As the seventy-fourth session of the World Health Assembly (WHA) closed its virtual doors on 31st May 2021, World Obesity reflects on this critical event in the Global Health calendar and considers the implications for advancing action on obesity at future assemblies.
The World Health Assembly (WHA), the decision-making body of the World Health Organization (WHO), meets every year to debate and decide on the most pressing global health issues. This year brought Member States together under the theme “Ending this pandemic, preventing the next: building together a healthier, safer and fairer world”, with a primary focus on COVID-19.
Over the past year World Obesity Federation, along with our members and allies, has been advocating to WHO and Member States for much greater prioritization of obesity, especially in light of the association between obesity and COVID complications and mortality. At last year’s WHA and regional committee meetings across the globe, members called for obesity to be prioritised, building on the ROOTS framework. Our work with WHO has since expanded, and we have also been fortunate that people with obesity have been able to participate in and drive key consultations and communications. Dr Tedros has demonstrated his support through a myriad of words and actions and we are increasingly seeing the inclusion of obesity in related topics, for example diabetes and food systems.
Our main focus at this year’s WHA was the Resolution on “Reducing the burden of noncommunicable diseases through strengthening prevention and control of diabetes” (A74/A/CONF/5). As obesity is a disease and a risk factor for other NCDs it requires treatment, prevention and management. Given that obesity causes 80 – 85% of type 2 diabetes, the Diabetes Resolution highlights this strong link and asks WHO “to develop, in collaboration with Member States, and in consultation with non-State actors and people living with or affected by diabetes, recommendations for the prevention and management of obesity over the life course, including considering the potential development of targets in this regard”, submitting those through the 150th Executive Board to the next WHA in May 2022.
This is a milestone for the obesity community as it paves the way to bring the disease out of the shadows and into the spotlight of Global Health.NCD statement
Recognised as one of the most pressing current public health challenges, the prevalence of obesity – among both adults and children - continues its upward trajectory in most countries, and COVID-19 only has aggravated this situation. WHO cannot achieve its target of “1 billion people to live healthier lives by 2023” without tackling obesity, nor does any national government have a chance to fully meet their targets to halt the rise of adult and childhood obesity.
Although the urgency is obvious, the complexity of obesity means actions to address it cannot be restricted to one or two areas of policy. Obesity is a medical condition with physiological, psychological and social dimensions, including genetics but also has many other drivers and accelerators, for example, weight stigma and discrimination, cultural perceptions, marketing, mental health challenges and poverty are all associated with obesity. Like tobacco, solutions to address obesity require working across sectors, with multiple actors and at all levels. This year’s WHA addressed some of these dimensions through two additional resolutions: the Resolution on “Oral Health” (EB 148.R1) and the Resolution on the “Social Determinants of Health” (EB 148.R2). Though they do not mention obesity they provide entry points for further action and their approval is cause for celebration in the obesity community.
The Oral Health Resolution not only acknowledges the “high intake of free sugars” but calls on Member States “to understand and address the key risk factors for poor oral health” and on WHO “to develop, by 2022, a draft global strategy, in consultation with Member States, on tackling oral diseases … and to translate this global strategy, by 2023, into an action plan for public oral health”. As further work is unfolding here, obesity needs to be addressed upfront both in the follow-up at national level and at global level.
Similarly, the Social Determinants Resolution also highlights multi- level action, asking Member States “to monitor and analyse inequities in health” and WHO “to support Member States, upon request, in the establishment or strengthening of monitoring systems of social determinants of health and health inequities”. Concrete action is demanded from national governments and obesity needs to be framed within the narrative of health inequities. In many countries, over-weight and obesity are skewed towards people from lower socio-economic groups, which in turn widens the equity gap.
World Obesity members and colleagues are working across the globe to help governments to fulfil their commitments and to shape action.Social determinants statement
Returning to the main COVID-19 theme, World Obesity’s 2021 Atlas on COVID-19 and Obesity presents a detailed analysis and peer-reviewed data demonstrating that overweight is a significant predictor of developing complications from COVID-19. The likelihood of death from COVID-19 is much higher in countries where more than half of the population is classified as overweight. These causal links cannot be ignored and the follow-up to the Resolution on “Strengthening WHO preparedness for and response to health emergencies» (A74/A/CONF/2) must consider obesity.
The COVID-19 Resolution speaks of mitigating risks, of strengthening partnerships, of developing strategies and tools, all in view of achieving Universal Health Coverage (UHC) and “building together a healthier, safer and fairer world”.COVID-19 statement
Now that obesity has been included in other agendas, the time to consolidate into our own is critical. Promising first steps include the formation of a Global Obesity Coalition with WHO, UNICEF, FAO and others, and at the EU level in increased prioritisation and recognition.
A coordinated and sustained effort on obesity can only happen if we integrate obesity in its own right across all sectors and topics. Building forward better means recognising obesity in its complexity and connecting the dots.