It's Time to Focus on Health Prevention and Promotion | Derek Yach | TEDxMonteCarlo

[Music] let's start with a team of vaccination workers traveling up the mountain to a remote village where their goal is to vaccinate the children that have gathered across the mountains as they um are approaching the village they realize that families are coming from very far away 3 4 days to be there just on that one day when they could get vaccinated but as they're driving up the mountain a car rolls in front of them the driver has fractured her femur she's bleeding to death if she doesn't get hospital treatment within a few hours she will

die but if they actually go on to treat her and take her to the hospital they will not make it in time to vaccinate the children high up in the mountains and some of those children will go on to get sick and die what do you do our core Humanity dictates that we would focus on treating the sick in front of us treat the person who's looking at you with her eyes that is the way we've been trained and that means that we would not be able able to address the long-term needs of the prevention

of people who otherwise may get sick in future I believe that is an unacceptable choice we need to make prevention of disease and health promotion greater priorities in the way we think about health and Health Care let's look at the consequences of that type of thinking today about 95% or more of the budgets of governments and in fact of the private sector spent on health Health are actually focused on treatment and Care way less than 5% on health prevention issues and promotion not surprising that we have Ebola outbreaks in parts of the world where the

failure has existed for basic sanitation or health care that could have prevented them not surprising that people take excess amount of salt and are unable to access decent treatment for blood pressure and go on to suffer from Strokes not surp surprising that people are unable to be aware of the importance of smoking sensation or governments act inadequately to raise the level of tax and they suffer from lung cancer and eventually die and not surprising that the elderly with Frailty go on to earlier and accelerated deaths because of the failure of the nutrition system or the

failure even of basic dental health care across their life the overall impact of this is economic despair at the societ societal level as well as at the family level and I believe we need to actually rethink our approach in the 1920s a very famous Professor at Yale Charles wislow taught his students that the goal of every generation was to redefine the unacceptable and act accordingly he was talking about our approach to health and the prevention Focus well think back to the 1920s what did we have for health promotion and prevention we had a fair amount

small poox vaccine we knew about the value then even of activity we certainly knew about the value of healthy diets and of handwashing but today today we have a much stronger armamentarium and knowledge base to do even more to promote Health prevent disease and in fact ensure that we can actually enhance the quality of our life in future yet we're still not using all of those tools in fact when I was at the World Health Organization ation or when I sat in the corporate sector or a foundation or Academia I find it extraordinary difficult to

make the case clearly for why we should be doing more about prevention and health promotion let's look at some of the issues that hamper our progress well it starts with us Daniel conman the well-known um Economist behavioral Economist who won the Nobel Prize for his work taught us that we tend to act irrationally we tend to make bad choices choices about our lives we don't do it because we're ignorant we do it because we are human and the kind of decisions we do tend to favor today's short-term rewards over our long-term potential to improve our

health think about it in your own lives in the early morning how many of you on a cold wintry day will go out to the gym or go for a run or go for a swim when faced with a spectacular Buffet what are you going to select and are you going to think at that point about what is in your best long-term interest in maximizing your health of course you're not the society is in structured to help you think that way but it also involves our health professionals our doctors and nurses and dentists are not

trained to focus on prevention and health promotion the incentive structures rarely actually encourage them to do that they are incentivized to actually provide more treatment and care we know that when a new shiny diagnostic equipment arrives in a hospital they will happily take it they would never think of allocating the same budget to a new preventive program that may say lives somewhere out in the future and when a budget is cut in the Health Care System the first budget to be cut relates to prevention and health promotion regarded as luxuries not essential of course they

are essential we know that public interest and the media tend to focus far more on an isolated case it might be a sailor lost at sea or it might be a child desperately in need of a transplanted organ that generates passion it generates enormous investment and money to save that one life which of course is important but can you ever imagine the Applause for an epidemic averted can you imagine the kind of Praise that goes out when we Rising the level of life expectancy across the world could you imagine a Twitter storm or BBC headlines

proclaiming the extraordinary advances that have been made in seeing the declines in heart disease and stroke over the last 15 years something by the way that is happening yet the response of the media is well mute let's return to the Mountain scene and look at it Through The Eyes of what should be what should the unacceptable should be the new Norm for today could this have been avoided we know that road traffic injuries are entirely preventable we know that safer cars and safer roads make that possible we know that in future it should be unacceptable

