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The Role of the World Bank inAddressing Childhood Obesity
Dr. Shiyan ChaoThe World Bank
PACO IIIHIGH LEVEL MEETING ON CHILDHOOD OBESITY PREVENTION
ArubaJune 6, 2013
Outline
1• Growing Burden of Non-Communicable Diseases
2• Changing the Role of the World Bank
3• Knowledge Production and Sharing
4• Opportunities
5 • Way forward
45%
30%
8%
7%
10%
Diabetes
Chronic respiratory disease
Cancer
Cardiovascular diseases
TOTAL NCD DEATHS 2009
4.5Millions
Other NCDs
NCDs #1 KILLER IN AMERICAS
149 million smokers30-40% of 25-64 hypertensive25% persons >15 years old obese
37% deaths are below age 70 years
Approx 250,000,000 people live with an NCD in the Americas region
4
Increase Burden of Disease due to NCDsin Disability-Adjusted Life Years (DALYs)
5
Changing of the World Bank’s Roles
The World Bank’s roles in the Health Sector in the Region are changing:• From HIV/AIDS Investment to Health System
Strengthening• From investment lending to Non-lending
Technical Assistance• From Bank alone investment to leveraging
partnerships
6
The World Bank Portfolio in the Caribbean
Barba-dos IIU
S$35M
Barba-do-sUS$15.15
Dominican
Republi-cUS$25M
GrenadaUS$4.66MGuyanaUS$10M
Jamaica IUS$10.6M
Jamaica II
US$10M
PANCAPUS$9M
STLUS$6.4M
SKN
US$4.05
SVGUS$7M
T&T
US$20M
CLOSED Project
ACTIVE Project
US$156.86Million
7
Engaging in NCDs Prevention and Control
• Knowledge Production– The Bank has produced a number of reports on
NCDs• Knowledge Sharing
– The UN High Level Meeting on NCDs– South to South Learning
• Investment Projects on NCDs
8
Generating knowledge on NCDs
Three Major Publications on NCDs– Jamaica: Non-Communicable Diseases in Jamaica:
Moving from Prescription to Prevention (2010)
– OECS: Reducing the Burden of Non-Communicable Diseases in the Eastern Caribbean (2010)
– Latin America and Caribbean Region (LAC): Promoting Healthy Living in LAC (2013)
Focusing on Obesity
Highest Female (15yr+) Overwt/Obesity in the world (WHO 2011)
Rank Country %
1 Nauru 82
2 Tonga 81
3 Micronesia
79
4 Cook Is. 73
5 Samoa 72
6 Niue 70
7 Kuwait 67
Rank Country %
8 Barbados 63
9 Palau 62
10 Trinidad 61
11 Dominica 60
12 Egypt 59
13 USA 55
14 Jamaica 53
0
20
40
60
80
(%
)
1970s 1980s 1990s 2000s
Male
Female
ADULT OVERWEIGHT/OBESITY TRENDS IN THE CARIBBEAN
Strategies to address Obesity
Preventing childhood obesity through Multisctoral Approach
Pregnancy, Early
childhood
School age
YouthWorking age
Old age
A life-cycle approach
Protection: Social pensionsPrevention: Old-age pensions, disability insurance
Promotion: Employment services, entrepreneurship, training and skillsProtection: Cash and in-kind transfers, public works programsPrevention: Unemployment, disability insurance
Promotion: Nutrition/ECD,
Prevention of childhood Obesity
Promotion: CCTs for (girls’) educationProtection: Child
allowances, school feeding
Promotion: Youth employment
programs, skills training
Interventions to Childhood Obesity
• Parental education• School education• Information for households and communities
Education
• Supply of healthy food• Agriculture production, trade • Demand for healthy food• School Lunch Programs
Nutrition
• Enabling environment (urban planning, transportation, etc
Physical activiteis
The Way Forward
16
What the World Bank can help
Setting up objectives/goals
Identifying Strategy/resources
Assessing results/impact
▪ What can we do: set up goals and identify interventions
▪ How to best achieve the goals?▪ What are the priorities ?▪ What are resources available?▪ What are the trade-offs?
▪ What are the outputs, outcomes and results?
▪ What are the short-term and long –term impact?
Knowing the statistics ▪ Who are obese (age, gender and socioeconomic status)
▪ What are the risk factors
16 The World
Bank
www.worldbank.org/lachealth
