WHO official urges CNMI leaders to address NCDs

A visiting official from the World Health Organization said the government is responsible for keeping its community healthy and urges the CNMI government to help address the epidemic of non-communicable diseases in the Commonwealth.

“These are not small diseases like bacteria or virus-causing disease that we can just contain. This is deeply weaved in the way we live and in what we eat. So we need to change this and need everybody’s engagement on this,” said WHO official Dr. Cherian Varghese.

From left to right: World Health Organization’s Dr. Cherian Varghese, Non-Communicable Disease Alliance chair Dr. Don Hardt, Commonwealth Healthcare Corp. Division of Public Health-NCD Bureau administrator Becky Robles, and CHCC’s Medical Director for Public Health Dr. Daniel Lamar discuss addressing NCDs through “a whole society approach.” (Jayson Camacho)

“NCD such as diabetes, heart disease, cancer, and lung diseases are a major problem for all Pacific islanders and CNMI is facing the brunt of these diseases. The government has a responsibility to help people live healthy and that is what translating this into a policy is. Sometimes it is viewed as an interference in the person’s choice, but it is not, you’re not interfering in the choice. If a person wants to live healthy, there should be an option for that,” said Dr. Varghese, who is also a team leader of WHO’s Western Pacific Region, Division of Pacific Technical Support, Pacific NCD & Health Through Life-Course.

At the forefront of this fight should be the government, particularly the Legislature, he said.

“But nowadays it is not like that for most of the options around us. That is where legislation is needed. An example is tobacco control. We cannot say that ‘smoking is my right and we want to smoke in the aircraft.’ Nobody does that. So it is not containing the person’s freedom, it is making everybody else’s health safe. So I think policies and regulations are very important,” he added.

Dr. Varghese has been on island since Monday and attended a presentation with the 19th Legislature, which he said was a good discussion on addressing public health. Among the discussions included taxation for healthier foods.

From Tuesday to yesterday workshops were held with Commonwealth Healthcare Corp. Division of Public Health and other health providers mainly to look at where the CNMI is now in terms of addressing NCDs.

Dr. Daniel Lamar, CHCC’s Medical Director for Public Health, echoed Dr. Varghese’s words, saying that health advocates as a group have all agreed that NCDs is such an important issue to address for the well-being of the community that they want to bring it to the attention of every single person, agency, department, business, organizations, and etc.

“We solicit their support because it will take a ‘whole society approach’,” Dr. Lamar said.

“It takes our legislators to create the right policies, to help create the environment, to set the stage to make it convenient for them to live lifestyles in promoting health because that is going to most likely change or impact the NCD epidemic, this tsunami that we’re in the midst of,” he added.

NCD Alliance chair Dr. Don Hardt said that if NCD problems are allowed to hold sway, problems continue, and people will destroy the society, its economy, and eventually its freedom because no one will be here anymore.

Dr. Varghese said that WHO has been very successful in advocating tobacco taxes and one of the main reasons for tobacco consumption going down is due to its high price in the market.

“So taxation as a whole…is really effective. When it comes to food, it is not as clear as tobacco but there are various countries looking at taxing unhealthy products and sugar-sweetened beverages and we know it is one of the major contributors for childhood obesity,” he said.

“There is an option to try and tax them in a graded fashion, but a tax on food should always be supported by either a subsidy or a removal of tax on something else so that people have better options rather than just raising tax on one product,” he added.

One example is if water is less expensive than sugary soda, people will drink water, but if water is more expensive than sugary sodas, people will drink soda.

One suggestion from Dr. Varghese is to look at importation where agencies can get involved in trying to get healthier products to come in.

Another suggestion is subsidizing a different product such as fruits and vegetables that are healthier when raising the tax on unhealthy products.

“I think that the Legislature can make it happen, because it is not just the responsibility of CHCC or DPH. Whether it is transportation, departments, or in the community, public health will be addressed. So my message to the Legislature is to look at that, how every department can contribute to making the CNMI a healthier CNMI because it cannot just be done by the hospital,” he said.