Max Baraka L, Mashauri Harold L
Department of Epidemiology and Biostatistics, Institute of Public Health Kilimanjaro Christian Medical University College Moshi Tanzania.
Department of Community Health, Institute of Public Health Kilimanjaro Christian Medical University College Moshi Tanzania.
Health Sci Rep. 2024 Mar 18;7(3):e1974. doi: 10.1002/hsr2.1974. eCollection 2024 Mar.
The world is observing a rapid shift in the burden of diseases with predominance of noncommunicable diseases (NCDs). NCDs contribute to 41 million deaths which is equivalent to 74% of all death globally per year. There is ongoing debate on the approaches to reduce public exposure to NCDs' modifiable risk factors which are of economic potential. As the World Health Organization and the World Bank recommend the implementation of taxation to these factors, still questions arise on the effectiveness, sustainability, and practicality of this strategy. With the ongoing transition globally from consumption of natural to processed foods, it is important to counter-check the best interventions on how to protect people from unhealthy eating behaviors. While taxation on unhealthy food and other products like tobacco has been recommended as one among interventional approaches, its effectiveness on sugar sweetened beverages is not reliable compared to approaches that increase self-control. Despite the perceived economic benefits of tobacco and sugar sweetened products, there is detrimental implication in terms of public health. The introduction of taxation which favors public health faces challenges due to conflict of interest from government authorities and other stakeholders. The intertwined relationship between public health and economic development becomes more obvious during implementation of preventive and control measures against modifiable risk factors for NCDs. It is evident that reaching a balanced rational decision on choosing between economic growth and public health is difficult. Countries should enhance both local and international intersectoral and multisectoral approaches in creating integrative policies which include health component in all non-health policies including economic policies so as to harmonize public health and economic growth during this era of extensive globalization.
全球疾病负担正在迅速转变，非传染性疾病（NCDs）占据主导地位。非传染性疾病导致每年4100万人死亡，相当于全球所有死亡人数的74%。对于减少公众接触具有经济潜力的非传染性疾病可改变风险因素的方法，目前仍存在争议。由于世界卫生组织和世界银行建议对这些因素实施征税，该战略的有效性、可持续性和实用性仍存在疑问。随着全球范围内从天然食品消费向加工食品消费的持续转变，重要的是要反复核查如何保护人们免受不健康饮食行为影响的最佳干预措施。虽然对不健康食品和烟草等其他产品征税已被推荐为干预方法之一，但与增强自我控制的方法相比，其对含糖饮料的有效性并不可靠。尽管烟草和含糖产品被认为有经济效益，但在公共卫生方面却有不利影响。由于政府当局和其他利益相关者的利益冲突，有利于公共卫生的征税举措面临挑战。在实施针对非传染性疾病可改变风险因素的预防和控制措施过程中，公共卫生与经济发展之间的相互交织关系变得更加明显。显然，在经济增长和公共卫生之间做出平衡合理的决策很困难。各国应加强地方和国际层面的部门间和多部门方法，制定综合政策，在所有非卫生政策（包括经济政策）中纳入卫生组成部分，以便在广泛全球化的时代协调公共卫生与经济增长。
