Figure L2 3: Prevalence of overweight and obesity in the pan-European region


70 60 50 40 30 20 10 0


considered environmentally derived through links to soils and land – agriculture and food systems, cities, biodiversity, and green and recreational spaces – the figure of annual burden of disease derived from the environment increases significantly (Nurse et al. 2010). In particular, if NCDs related to climate change, such as cardiovascular events due to heat waves or mental disease associated with natural disasters (McMichael et al. 2006, Noji 1996), are included, the figure increases further (Dora et al. 2015).


6: One health paradigm Years Overweight Obesity


freely available from the European Health Report Targets and beyond – reaching new frontiers in evidence (WHO 2015a) (Figure L2 3). In particular, the numbers of overweight and obese children are now alarming and children who are obese are more likely to suffer from NCDs later in life.


Approximately 50 per cent of citizens in the region are overweight and in several countries – Azerbaijan, Bosnia and Herzegovina, Czech Republic, Hungary, Ireland, Israel, Kazakhstan, Lithuania, Malta, the Russian Federation, Spain and the UK – the prevalence of obesity is ≥24 per cent in the general population.


A study of nine countries in the region suggested that about 3–7 per cent of the annual burden of disease is associated with known, but narrowly defined, environmental risk factors (Hänninen et al. 2014). Airborne fine particulate matter (PM2.5) is the leading risk factor associated with the loss of 6 000–10 000 Disease Adjusted Life Years (DALYs) per year per million people (Hänninen et al. 2014). Second-hand smoke, traffic noise, including road, rail, and air traffic noise, and radon had overlapping ranges estimated at the loss of 600–1 200 DALYs per million people. If the NCDs derived from poor diets, overconsumption and lack of activity are


188


During the early years of the 21st Century a new movement has emerged around concepts of One World, One Health. This arose from discussions amongst professionals, academics, NGOs and government sectors and resulted in the adoption of a set of One Health principles and a tripartite agreement by the main human and animal health and agricultural development agencies, OIE, FAO and WHO.


There is now a significant body of academia and public agencies adopting this approach. There is a focus on links between human-animal infections and emerging diseases and also a strong emphasis on the environment and how social, economic and environmental factors and/or changes can drive or trigger disease emergence and evolution (Wallace et al. 2014a). Examples of the One Health context include:


i) Nipah virus emergence in Malaysia where livestock and fruit development strongly interfaced with Pteropid bat habitat and led to the spill over and emergence of a serious disease in pigs and people with significant human mortality and high economic costs;


ii) SARS coronavirus was driven by wild and domestic animal markets in China, which provided a conduit for viral emergence and evolution; and


iii) Ebola virus in West Africa is suggested to be driven by changing landscape and forest disturbance (Wallace et al. 2014b).


Percentage Population


Central Asia SEE WCE AVERAGE EECA AVERAGE Russian Federation Israel Turkey


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