Opinion – Pedro Hallal: Covitel: knowing to act

Worldwide, 7 out of 10 deaths are caused by chronic noncommunicable diseases such as cancer, diabetes, cardiovascular and chronic respiratory diseases. In Brazil, in 2019, 54.7% of deaths were caused by non-communicable chronic diseases, in addition to another 11.5% that were consequences of their diseases.

In the last two years, Covid-19 has put chronic noncommunicable diseases even more in the spotlight, as chronic comorbidities have increased the risk of hospitalizations and deaths from Covid-19. At the same time, with attention focused on health emergencies, care for chronic noncommunicable diseases was less prioritized, increasing difficulties in accessing new diagnoses and timely treatments.

And this is not a one-off situation. The reflections of what we have been experiencing since the beginning of 2020 will be felt in the coming years and even decades. Therefore, we are at a decisive moment to invest in a healthier future for Brazilians.

Governments need to prioritize smart and strategic investments, which requires strengthening the analytical capacity of managers in an intersectoral way. And this can only be done if we have robust and up-to-date monitoring, which shows a faithful picture of the population’s health situation, and guides priorities, planning and actions to reduce morbidity and mortality.

Information is an even more valuable resource in a country like Brazil, which, with continental dimensions, has glaring socioeconomic and regional inequalities. And here, as it happens all over the world, chronic non-communicable diseases affect people unequally, especially affecting the most vulnerable populations, such as low-income and less educated populations.

In this scenario, surveys such as the recently launched Covitel (Telephone Survey of Risk Factors for Chronic Non-Communicable Diseases in Pandemic Times) are essential. Developed through a partnership between academia and civil society, the research responds to the urgency of the moment, bringing relevant results for the construction of knowledge about the influence of Covid-19 on risk factors for non-communicable chronic diseases in the adult population. from Brazil.

In summary, Covitel shows that the pandemic has hindered the fight against chronic non-communicable diseases in Brazil, increasing some risk behaviors, such as physical inactivity, for example, and interrupting the trend of improvement in others, such as smoking. In addition, the pandemic has exacerbated inequalities in the occurrence of chronic noncommunicable diseases.

It is important to emphasize that, to a large extent, chronic non-communicable diseases are preventable and are related to people’s living conditions, determined by access to public goods and services, guarantee of rights, access to information, employment and income and possibilities of doing health-friendly choices.

The main risk factors for illness —smoking, alcohol consumption, unhealthy diet and physical inactivity—can be modified by behavior change. Public policies have the power (and the duty) to make healthy choices the default choices for the population. They can make public spaces smoke-free, inform consumers with appropriate labels for processed foods and promote smart cities, which create safer spaces for walking and cycling, for example.

We need to invest in an agenda based on data, working together, tackling inequalities and, of course, fighting chronic noncommunicable diseases. With public health intelligence, we prevent diseases, promote quality of life and, above all, save lives. This while optimizing resources, reducing costs for treatments and consequences of lost productivity of a sick population.