High blood pressure is one of the most serious risk factors for cardiovascular disease (e.g. stroke, heart failure and coronary heart disease (CHD)), the leading cause of death worldwide. High blood pressure is responsible for more than half of strokes and heart attacks. In Fiji non-communicable diseases (NCDs), including cardiovascular disease, result in thousands of deaths every year and affect the lives of many more. Around 80% of deaths in Fiji are caused by an NCD and those numbers are growing.

The relationship between eating too much salt and high blood pressure is well established. Reducing salt intake is widely recognised globally as one of the most cost-effective measures for preventing NCDs.

This report assessed the potential benefits of implementing a national salt reduction program in Fiji to prevent stroke and CHD events such as heart attack, and reduce healthcare needs, informal care and productivity costs. These benefits were used to calculate the threshold cost of implementing a profitable salt reduction program from a social perspective.

The base case salt reduction target was 1 gram (g) reduction per day over a year. Results showed reducing salt intake by 1g per day for a year would potentially prevent 234 heart attacks and 72 strokes resulting in 131 lives saved and more than FJD 1.8 million in reduced costs to society each year. Considering these savings, a threshold value of FJD 2.04 per person per year would result in equivalent costs and savings per year from a 1g per day salt reduction program in Fiji.

The findings demonstrate a minimal investment in a national salt reduction program in Fiji is likely to yield a positive social return on investment for the prevention of cardiovascular events.

The George Institute for Global Health is pleased to contribute to the Consultation for the development of the CFS Voluntary Guidelines on Gender Equality and Women’s and Girls’ Empowerment in the Context of Food Security and Nutrition.

The George Institute believe the Zero Draft is an important step in moving towards more equitable outcomes for women and girls.

To strengthen the Zero Draft, The George Institute has made a number of recommendations, including:

• An emphasis on nutrition for women and girls throughout the life-course
• The promotion of policies that support the ongoing recognition of women in the workforce and agricultural production
• Better inclusion of data

The consultation information can be found here.

The George Institute for Global Health is pleased to contribute to the public consultation of the National Obesity Preventive Strategy (NOPS).

The National Obesity Preventive Strategy (NOPS) will enable a more collaborative and comprehensive approach to addressing obesity nationally. It will also provide a way to identify actions and priorities for all levels of government as well as provide a focus for multi-sectoral partnerships and collaboration.

The George Institute for Global Health strongly supports the overall approach of the National Obesity Preventive Strategy (NOPS). The George Institute, however, believes there are several ways the NOPS could be improved to have greater impact on rates of overweight and obesity, and improve the health of Australians.

To ensure its objectives and ambitions are realised, the NOPS should be accompanied by:

• Strong targets that, at a minimum, align with the National Preventive Health Strategy (NPHS).
• A national governance committee to oversee implementation of the strategy, with representation from all governments, led by Health Ministers.
• A national implementation plan to be developed within six months of the strategy’s release and including:
  • agreed evidence-based actions for each strategy, with responsibility for each action assigned to federal, state, and territory governments or both, as appropriate.

• • a timeline for implementation and reporting, with the strategy’s 10-year timeframe divided into blocks at three, six, and nine years.
• A funding plan that identifies committed, ongoing, and adequate funding from all governments.
• A monitoring and evaluation framework, requiring regular reporting on implementation and outcomes from each jurisdiction and an independent evaluation of impact.
• A process free from conflicts of interest.         

The George Institute congratulates the Working Group on the development of the National Obesity Prevention Strategy. We look forward to reviewing the next iteration of the NOPS and participating in the development of its implementation. The Draft National Obesity Prevention Strategy 2022-2032 can be found here.

Worldwide, too few children are breastfed. Commercial promotion of breast-milk substitutes such as infant formula and toddler milks is one factor undermining breastfeeding practices globally.

The International Code of Marketing of Breast-milk Substitutes (BMS) was adopted by the World Health Assembly to protect and promote appropriate infant and young child feeding in 1981. While progress has been made in many countries, challenges to full and effective implementation remain. Over the last two decades, digital marketing practices that were not yet conceived when the Code was written have accelerated in use, reaching women and their families with messages that undermine breastfeeding practices.

In 2021, The George Institute was commissioned by the World Health Organization to conduct a systematic scoping review of academic and grey literature to understand the scope and impact of digital marketing of BMS.

This work has recently been published in Current Nutrition Reports (Digital Marketing of Breast-Milk Substitutes: a Systematic Scoping Review (springer.com)) and has already been cited extensively in the World Health Organization’s Report on the Scope and impact of digital marketing strategies for promoting breastmilk substitutes (who.int). The Report will be presented at the seventy-fifth World Health Assembly in May 2022, where it is anticipated that Member States will consider the need for further guidance from WHO to protect women and children from digital marketing of BMS.

