Novo Nordisk: Develop top-level policy design for obesity prevention and treatment
Novo Nordisk (China) Pharmaceuticals Co., Ltd.
Executive summary
Since its reform and opening-up, China has made great achievements in economic and social development, such as its per capita gross domestic product (GDP) exceeding the average amount for upper-middle-income countries. Since the full rollout of the Healthy China 2030 initiative in 2016, China now also fares among top-performing middle- and high-income countries in terms of key health indicators. Between 2015 and 2021, life expectancy increased from 76.34 to 78.2 years, the maternal mortality rate fell from 21.8 to 16.1 per 100,000 live births, the infant mortality rate decreased from 8.1 to 5.0 per 1,000 live births, and the under-five mortality rate decreased from 10.7 to 7.1 per 1,000 live births in China.
China’s rapid economic and social development changes have also led to a rise in chronic diseases such as cardiovascular and cerebrovascular diseases, cancers, and diabetes. Additionally, an abundance of food, combined with sedentary lifestyles, have brought about a rapid increase in the prevalence of people suffering from excessive weight and obesity. Obesity has ultimately become a grave public health concern, both as a chronic disease in its own right and as a risk factor for numerous other chronic diseases.
Obesity can be defined as abnormal or excessive fat accumulation that is usually chronic, relapsing, and multifactorial which may impair a person’s health. Globally, the rising prevalence of obesity imposes a significant disease burden on nations, leading to social and economic repercussions. According to the World Health Organization (WHO), the number of overweight adults in 2016 stood at 1.9 billion. Among them, 650 million were obese. More than 378 million children and adolescents were found to be overweight or obese as well. As of 2020, the World Obesity Organization (WOO) reported that global obesity prevalence had increased to around 764 million adults and 157 million children and adolescents under eighteen. The number of obese adults is projected to reach 1.03 billion in 2030, doubling 2010’s figure.
Obese patients are at a significantly higher risk of developing more than 200 diseases including cancers, cardiovascular diseases, diabetes, and kidney diseases. Obesity increases the risk of 11 types of cancer and is closely linked to a further 21 diseases, all of which result in a significant global disease burden. Meanwhile, overweight and obese populations also exacerbate global issues regarding inequality, with costs related to obesity management and treatment putting tremendous pressure on nations’ healthcare systems and economies.
In April 2022, the WHO released the Acceleration Plan for the Prevention and Management of Obesity over a Life Course, creating an overarching policy framework for global obesity prevention and control. The WHO’s Action Plan recommends member nations take all demographic groups, aspects of obesity, and lifecycle stages into consideration, as well as utilize all necessary tools such as obesity prevention, self-management, medical management, and specialized treatment. Some countries such as the UK and Singapore also provide valuable policies and pathways for obesity prevention and control.
China’s overweight and obesity incidence is rapidly increased in recent years, leading to severe challenges in its prevention and control. According to the WHO standard, in which a BMI of 30kg/m2 or greater is considered obese, China ranks first in the world for the number of obese children and second in the world for the number of obese adults. By Chinese standards (BMI ≥ 28kg/m2), China ranks first in the world for the number of obese people. By both standards, the prevalence of obesity doubled between 2004 and 2014. According to the latest survey, more than 50 percent of adults, almost 20 percent of children and adolescents aged 6-17, and 10 percent of children under six are currently overweight or obese.
While the disease burden of overweight and obesity in China is consistent with that of other countries, China still needs to improve its obesity monitoring system. As its prevalence increases, overweight and obesity not only cause a series of social problems at the individual, household, and societal levels, such as impacting the national fertility rate, but also impose a long-term burden on China’s economy as related costs continue to increase in total health expenditure. By 2030, obesity-related medical costs will reach RMB 418 billion in China, which would account for about 22 percent of the total national health expenditure.
Given global experiences as well as the severe challenges imposed by overweight and obesity, it is urgent for China to strengthen its top-level policymaking in relevant fields and comprehensively improve systematic planning on all levels, from macro decision-making to meso-level cross-industry policy system establishment and implementation, in a bid to best strengthen holistic prevention and control and mobilize all sectors of society to jointly deal with the challenges of the overweight and obesity epidemic. Thus, the following actions are recommended:1. Macro-level Strategy: Obesity should be included in the national health plan as an independent disease, top-level design should be strengthened, and a special coordination mechanism should be established.
Obesity should be officially recognized as an independent chronic disease and included as a key condition in the Healthy China Action Plan and China’s Medium-to-Long Term Plan for the Prevention and Treatment of Chronic Diseases. In addition, a special leadership coordination mechanism for obesity prevention and control should be established under the Healthy China Action Promotion Committee to coordinate cross-industry policy formulation.
2. Meso-Level: Establish an inter-industry, holistic, full life-cycle obesity prevention and treatment policy system for all age groups, covering the entire population.
Under the guidance of the government, relevant interdisciplinary expert committees should be set up to build a comprehensive full life-cycle obesity prevention and treatment system that spans different industries, serves the entire population, and covers health promotion, prevention, diagnosis, treatment, and health management. In non-medical fields, it is recommended to accelerate the implementation of a range of evidence-based interventions and improve relevant policy and legal systems.
3. At the implementation level: Integrate the full-cycle management of obesity prevention and treatment into the existing healthcare system, enable the creation of specialized diagnosis and treatment capacities for obesity, and strengthen the monitoring and information collection of interdisciplinary disease burden and related research.
1) Integrate the health promotion, prevention, diagnosis, treatment, and management of obesity into the existing healthcare policy implementation system to improve coverage and effectiveness.2) Improve the formulation of obesity diagnosis and treatment policies, and enable capacity building for obesity diagnosis and treatment.
3) Strengthen monitoring, information collection, and related research regarding the burden of obesity and its associated diseases.
Novo Nordisk, as a leading global biopharmaceutical company specialized in diabetes, obesity, and other serious chronic diseases, is committed to preventing and eventually curing chronic diseases through its leading technological breakthroughs and expanding access to medicines. With its various product and extensive management experiences, Novo Nordisk is willing to deepen cooperation with the Chinese government, including actively sharing international experience in obesity prevention and treatment and providing support for relevant public-private cooperation projects, and ultimately contributing to the realization of the Healthy China 2030 objectives.
Download the full report：
