February 07 2020
Iran and Costa Rica are the two best countries in the world when it comes to implementing the recommendations of the World Health Organization (WHO) for reducing chronic disease, a new study reports.
In 2015, 193 countries committed to reducing these deaths by one third by 2030, through 18 policies to improve healthcare provision as well as public health through nutrition, physical activity, tobacco use and alcohol use.
The researchers analyzed WHO progress reports from 2015 and 2017 to calculate implementation scores for 151 countries for the 18 policies.
In 2017, the average policy implementation score worldwide was 49 percent. But Iran and Costa Rica had the top scores for implementing 86 percent of the recommendations. Scores were lowest in Haiti and South Sudan, with 5.5 percent of the policies implemented. Overall, scores rose in 109 countries between 2015 and 2017 and dropped in 32 countries.
In general, implementation increased for all 18 policies except for mass media campaigns around physical activity and bans on alcohol advertising. The most commonly implemented policies were graphic warnings on tobacco packaging, disease risk-factor surveys and national clinical guidelines. Least-implemented policies included tobacco taxation, anti-tobacco mass-media campaigns and provision of cardiovascular therapies.
Among the bottom 20 countries, 17 were in sub-Saharan Africa.
Allen said, “You wouldn’t naturally think of Iran, Costa Rica, Moldova and Estonia as offering the highest standards of health policies to their populations, but it goes to show that it isn’t actually that expensive—just a matter of political will—to prioritize health,” he said. “All 151 countries have repeatedly committed and publicly endorsed the full list of policy options, yet no country has actually implemented all of them.”