By gathering the evidence on the topic in one place, the review builds a foundation for future work by the WHO, its member states and other stakeholders to help address the problem of harmful marketing of these substitutes by manufacturers and social media companies alike.

The ongoing impacts of climate and health crisis in Australia, such as catastrophic bushfires, floods, drought and the COVID-19 pandemic, remind us the world is rapidly changing. This presents challenges and consequences for human and planetary health, and the wellbeing of current and future generations. Social, environmental and economic imbalances pose a threat to all, but particularly people living on low incomes or experiencing disadvantage.

The imperative to ‘build back better’ creates opportunities for governments to look for new ways of working to better support the health and wellbeing of the community now and into the future. 

A wellbeing economy takes a sustainable development approach to economic development that addresses the social, environmental and health needs of a population by prioritising wellbeing over exponential growth. A wellbeing economy values indicators of wealth beyond gross domestic product, such as equity, happiness and environmental outcomes. It can provide society with a more holistic and balanced approach to development.

“Wellbeing economies have the power to reframe the human experience in the 21st century. By placing people and planet at the centre of policy making, social, environmental and health outcomes can all be improved. Countries like Wales and New Zealand have shown us what is possible – we now need to State, Territory and Commonwealth jurisdictions in Australia to step up” says Dr Alexandra Jones, Senior Research Fellow, Food Policy at The George Institute for Global Health.

2023

In February 2023, The George Institution contributed a written submission to the Commonwealth Treasury on the consultation for the ‘Measuring What Matters’ Framework (the Framework). The submission focused on providing contextually relevant feedback to proposed OECD Framework for Progress and Well-being and providing additional proposed indicators including the inclusion of chronic disease, injury and disability; access to quality, culturally safe healthcare; healthy, affordable and sustainable food and water supply; and, the inclusion of Aboriginal and Torres Strait Islander peoples wellbeing.

2022 

In October 2022, The George Institute and VicHealth released its toolkit to progress wellbeing economy approaches in Australia. This toolkit was created to support Australian policymakers to build healthier, more just and more sustainable economies for people and the planet. The toolkit builds upon the work of global thought leaders, including the Wellbeing Economies Alliance, the Organization for Economic Co-Operation and Development and the World Health Organization as well as individual country case studies, to provide practical guidance for governments to accelerate visionary action in Australia. Please refer to the toolkit on this page.

In July 2022, the Treasurer of Australia, the Hon. Jim Chalmers MP, announced the Albanese Government’s intention to include a wellbeing chapter in the October 2022 Federal Budget. This is the first time the Commonwealth Government will have implemented a wellbeing approach to economic policy in Australia.

In August 2022, The George Institute hosted over 300 people for a virtual panel discussion ‘Measuring what matters: What a wellbeing economy can do for all Australians’ with Dr Katherine Trebeck (Wellbeing Economy Alliance), Dr Richard Denniss (The Australia Institute), Cressida Gaukroger (Centre for Policy Development) and Dr Julieann Coombes (The George Institute). This event explored how a wellbeing economy might improve social, health and environmental outcomes and what should be the initial focus of the October 2022 budget.

2021

The George Institute, VicHealth and the Victorian Council of Social Service hosted a roundtable, bringing together experts from the health, community, environment, research and youth sectors to discuss the Report and workshop how this concept might be implemented in Victoria.

The ‘Integrating wellbeing into the business of government: The feasibility of innovative legal and policy measures to achieve sustainable development in Victoria’ Roundtable Communique summarises discussions from the roundtable, including participants’ feedback on what a wellbeing economy can do for the people of Victoria, potential barriers to its implementation and practical steps to moving the agenda forward.

Participants identified the following principles for moving the wellbeing economy agenda forward:

1. Base the wellbeing economy agenda on principles of equity and sustainable development
2. Advocate for transformation of the structural drivers that underpin a wellbeing economy
3. Engage widely and strategically with diverse stakeholders in the development of the wellbeing economy agenda
4. Build a coalition of community, sector and political champions around a coherent advocacy agenda
5. Embed diversity and community voices in campaigns
6. Employ qualitative and quantitative methods to find appropriate indicators for wellbeing priorities
7. Move beyond traditional cost–benefit analysis to assess policies in terms of their contribution to current and future wellbeing
8. Strengthen collaboration with existing networks working in this space in Australia and globally

2020 Report

The Victorian Health Promotion Foundation (VicHealth) commissioned The George Institute for Global Health to develop a report on how a wellbeing approach to policy could be incorporated into the business of government. The ‘Integrating wellbeing into the business of government: The feasibility of innovative legal and policy measures to achieve sustainable development in Australia' Report draws upon a number of international case studies to consider the feasibility of a wellbeing economy in Australia.