for people to die on the roads and we know that Sweden in fact is leading the way with their goal of reaching zero deaths on the roads in the next few years it is possible could this been avoided of course it could it is nowadays unacceptable not to vaccinate children against a wide range of conditions that could potentially harm and kill them we know that just over the last 15 years 20 million children's lives have been saved for measles vaccination alone it should be unacceptable but it still is happening on a daily basis but let's

think further the future challenges of the world and the current ones really revolve around a number of big Killers heart disease cancers diabetes lung diseases driven by just four big risk factors smoking physical inactivity unhealthy and excess diets and let's be honest excess alcohol those those four big risk factors in the diseases constitute almost 60% of the burden of disease do you think that it is going to be possible to tackle the 1 billion deaths from tobacco alone we expecting this Century in the world using better methods yes it must be and I believe that

the r the opportunities now of using reduced risk tobacco products offer us unique opportunities to cut the death rate among adult smokers faster than we have ever been able to do before in fact I would go further and say that it's unacceptable that we aren't getting behind these new reduced risk tobacco products faster and more vigorously that would have a big impact on the number one preventable cause of death in the world but of course we we could be doing more and we should be we should be addressing the issues related related to the lack

of physical activity the relations related to screening as well as um to healthy diets we must raise our ambition and voice and prevent the preventable and promote health for all so what will it take first let's Place disease prevention and health promotion at the center of our issues around healthc care this this week is actually the 30th anniversary of the Ottawa Charter on health promotion which was signed in 1986 in Ottawa and coined this very simple phrase the importance of making the Healthy Choice the Easy Choice the Healthy Choice the Easy Choice at the time

the interventions mainly spoken about involved government leading the way and government paternalism was common at that time more regulations more taxation more education would do the trick but today we're in a new era people expect to take far greater control of their lives they do not expect government alone to fix their health problems we're seeing how Millennials are leading the way in demanding that they become a healthier generation and we're seeing how older people are ensuring that their future the future Generations that follow them are going to be healthier than they are we're also seeing

that Technologies and behavioral economics are giving new opportunities to innovate think about the Innovative insurers technology companies and retailers who are starting to think about how we could activate people in their daily lives to make health promotion part of their common way of moving ahead the second big action we need to take is to try and ensure that we make markets work for prevention when we think about the private sector and health most of you would think about the role of the pharmaceutical industry of medical devices and of the hospital sector their focus though is

on Health Care not so much on health itself we need to think about what are the companies who are starting to focus on health and putting it central to their business plan well they're coming from unlikely places they include the wearable industry the software industry um artificial intelligence everything including robotics insurers healthy food companies the fitness industry all coming together to redefine the way we think of Health itself and putting it at the center of their business plans I think in the future it'll be unacceptable to think about life insurers not actively and aggressively promoting

life itself why are they called life insurers if they don't do that similarly I think the time has long come for health insurers to put the gainings of Health right at the center of their planning and their thinking some are starting to do that but that be not doing it should be seen as unacceptable similarly it should be seen as unacceptable for retailers and the food industry not to reduce the portions sizes not to reduce salt sugar and fat that may be harmful to health and be more aggressive in the promotion of healthy foods it

can and is profitable for them to do it it can and is going to improve the health of the planet we can do that and of course that is coming together at the time when software or the companies you associated with your home appliance manufacturers or your search engines are starting to see they can actually combine in ways to better predict your future health and support you to get onto a pathway of Health before you need to address the costs of disease but to ensure this happens we need to make sure we hold them accountable

to saying what they are going to do and that requires us making reporting on health more transparent just think about it when you read company reports you will see they report on their profit and loss they increasingly are encouraged to report on the environmental impact of their company to focus on diversity and to focus on good governance not because it's nice to do those things but because it's material to the long-term growth of the company so the question is where's Health the health of employees is one of the most powerful determinants of the morale the

retention the productivity and the health care costs borne by our company yet it's ignored virtually instead we focus on plant and Machinery which of course is important but surely the most important asset in a company are its people think about the impact companies have through their products and services on every aspect of our life how we as consumers billions of us every day make a decision on buying or purchasing a product what is the impact of those products and services on health should companies not be starting to report on that and the more they report

on that the more we as consumers would be able to make more informed choices about whether these products and services truly enhance our health or will lead us down the road of continued misery and Hill Health I believe the time has come for a greater focus on verification of what companies and governments say they're doing about health before we can start increasing our trust in those very companies imagine a world in which the incentives for individuals for governments and the private sector are aligned toward that common goal of promoting health and of enhancing the quality

of lives as we age it would be a world in which the acceptable would be the Contin stimulation of the vitality and quality of life of people it would be a world in which doing anything less would be deemed unacceptable join me on that Journey thank you very much