Statement to the 45th Session of the
                                   UN Commission on Population and Development
                                                                23-27 April 2012

The World Heart Federation is honored to be participating in the 45th Session of the UN Commission on Population and Development and pleased to be joining government delegations and civil society organizations for these important deliberations on adolescents and youth.  The following statement represents the collective views of the NCD Alliance, of which the World Heart Federation is a founding member.

Since the UN High Level Meeting on the prevention and control of non-communicable diseases (NCDs) this past September in New York, where Member States declared NCDs to be a development issue, we have continued to advocate for recognition of NCDs as a priority on the development agenda. As discussions continue, we urge Member States to consider the economic and social impact that NCDs have worldwide, particularly on adolescents and youth.

NCDs, defined for the purposes of this statement as cancer, cardiovascular disease, diabetes, and chronic lung disease, are responsible for a total of 36 million deaths worldwide every year.  A common misconception is that NCDs affect primarily developed countries, however 80% of deaths due to NCDs occur in low- and middle-income countries, where they place a significant burden on the local economy and serve as a barrier to development.  As many infectious diseases are brought under control, NCD rates are expected to grow with the greatest increases occurring in the developing world.

NCDs are a leading cause of disability, morbidity and mortality among adolescents and youth.  In 2002, more than 1.2 million people under the age of 20 died from an NCD.  These mostly non-infectious, sometimes life-long conditions result in high medical costs, a reduction in productivity, and lower quality of life. Additionally, adolescents represent the largest group of society in many low-income countries.

Future sustainable human development cannot occur without a strong focus on improving the health of the global population. To this end, it is imperative that NCDs be considered in the context of the adolescents and youth for three reasons.

First, NCDs directly affect youth through conditions such as childhood cancers, type 1 and type 2 diabetes, asthma, congenital and acquired heart disease, obesity, and infection with viruses (HPV and HBV) that may cause cancer in their future lives. The growing double burden of overnutrition and undernutrition is also of significant concern.

Second, evidence shows that susceptibility to NCD risk factors occurs at the very beginning of human life-course, including the foetal stage, putting more emphasis on the importance of maternal health, especially among adolescent mothers. The nutrition and health of a mother during pregnancy affects the chance that her child will develop an NCD later in life. In 2008, 11% of births worldwide were to mothers aged 15-19 years.   Vaccinations for infants and young women against HBV and HPV are critical in preventing cancer later in their lives. To this end, traditional vaccination schemes must be expanded to include these critical preventative measures. As younger mothers are more likely to engage in unhealthy behaviours, health promotion among these groups will be key.

Adolescents are particularly vulnerable to NCD risk factors and their exposure to unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol is increasing.  The behaviours that are the key determinants of NCDs in adult life generally start during adolescence. Of particular concern is tobacco use, which often begins in early adolescence and leads to increased rates of six of the eight leading causes of death in adults.  Worldwide, between 80,000 and 100,000 children start smoking each day and globally almost half of all children are exposed to secondhand smoke. , 

Unhealthy diets, physical inactivity, and the harmful use of alcohol – comprising the four main NCD risk factors together with tobacco- also threaten the health of adolescents and youth. As stated in the Report of the Secretary-General on the Prevention and control of non-communicable diseases, “non-communicable diseases and their risk factors are best addressed throughout the course of people’s lives, through healthy behaviours and early diagnosis and treatment that begin before pregnancy and continue through childhood and adult life.”

The prevention of NCDs is linked with other adolescent and youth initiatives such as education promotion and poverty reduction.  Integrating lessons on healthy lifestyles and behaviours into primary education curricula is a particularly effective way to prevent NCDs later in life. Furthermore, addressing the risk factors for NCDs among adolescents has benefits that extend beyond health.  Research suggests students who maintain healthy diets and are physically active are more likely to succeed academically. 

Finally, NCDs impact adolescents indirectly when a family member becomes sick with an NCD.  Having a parent that lives with an NCD can affect a youth’s social, emotional, and educational development.  In some cases the child must choose work over school in order to provide the family with financial support after the primary breadwinner becomes sick.  In other cases adolescents may be expected to become caregivers at an early age.

As the number of individuals living in cities is set to rise to a staggering 9.3 billion people by mid-century, the exposure of young people to the risk factors leading to NCDs will only increase.  Adolescents living in towns and cities, particularly in low- and middle income countries, face the very real health risks of crowded living conditions, air and water pollution, inadequate sanitation, limited green space and an overwhelming display of tobacco, alcohol and fast-food marketing, all disproportionately affecting the most vulnerable populations and placing limitations on “choice.” Thus, the challenges posed by the increasingly urban landscape cannot be addressed simply through individual lifestyle choices. For most of the world’s people, and especially its youth, where a person lives intrinsically affects their health and life options.

Every young person deserves the same chance to live a healthy, productive life.  In order to make this possible, NCDs and their risk factors among the youth population must be addressed.  Neglecting to address NCDs will lead to an increased burden on the global economy and further impede the achievement of development goals.  Together with the support of the UN Commission on Population and Development and member states, we can make the world a healthier place for youth and adolescents worldwide.