By Dr. Eric Ulloa

Cardiovascular diseases, including heart attacks, strokes, cancer, diabetes and chronic respiratory diseases are the main causes of death in the world, with an estimate of 35 million deaths in the year 2005. 

These causes represented 60% of all deaths in the world. About 80% of these deaths occurred in middle and low income countries.
However, with proven intervention in behaviors, health systems and policy, it could be possible to prevent about 80% of heart disease, stroke and diabetes, and about 30% of cancers.
The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system.{jathumbnail off}

 These circumstances are shaped by the distribution of money, power and resources at the global, national and local levels, which are themselves influenced by policy choices. Our lifestyles besides our genes have a lot to do with chronic diseases: there is enough evidence to show that obesity, lack of exercise, and smoking contribute to cardiovascular disease and cancer.

Lately a lot has been found about food quality and chronic diseases: sugary beverages and ingestion of too much high caloric foods (fatty and starchy food), as well as processed meats, have been associated with cardiovascular diseases and cancer.

Eating more fruit and vegetables seems to be protective, as well as doing moderate to vigorous exercise at least 150 minutes per week.

We have been exposed to massive communication media since we were younger: “the Malboro Country”, and the promotion of smoking with cowboys movies; Coca Cola and Pepsi Cola advertisements everywhere, and McDonalds and fast food restaurants proliferated even in small towns of many countries. As I mentioned in a previous article, TV and computer games also contributed to the lack of exercise in our children. The amount of salt  we eat in our food is exaggeratedly high, sometimes up to 10gs and this affects our cardiovascular health. Many of the additives and seasoning of our food are high in sodium.

On December 3, 2009, the Pan American Health Organization (PAHO) launched the initiative “Partners’ Forum” with participation of health, education, agriculture, trade, as well as various parties including government, industries and civil groups. The goals were:
I.To promote healthy living as the best way to prevent and reduce chronic diseases and their main risk factors in the Americas.
II. To mobilize, recognize, and scale up the efforts that companies, organizations, and countries undertake individually and collectively to promote health and prevent and control heart disease, stroke, cancer, hypertension, diabetes, and obesity.
III. To raise awareness among the public and decision-makers of the impact of chronic diseases and how to prevent them.
IV. To build partnering skills and synergies to enhance the effectiveness, efficiency, and reach of joint efforts by all sectors.
V. To support and expand existing and new innovative chronic health initiatives to increase their impact.
VI. And the Ultimate Goal: To prevent 3 million deaths over the next 10 years.
To date, several companies have joined the group, including Kraft Foods, The Coca Cola Company, Pepsico, Sanofi Aventis, Consumers International, World Health Organization, World Economic Forum and many others.

Activities like Smoking Cessation and Reduction of Salt in the Diet are the most cost effective interventions, costing less than $0.40 per successful individual intervention.
In Panama, on March 17-18, an expert council on Chronic Diseases and Cancer convened from the Central American Countries and Dominican Republic, to make an operative plan to develop strategies and work together to fight against these diseases. They were headed by the Executive Secretary of COMISCA (Council of Ministries of Health of Central America and Dominican Republic), and Panama having the Pro Tempore Presidency. During the meeting, INCAP ( Nutrition Institute from Central America and Panama) and PAHO convened a Partners’ Forum Regional Initiative, with participation of Universities from the area, Private Institutions and Consumer associations, and representatives of the Ministries of Health and Social Security.
These initiatives aim to promote policies and specific programs to prevent these chronic diseases. This “all together” approach will try to fight more efficiently against the epidemic of chronic diseases. But it is necessary that the individual also contributes with a will to change, and that the programs get to local levels.
In Panama there are initiatives with the Ministry of Education, working on healthy diets at the school kiosks, cancer awareness and exercise promotion. Private industries like Tetra Pack have been cooperating.

The smoke free environments and the tobacco cessation clinics are a great advance in our country. We still have to create better work environments, bicycle paths and more exercise, but most important is PARTICIPATING in our own health promotion. Efforts that our governments, health system, industries, and civil society do, will not work if WE do not make an active effort for OURSELVES.

Dr. Ulloa is a practicing internal specialist and advisor to the Ministry of Health.