Prevention: A priority, the way forward

Health is a top priority for this government. We believe that every citizen has a right to live a healthy life, as free as possible from disease and disability. This not only ensures that every citizen achieves a high standard of living but it also allows the country as a whole to move forward as a prosperous, modern and peaceful nation. While remaining committed to continue to invest in hospital and community infrastructure and technology to ensure the delivery of a wide range of high-quality health services, the government is increasing its emphasis on health promotion and prevention.

We recognise that there is a huge burden of illness and death, which is preventable. Non-communicable diseases, such as coronary heart disease, stroke and diabetes, are responsible for about 82 per cent of deaths in Malta. They are also responsible for a similar amount of disability and morbidity in the form of pain and suffering, reduced mobility and loss of independence. The strategy dealing with the prevention and control of non-communicable diseases is an important milestone in our endeavours to reduce and postpone deaths, thereby increasing life expectancy and improving quality of life for the Maltese population.

Evidence shows that major chronic diseases, such as cardiovascular disease, chronic obstructive pulmonary disease, mental ill health and cancer, can all result from a number of lifestyle-related factors, namely unhealthy diet, physical inactivity, tobacco use and alcohol abuse, which, in turn, are related to clear biological risk factors, namely obesity, hypertension, high lipid and cholesterol levels and carbohydrate abnormalities, such as diabetes. Chronic non-communicable diseases are all linked by a group of common and modifiable risk factors.

By means of appropriate strategic approaches, incorporating population risk assessment and individual high-risk reduction, a referral support system, a robust health information system, the enhancement of a primary healthcare system and developing health promotion initiatives, we can strive towards reducing such diseases and keeping healthy.

There are several key approaches to combat diseases and disease burden. The first is to pay particular attention to the risks to health.

Unless the risks are reduced, outcome measures, such as reduction of mortality and morbidity, cannot be achieved. Moreover, focus on risks is preventive by nature. Above all, evidence of success is available to demonstrate that such risks can be dealt with. To this end, people in the wider community must adopt a host of healthy behaviours, including refraining from smoking, eating healthily, remaining active and regularly measure their blood pressure and cholesterol levels. Stress has also been found to be a risk that leads to a host of diseases and unhealthy behaviour, so this should be another area of focus.

To tackle these risks and promote healthy behaviour, while it is important to change people's attitude and knowledge towards health, the creation of a physical and social health-conducive environment is of equal importance.

For example, to cut cigarette smoking, it is important to improve people's knowledge about the harmful effects of tobacco, how the tobacco industry promotes sales through advertising and what options are available to help quit smoking. However, regulations and legislation are also very effective means of tobacco control. Tobacco use can be more readily reduced through structural measures, such as higher tobacco taxes, a ban on advertising, warnings on tobacco products and a ban on smoking in public places as well as restricted sales of tobacco.

This week, in the presence of Zsuzsanna Jakab, regional director of the World Health Organisation for Europe, we will be proposing a concrete and co-ordinated action to implement strategies that work and that will result in a substantial reduction in death and illness.

This requires action both as a nation and on an individual basis. It is with pleasure that I, as Minister of Health, will be presenting this strategy for the prevention and control of non-communicable diseases as a concrete step on the path to an increased emphasis on preventive services. This is our way forward.

The author is Minister for Health, the Elderly and Community Care