IHP news 504: NCDs

By on January 11, 2019

JECH – Effect of increasing the price of sugar-sweetened beverages on alcoholic beverage purchases: an economic analysis of sales data

D Quirmach, R Smith et al; https://jech.bmj.com/content/72/4/324

Taxing soft-drinks may reduce their purchase, but assessing the impact on health demands wider consideration on alternative beverage choices. Effects on alcoholic drinks are of particular concern, as many contain similar or greater amounts of sugar than soft-drinks and have additional health harms. Changes in consumption of alcoholic drinks may reinforce or negate the intended effect of price changes for soft-drinks.”

Results & conclusion: “An increase in the price of high-sugar drinks leads to an increase in the purchase of lager, an increase in the price of medium-sugar drinks reduces purchases of alcoholic drinks, while an increase in the price of diet/low-sugar drinks increases purchases of beer, cider and wines. Overall, the effects of price rises are greatest in the low-income group. … …Increasing the price of soft-drinks may change purchase patterns for alcohol. Increasing the price of medium-sugar drinks has the potential to have a multiplier-effect beneficial to health through reducing alcohol purchases, with the converse for increases in the price of diet-drinks. Although the reasons for such associations cannot be explained from this analysis, requiring further study, the design of fiscal interventions should now consider these wider potential outcomes.”

Lancet Editorial – Cervical cancer: unequal progress


Cervical cancer—a disease affecting more than half a million women every year—is now largely preventable. And yet despite an effective vaccine being available for more than 13 years, it still caused 270 000 deaths globally in 2015, 90% of which were in low-income and middle-income countries (LMICs). By setting out epidemiological patterns, outlining the most effective strategies for prevention, diagnosis, and treatment, and discussing ongoing research questions, a Seminar in today’s Lancet by Lynette Denny and colleagues explains why women are still contracting and dying from the disease….

Global Public Health – Ethics of mobile phone surveys to monitor non-communicable disease risk factors in low- and middle-income countries: A global stakeholder survey

J Ali et al; https://www.tandfonline.com/doi/full/10.1080/17441692.2019.1566482

“Active public health surveillance has traditionally been carried out through face-to-face household surveys or contact with providers, which can be time and resource intensive. The increasing ubiquity of mobile phones and availability of phone survey platforms provide an opportunity to explore the use of mobile phone surveys (MPS) for active disease and risk factor surveillance, including for non-communicable diseases (NCDs). Scholars are increasingly examining the ethics implications of mobile health (mHealth), but few have focused on the ethics of mHealth in low- and middle-income countries (LMICs), and even fewer on mHealth for active surveillance. Given that little is known about ethics-related attitudes and practices of stakeholders invested in the conduct and oversight of mHealth in LMICs, we undertook a cross-sectional global stakeholder survey of ethics-related issues implicated by active observational MPS, with a contextual frame of monitoring NCD risk factors in LMICs…”

Guardian – Toxic fumes threaten our children. We have to take on the pollution lobby

G Monbiot; https://www.theguardian.com/commentisfree/2019/jan/09/toxic-fumes-children-health-air-pollution-emissions?CMP=share_btn_tw

Cfr a tweet by Kent Buse: “Monbiot outlines why air pollution not on agenda as it ought to be – vested interests & complexity at the core of this political challenge – calls for mobilisation.”

Excerpt: “…Pollution is off the agenda. Why?  I think there may be three reasons. The first is that there is no heroic narrative built around tackling air pollution, while there are plenty (Louis Pasteur, Alexander Fleming, John Snow) surrounding the fight against infection. The second is that the necessary interventions are not discrete but systemic. Rather than distributing mosquito nets or reducing the salt in processed food, you must change entire transport and industrial systems. The third is that, while no one has a commercial interest in spreading tuberculosis or polio, there is a massive global lobby, comprised of fossil fuel, motor and infrastructure companies, blocking effective action against pollution and the technologies that cause it. If you take on pollution, you take on the combined might of some of the world’s most powerful industries. Pollution is the tangible manifestation of corruption….”

Plos Med – Health system costs for individual and comorbid noncommunicable diseases: An analysis of publicly funded health events from New Zealand


Tony Blakely & colleagues use national health data for New Zealand to estimate the costs of individual diseases as well as determine whether multiple morbidities add an additional cost above the expected sum.”

NEJM (Editorial) – Hydroxyurea — An Essential Medicine for Sickle Cell Disease in Africa

L Luzzatto et al; https://www.nejm.org/doi/full/10.1056/NEJMe1814706?query=featured_secondary

“More than 20 years ago, a major clinical trial of hydroxyurea in the management of sickle cell disease proved successful….”

“… Hydroxyurea has been used in many parts of the world, and there is “no theoretical or empirical reason why hydroxyurea should be less beneficial or less safe for African patients compared to patients elsewhere.” However, it is one thing to assume that hydroxyurea is going to be safe and efficacious in Africa; it is another to have evidence. In this issue of the Journal, Tshilolo et al. provide this evidence, and they also dispel the myth that clinical trials cannot be performed in Africa. Their article gives a detailed account of the benefits of hydroxyurea in children with sickle cell disease attending clinics in four African countries — Angola, Democratic Republic of Congo, Kenya, and Uganda — and it highlights the potential of professional partnerships on a global scale….”


And a few quick links:

Philip Morris International – which makes Marlboro and other leading brands – is moving into smoke-free products. … Sky News was given unprecedented access to a Swiss research centre of PM….”

The article ends, appropriately: “The biggest test is what Philip Morris does in low and middle income countries, where most smokers live and where it continues to make huge profits from its cigarettes.”

Once a smoker’s paradise, Southeast Asia has been turning up the heat on its tobacco-addicted citizens with regulations and taxes to encourage them to kick their habit….”

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