By Nkasima Janet
KAMPALA, Uganda|SHIFTMEDIA| The global cancer burden is estimated to have risen to 18.1 million new cases and 9.6 million deaths in 2018. One in 5 men and one in 6 women worldwide develop cancer during their lifetime, and one in 8 men and one in 11 women die from the disease. Worldwide, the total number of people who are alive within 5 years of a cancer diagnosis, called the 5-year prevalence, is estimated to be 43.8 million.
According to WHO (NCD Uganda country Profile 2018), NCDs in Uganda is estimated to account for 33% of all deaths, and according to records from the Uganda Cancer Institute, over 22,000 Ugandans succumbed to different cancers in 2018. The Kampala Cancer Register shows that 32,617 new cases were recorded in 2018. This indicates that at least 350 new cancer patients were detected per 100,000 people compared to 2008 when the figure stood 250 per 100,000 people.
Unhealthy Diets As A Major Risk Factor of Cancer
Cancer is a non-communicable disease (NCD), caused by a variety of identified and unidentified factors. The most important established cause of cancer is tobacco smoking.
Dietary factors are estimated to account for approximately 30% of cancers in industrialized countries, making diet second only to tobacco as a theoretically preventable cause of cancer (https:/cbsnews.com/news/unhealthy-diet-now-kills-people-than-tobacco-and-high-blood-pressure-study-finds/). This proportion is thought to be about 20% in developing countries. Body weight and physical inactivity together are estimated to account for approximately one-fifth to one-third of several of the most common cancers.
Although this is the case, the government, non-state actors and the general public have a limited understanding of how unhealthy diets and physical activity are causing premature deaths from cancer.
A healthy diet helps to protect against malnutrition in all its forms, as well as non-communicable diseases (NCDs), including; diabetes, heart disease, stroke and cancer. The increased production of processed foods, rapid urbanization and changing lifestyles have led to a shift in dietary patterns. People are now consuming more foods high in energy, fats, free sugars and salt/sodium, and many people do not eat enough fruit, vegetables and other dietary fibre such as whole grains.
In Uganda, the regulatory framework is weak and unimplemented to prevent these NCDs related to unhealthy diets and physical inactivity. This has led the most vulnerable groups, such as children, without protection from pressure from the industry marketing strategies to succumb to NCDs such as cancer at an early age.
Fiscal policies including taxes, which would influence the availability of, access to, and consumption of, poorly nutritional foods; and subsidies to promote access among poor communities to recreational and sporting facilities, are not promoted. The low taxes levied and unregulated marketing of unhealthy food and non-alcoholic beverages is a clear violation of the state’s legal obligations to promote and fulfil the right to health at both international and domestic levels.
Uganda is a member of the WHO and the United Nations Food and Agricultural Organization (FAO). These UN Agencies have already issued global strategies, plans of action and guidelines to guide countries’ response to curb diet-related NCDs. The Guidelines recommend and urge countries to undertake multi-sectoral interventions, including; fiscal policies, restrictions on advertising and promotion of unhealthy diets, physical activity promotion and restriction of marketing of unhealthy foods and non-alcoholic beverages to children. They also insist that national food policies should be consistent with the protection and promotion of public health.
Uganda is also a signatory of the main International Human Rights Treaties including the International Covenant on Economic, Social and Cultural Rights (ICESCR) that address issues of safe food consumption and the right to health. This, therefore, requires the State to mainstream a human rights-based approach to health, including curbing NCDs due to unhealthy diets. A human rights-based approach to public health issues specifically aims at realizing the right to health and other health-related human rights.
Promoting a healthy food environment, including food systems that promote a diversified, balanced and healthy diet requires the involvement of multiple sectors and stakeholders, including government, the public and private sectors.
Government has a central role in creating a healthy food environment that enables people to adopt and maintain healthy dietary practices. The government also needs to create coherence in national policies and investment plans – including trade, food and agricultural policies – to promote a healthy diet and protect public health, this can be done through;
- Implementing the WHO recommendations on the marketing of foods and non-alcoholic beverages to children
- Exploring regulatory and voluntary instruments like marketing regulations and nutrition labelling policies, and economic incentives or disincentives like taxation and subsidies to promote a healthy diet
- Increasing incentives for producers and retailers to grow, use and sell fresh fruit and vegetables
 The International Agency for Research on Cancer (IARC) of the World Health Organization Releases Latest Global Cancer Data: The GLOBOCAN 2018
 The International Agency for Research on Cancer (IARC) of the World Health Organization Releases Latest Global Cancer Data: The GLOBOCAN 2018 http://gco.iarc.fr/https://www.cancerhealth.com/article/world-health-organization-releases-latest-global-cancer-
 Willet MC. Diet, nutrition, and avoidable cancer. Environmental Health Perspectives, 1995, 103(Suppl. 8): S165–S170.
 Weight control and physical activity. Lyon, International Agency for Research on
Cancer, 2002 (IARC Handbooks of Cancer Prevention, Vol. 6).