childhood Obesity and was recently one of the three shortlisted nominees for WHO director general.

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