The George Institute for Global Health made a submission to the Department of Industry, Science, Energy and Resources, and the Australian Competition and Consumer Commission (ACCC) on the Evaluation of Country of Origin Labelling for Food. The George Institute has been tracking Country of Origin Labelling (CoOL) data since 2016 using FoodSwitch, a database of nutrition and labelling information for packaged and restaurant foods.

Over the past five years, CoOL compliance has significantly increased. In 2019, we recorded 15,134 priority food products, with 91% exhibiting CoOL. We recorded a further 5,599 products that were classified as non-priority, with 42% exhibiting CoOL.

Type of CoOL displayed by ‘priority’ products:

• 12% of products displayed a ‘grown in’ or ‘produced in’ Australia label.
• 48% of products displayed a ‘made in Australia’ label. These products were made mostly from Australian ingredients but also sometimes from imported ingredients.
• 7% of products displayed a ‘packed in’ Australia label.
• 24% displayed a label indicating they were imported.
• 9% were not yet displaying CoOL. These may be genuine instances of non-compliance, or some of these products may be able to argue they are in ‘non-priority’ categories.

A large proportion of products in the non-priority categories of beverages, snacks and confectionery did not display CoOL.

Further research by The George Institute may include an analysis by company to provide more detailed insights into areas of compliance and non-compliance.

The George Institute for Global Health submission to the Australian Medical Research and Innovation Strategy and Priorities calls for ‘Equity’ to be at the heart of the Australian Medical Research and Innovation Strategy and Priorities. The Strategy and Priorities are determined by the Australian Medical Research Advisory Board (AMRAB). The new Strategy will be from 2021 to 2027, with new Priorities from 2021 to 2024. This will be finalised based on legislation passed by the Parliament before the end of 2021.

The George Institute believes equity is critical to the Australian health system. Equity is required for individuals and communities to reach their full potential in life. All individuals and communities in Australia and around the world should have access to quality healthcare services as a human right, regardless of sex and gender, ethnicity, disability, age, geography, intersectionality, and socioeconomic status. Disappointingly, inequity exists in the Australian health system, particularly in gender, ethnicity and geography. The lack of access by individuals and communities to quality healthcare creates barriers and risks. The next MRFF Strategy should play an important and strategic role to address inequities.

The George Institute has also called for:

• The Strategy should align with the Medical research Future Fund 10 Year Plan and Priorities, the National Health and Medical Research Council, the Australian Research Council, and Department of Health strategies.
• New priorities to include:
  • ‘Sex and Gender in Research’.
  • ‘Global health challenges’ separate from ‘Pandemic and health crisis preparedness’.
  • ‘Planetary and human health’.
• ‘Sepsis’ be acknowledged under the current priority, ‘Antimicrobial resistance’.
• A comprehensive review and report in relation to current Priorities.

The Ministry of Health and Family Welfare (MoHFW) - under the Ayushman Bharat Comprehensive Primary Healthcare (CPHC) program - launched a population-based screening program for all men and women of age group thirty years and above, with a specific focus on hypertension, diabetes, oral, breast and cervical cancers. The National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) operational guideline states that appropriate strategies that combine effective outreach and facility based UPHC services should be developed for NCD screening in urban areas in PHCs and the community health centres (CHCs).

With the above context, this request was received from the National Health Systems Resource Centre (NHSRC). The requester communicated that the Union Ministry of Health was in the process of streamlining the National Health Mission (NHM) and this rapid review was requested to offer evidence on interventions to improve NCD screening uptake in urban areas under the National Programme on Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke.

In consultation with the requester, the remit of this review was defined for two components:

• Component I : Different strategies used to increase the uptake of screening for hypertension, diabetes, oral, breast and cervical cancers in adult patients over 30 years in urban areas
• Component II : Enablers and barriers of screening for hypertension, diabetes, oral, breast and cervical cancers in adult cancers in adult patients over 30 years in urban areas.

This review was completed in a span of one month and a few key policy considerations are:

1. Community-based outreach facilities, capacity-building, and integration of screening services within existing health services should be considered to improve screening uptake. 
2. Health education (contextually tailored, in local languages), along with integration of screening into existing health system, demand-side.
3. Improving access to screening services through various initiatives such as financial incentives (e.g. transport costs) or providing transportation could help create awareness and uptake. 
4. Ensuring privacy and having female health care workers or providers available at health facilities can address embarrassment related to the screening procedures. In addition, standard protocols to be followed. 
5. Encouragement to attend screening by other women in the community (particularly for cancers) or health care workers has been identified as an important facilitator for accessing and availing screening services