by Marion Nestle
Sep 27 2018

The Fight Against Non-Communicable Diseases: A Global Emergency

I signed a letter published in Le Monde on September 18:  La “lutte contre les maladies non transmissibles:” une urgence sanitaire mondial.  It is addressed to the The Third United Nations High-Level Meeting on Noncommunicable Diseases taking place in New York today.  Here it is in English translation.

The Fight Against Non-Communicable Diseases: A Global Emergency

Just 10 years ago, infectious diseases such as tuberculosis, HIV/AIDS and malaria were the main worldwide threat for health. But today, Non-Communicable Diseases (NCDs), such as diabetes or cardiovascular disease, which only receive 2% of the total financing allocated by international health partners, constitute a health emergency in high-income countries and low-income countries alike.

Changes in food consumption and increasingly sedentary lifestyles have a strong impact on human health and the environment, and increase risks of developing NCDs. For over 10 years now, Non-Communicable Diseases have become the main causes of death in the world, leading to 15 million premature deaths every year.

Today, these changes in lifestyles are hitting hard low-income and intermediate countries. Contrary to common belief, a large number of inhabitants in West Africa are faced with overweight and obesity. Who could imagine that 38% of women of childbearing age there are already overweight and 15% are obese? The increase in the consumption of animal fats and industrial foodstuffs, combined with massive urbanization source of lifestyle change more conducive to NCDs,  are the causes of these epidemiological transitions.

The agri-food industry, the driver of these changes, has an impact on both human health and the environment. The intensification of production methods, the overconsumption of meat, the massive use of chemical products in agriculture (glyphosate), and the use of chemical substances and packaging (phthalates) to preserve food have a major impact on the environment and contribute to the high level of CO2 emissions. At the same time, too much fat, too much sugar, food with too many calories and a major consumption of sweetened beverages and alcohol, or food contaminated by pesticides, combined with a reduction in physical activity, are major risk factors for NCDs.


Diabetes is a perfect illustration of this strong link between the health of populations and the health of our planet and the related challenges. In 2017, 425 million people were living with diabetes. One person died from it every 6 seconds and the disease cost USD 723 bn. Diabetes is also the leading cause of blindness, persons undergoing dialysis and non-traumatic amputations around the world. The International Diabetes Federation estimates that by 2045, there will be 628 million patients, over 80% of which will be living in low-income and middle-income countries. Diabetes will affect 42 million people in Africa and will cost the African continent USD 6.6 bn. 90% of cases of diabetes would be avoidable if we adopted ambitious prevention policies aiming at changing eating behavior and sedentary lifestyles.

Unfortunately, this objective is still a dream. For people who are already suffering from diabetes, treatments are extremely expensive for the patient, their family, but also for governments. In certain countries, these treatments are not available to all, and in others, these treatments are available, but the cost is a huge burden. In Africa, an antidiabetic drug like insulin is only available in 40% of countries and at a very high price. For example, in Mali, 56% of households with a diabetic patient devote over 40% of their incomes to healthcare payments. Policies for access to treatments are consequently essential.

  • Feed the planet more healthily in order to reduce the impact of poor nutrition on human health and the environment;
  • Prevent chronic diseases in order to reduce their economic burden;
  • Provide patients suffering from an NCD with access to treatments essential for their care at an affordable cost or “free” thanks to universal health coverage;
  • Regulate private sector involvement in order to reduce conflicts of interests and achieve real progress in the quality of food products and access to treatments.

These challenges require taking urgent measures:

—Adopt a taxation and regulations that guarantee healthy and ecological nutrition

  • Adopt taxes on alcohol and sweet beverages to reduce their consumption (based on the sugar tax model in France);
  • Universalize labelling on food content (like Nutri-Score);
  • Ban adverts on junk food targeting the youngest public;
  • Adopt positive tax measures to make healthy products with high nutritional qualities cheaper.

—Develop prevention programs which will allow consumers to make better food choices, while ensuring there are living and working spaces favorable for doing a regular physical activity.

—Ensure access to high-quality treatments at a lower cost for NCDs and include the medical treatments/systems required for universal health coverage.

—Finance the global response against NCDs by a Trust Fund to structure effective prevention in countries which do not have sufficient means, and exchange expertise to support countries in their strategies to fight against NCDs.


  • Cynthia Fleury – Philosophe et Professeur au Conservatoire National des Arts et Métiers)
  • Stéphane Besançon – Directeur Général de l’ONG ONG Santé Diabète
  • Gaël Giraud – Chief Economist Agence Française de Développement
  • Cyril Dion – Réalisateur et cofondateur du mouvement Colibris
  • Katie Dain – Directrice Générale de l’ONG NCD Alliance
  • Pierre Salignon – Responsable des partenariats avec la société civile à l’Agence Française de Développement
  • Marion Nestle – Professeur de Nutrition à l’Université de New York et écrivaine
  • David Beran – Chercheur, service de médecine tropicale et humanitaire des Hôpitaux universitaires de Genève
  • Jean Marie Milleliri – Secrétaire Général du Groupe d’intervention en santé publique et épidémiologie
  • David Hacquin – Président de l’ONG Santé Diabète

Camille Mary – Coordinatrice ONG Santé Diabète

Copyright ID4D