International Circulation: Recently the Global Cardiovascular Disease Taskforce set a target of reducing the non-communicable diseases by 25%. What do you think are some of the main issues and barriers in reaching this goal? Dr Zoghbi: To reduce this 25%, which is targeting cardiovascular death, cancer death and the incidence of diabetes and lung disease, and to be able to do it within a relatively short period of time, we know we have some challenges ahead. There is no question about that. Of the barriers (believe it or not), number one is smoking. How can you decrease the incidence of smoking which in some countries involves up to 50% of the population? Although you can develop policies (and I can tell you from the experience in the Middle East where these policies are recent) there are many barriers within the community to enacting these policies. One is to adopt the legislation and two is to make it effective. Business at times is against it because they benefit and they will need to diversify. For farmers, if tobacco is grown in a particular country, government is going to have to provide some subsidies to change that industry and that will happen over time. If smoking is one of the major factors then we know we have hurdles. From the United States experience, it took some time to decrease the incidence. It is not zero of course but it is close to 20% which is still relatively high after all that we know. I think though we are heading in the right direction. 《国际循环》:最近全球心血管疾病特别工作组设定了一个目标,要将非传染性疾病降低25%。您认为实现这一目标的主要问题和障碍是什么? Dr Zoghbi:要降低25%,这是针对心血管死亡、癌症死亡和糖尿病及肺部疾病的发病率,以及能够在一个相对短的时间内做到这一点,我们知道我们面临着一些挑战。这毫无疑问。在这些障碍中,不管你信或不信,第一位是吸烟。你如何能降低吸烟率?在一些国家吸烟涉及到高达50%的人口。尽管可以制定政策,根据最近制定这些政策的中东地区的经验,我可以确定,在社区内要通过这些政策有许多障碍。一是要批准立法,二是使其有效。有时是商业反对,因为他们受益,他们将需要多样化。对农民来说,如果烟草种植于特定的乡村,则政府要提供一定的补贴来改变该行业,这随着时间的推移会发生。如果吸烟是主要因素之一,那么我们知道我们有障碍。根据美国的经验,它花费了一些时间来降低吸烟率。当然吸烟率不为零,但接近于20%,我们知道毕竟这还是相当高的。我这么认为,尽管我们正朝着正确的方向前进。
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