Let's make a plan (before it's too late)

First published in the Sunday Star-Times 10 August 2014. 

I recently attended the launch of Diabetes NZ Auckland’s mobile diabetes screening van. This is an excellent service which will take screening for diabetes into at-risk communities. They’ve already identified people with diabetes – both type 1 and type 2 – who did not know they had the disease. About 30% of the people getting tested are found to have diabetes or prediabetes.

That’s pretty scary. Diabetes is at epidemic levels in NZ, and it’s only getting worse, despite the excellent work being done by organisations like Diabetes NZ. Fifty Kiwis every day are diagnosed with diabetes. Within seven years it will cost the country a billion dollars a year. We could use 50 more vans like the Auckland one around the country.

Unfortunately, there is no funding for this. Like many of the fantastic grass-roots projects going on around the country to try and fight the obesity epidemic, this diabetes screening programme is not government-funded. Nor is it part of any overall nationwide government-led strategy. That’s because we don’t have one.

Prime Minister John Key spoke at launch event for the van, and emphasised again that he sees education as the only solution for our obesity crisis. I couldn't help thinking that not many of the people at the coal face of health would agree with him about that. Yes, education is important. But education and awareness programmes can work so much better when they are just one part of an overall strategy – a strategy that includes funding for education along with sensible policies aimed at making our obesogenic environment less so. It’s great to identify that you’ve got prediabetes and learn about how to manage that – but trying to do it in an environment that’s designed to make us unhealthy is an uphill battle.

On the positive front, overseas there are some countries taking huge steps forward in starting to solve this problem.

Ireland recently introduced its ‘Healthy Ireland’ plan – a whole-of-government approach to helping Irish people become healthier. Along with education and community support, priorities include a 20% tax on sugar-sweetened drinks; front-of-pack nutrition labelling and restrictions on marketing of food and drinks to children. Ireland and NZ have a lot of parallels – including a similar-sized obesity problem.

Elsewhere, Brazil recently unveiled new easy to understand, food-based healthy eating guidelines (see last week’s column) along with a comprehensive policy on healthy food in schools which includes making sure schools source their ingredients from local farms. They also have a complete ban on advertising aimed at kids. What both countries have done as a cornerstone to their plans is to set national targets. Brazil’s are to halve obesity in kids by 2022; to stop the rise of obesity in adults; to increase fruit and vegetable consumption and to reduce salt intake.

If policymakers are looking for ideas on where to start in dealing with this crisis, here are two fantastic examples. I’d love to see us make a plan, set some targets and get on with doing the same here.