World Health Organisation Internship

1. World Health Organisation Internship • Tara Purcell 27 September 2012

2. A little about myself... • Doctor of Medicine (MD) • Bachelor Exercise & Sport Science (BAppSc) • Registered Exercise Scientist (ESSA) • Certificate III & IV Fitness • Basketball referee

3. Noncommunicable Disease (NCD) • Non-infectious and non-transmissible between persons • Cardiovascular diseases • Cancer • Chronic respiratory diseases • Diabetes

5. Risk factors for NCDs • Tobacco • Alcohol • Physical Inactivity • Unhealthy Diet • Hypertension • Overweight & Obesity • Raised Cholesterol

6. NCDs: Worlds biggest killers • Causing ~35 million deaths each year • 60% of deaths globally • 80% middle income countries • 9 million NCD deaths occur < 60 yrs Source Alwan et al. 2010

7. Breaking it Down • Cardiovascular disease represents 39% of NCD deaths Text Source AIHW 2010a

8. Cardiovascular Disease • All diseases of heart and blood vessels • Leading cause of death & disability in the world • 17% Australians have CVD • Increases with age • 19% 45-54 yrs • 62% >75 yrs Source AIHW 2010a

9. A Rising Epidemic • The burden of NCDs will ↑ by 17% in 10 yrs Source WHO 2008

10. The Role of Physical Activity • Decreased exercise ↑ the mortality for people with risk factors for CHD • Exercise capacity should be given as much attention by clinicians as other major risk factors • Physical activity reduces all cause mortality Source Kokkinos et al. 2008

11. The Role of Physical Activity • Exercise significantly reduces CVD events and associated risk factors to a degree comparable to that of not smoking Source Mora et al. 2007

12. The Role of Physical Activity • Exercise interventions provide better outcomes in T2DM than Metformin Source Diabetes Prevention Program 2002

13. The Role of Physical Activity • There are protective effects of exercise across all ages Source Blair & Wei 2000

14. Physical Activity Guidelines • Be active in every way • At least 30 mins of moderate intensity physical activity on most, preferably all, days • Include regular vigorous activity, weight bearing and stretching

15. Australian’s Inactivity • PA is independent of sitting time • Although some people are meeting the exercise requirements, sedentary time is still 70% of waking hours • It is better to be a breaker than a prolonger Source Mora et al. 2007

16. World Health Organisation (WHO) • Directing body for health within United Nations • Provide leadership on global matters • Guide health research • Develop policies and standards • Heavily relies on voluntary contributions

17. Internship Program • Volunteer program for graduate medical / public health students • Enhances educational experience through practical work assignments • Exposes students to the role of WHO • Develops WHO programmes with the assistance of students specialising in various fields

18. Noncommunicable Disease Department • Provide leadership and evidence for international action on prevention and control of NCDs • Prevent & reduce disease, disability, morbidity • Prevent key risk factors • Improve nutrition

19. My Position • Implementation of the Global Strategy on Diet, Physical Activity and Health • The Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases • Based at Geneva headquarters for 10 week program

20. My Position • Collate evidence on effective interventions for physical activity • Collation of costing information on interventions for physical activity • Provision of data for modelling of physical activity interventions to identify cost effective for programs

21. Personal Goals • Enhance my understanding of global health issues and the intricate complexities of these matters • Encourage a heightened confidence within myself, to tackle public health issues now and into the future • Bestow knowledge and skills upon community members • As it is due to family, friends and teachers that I am privileged to have such opportunities today

22. Benefiting Our Community • Collaborate with Nossal Institute and Local Community Groups • Address risk factors & social determinant of health for disease prevention and management • Health Literacy • Education to Empower • Social support • Community Exercise Programs • Food Supply

23. “… All parts of the body which are designed to be used, will stay healthy, will • grow well and will remain young if they are used in the right way and if they • are trained sufficiently, each of them in the manner in which they are used; • but if you do not use them, they will become ill, they will shrink and will grow • old before their natural time.” • Hippocrates (460 – 377 BC)

24. References • Alwan, A. et al. 2010. Monitoring and surveillance of chronic noncommunicable diseases: progress and capacity in high-burden countries. The Lancet, 376:1861–1868. • AIHW 2010b. Cardiovascular disease mortality, trends at different ages. Cat. no. CVD 47. Canberra: AIHW. • Blair, S.N. & Wei, M. 2000. Fitness, ageing and mortality. American Journal of Health Promotion. 15: 1-8 • Diabetes Prevention Program Research Group. 2002. Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. The New England Journal of Medicine, 346: 393-403 • Kokkinos, P. et al. 2008. Exercise capacity and mortality. Circulation. 117: 614-622 • Mathers, C & Loncar, D. 2006. Projections of Global Mortality and Burden of Disease from 2002 to 2030. PLOS Medicine • Mora, S., Cook, N., Buring, J., Ridker, P. & Lee, I. 2007. Physical Activity and Reduced Risk of Cardiovascular Events: Potential Mediating Mechanisms. Circulation, 116(19): 2110-2118 • The global burden of disease: 2004 update. 2008. Geneva, World Health Organization

25. Thank You