There’s a public perception that if you contract cholera, you had bad luck — but if you develop diabetes, that’s your fault. This view is both wrong and dangerous.
Around the world, noncommunicable diseases — including heart disease, cancer, and diabetes — and injuries from traffic crashes and other causes kill 44 million people a year. In fact, these illnesses and accidents kill more people than communicable diseases such as AIDS, tuberculosis, or malaria.
Yet it’s much harder to get funding to tackle them. Noncommunicable disease cause two-thirds of the deaths in low- and middle-income countries, but less than 1 percent of total development assistance for health goes toward addressing them.
That’s why I’m so heartened to see initiatives such as the Partnership for Healthy Cities, launched earlier this week by former New York Mayor Michael Bloomberg in his role as the World Health Organization’s global ambassador for noncommunicable diseases, or NCDs.
Mayors of 40 cities around the world — including Boston and Accra, Ghana; Shanghai; and Guadalajara, Mexico — are joining this global network to reduce NCDs and injuries with policies proven to improve both health and the economy.
You sometimes hear the argument that individuals should take charge of their own health, and not expect government to safeguard them. I believe that individuals and governments share responsibility. It’s not a question of either/or, but “all of the above.”
For example, I should look both ways before crossing the street, but I should also be able to have a reasonable expectation of crossing the street without being run down by a drunk or distracted driver. And while I know that drinking water is better for me than drinking soda, I’d be less likely to drink soda if bottled water cost less than — instead of more than — soda at my local supermarket.
The challenge is to make the healthy choice the easy one. This sort of change can be slow and politically fraught. The new partnership announced last week aims to spur action.
The mayor of each participating city commits to implementing one of 10 evidence-based policy interventions over the next 18 months. For example: banning tobacco advertising, creating walkable streets, or reducing road crash deaths by lowering speed limits. Cities are eligible for seed grants and assistance from public health specialists.
They also have access to other mayors in the network to learn from each others’ successes — and stand together when special interests fight back, as they inevitably will.
Mayors are uniquely positioned to lead the way on fighting NCDs and injuries. For the first time, most people on earth now live in cities. And modern cities are hubs of innovation.
A few years ago, Bogotá, Colombia, made the city more friendly to pedestrians and bicyclists, with new bike lanes and more parks and public spaces. Bogotá also introduced the city’s first rapid transit system and limited commuting by car.
In Ethiopia, Addis Ababa has been working to make pedestrians safer by reducing speed limits, improving road design, and cracking down on people who break traffic laws.
And New York City was ahead of the curve not only on tobacco control but also in combating obesity by mandating that certain restaurants provide calorie information — and preventing heart attacks by eliminating artificial trans fat from all restaurants.
During Mayor Bloomberg’s tenure, in large part because of policies that empowered people to resist NCDs, the life expectancy of New Yorkers rose by three years. Now he’s taking this model worldwide. With a global commitment to local change, we can save billions of dollars in health care spending and prevent literally millions of heart attacks, strokes, and other NCDs.
Global health leader Tom Frieden, MD, is the former director of the Centers for Disease Control and Prevention.