Establishing an EU-wide front-of-pack nutrition label: Review of options and model-based evaluation.

This paper reviews the effectiveness of four types of front-of-pack nutrition labels (FoPLs) in influencing calorie purchases. The four FoPL types are poised for unified implementation across European countries. Further, this study extends its analysis to evaluate the impacts of the voluntary adoption of these FoPLs within 27 EU nations. Nutri-Score displays higher potential for yielding positive health and economic outcomes, compared with other FoPLs. Across EU countries, Nutri-Score is projected to avert nearly two million cases of non-communicable diseases, in total, between 2023 and 2050. Keyhole demonstrates effects of a similar magnitude but with no statistical significance. Nutri-Repere shows smaller impacts, while Nutri-Couleurs has non-significant effects. Nutri-Score is projected to significantly lower annual healthcare spending by 0.05%, whereas the other labels have negligible impacts. By reducing cases of disease, FoPLs have the potential to improve employment and work productivity. Nutri-Score surpasses the other labels with an estimated annual gain of 10.6 full-time equivalent workers per 100,000 individuals of working age across EU countries. In all, mandatory implementation of any of the four labels would lead to greater effects than those obtained with a voluntary implementation, providing evidence to inform legislation proposal for an EU-wide nutrition labelling system.

Estimating the return on investment of selected infection prevention and control interventions in healthcare settings for preparing against novel respiratory viruses: modelling the experience from SARS-CoV-2 among health workers.

Background: Insufficient infection prevention and control (IPC) practices in healthcare settings increase the SARS-CoV-2 infection risk among health workers. This study aimed to examine the level of preparedness for future outbreaks. Methods: We modelled the experience from the COVID-19 pandemic and assessed the return on investment on a global scale of three IPC interventions to prevent SARS-CoV-2 infections among health workers: enhancing hand hygiene; increasing access to personal protective equipment (PPE); and combining PPE, with a scale-up of IPC training and education (PPE+). Our analysis covered seven geographic regions, representing a combination of World Health Organization (WHO) regions and the Organisation for Economic Co-operation and Development (OECD) countries. Across all regions, we focused on the first 180 days of the pandemic in 2020 between January 1st and June 30th. We used an extended version of a susceptible-infectious-recovered compartmental model to measure the level of IPC preparedness. Data were sourced from the WHO COVID-19 Detailed Surveillance Database. Findings: In all regions, the PPE + intervention would have averted the highest number of new SARS-CoV-2 infections compared to the other two interventions, ranging from 6562 (95% CI 4873-8779) to 38,170 (95% CI 33,853-41,901) new infections per 100,000 health workers in OECD countries and in the South-East Asia region, respectively. Countries in the South-East Asia region and non-OECD countries in the Western Pacific region were poised to achieve the highest level of savings by scaling up the PPE + intervention. Interpretation: Our results not only support efforts to make an economic case for continuing investments in IPC interventions to halt the COVID-19 pandemic and protect health workers, but could also contribute to efforts to improve preparedness for future outbreaks. Funding: This work was funded by WHO, with support by the German Federal Ministry of Health for the WHOResearch and Development Blueprint for COVID-19.

A comparative assessment of action plans on antimicrobial resistance from OECD and G20 countries using natural language processing.

Following the launch of the Global Action Plan on antimicrobial resistance (AMR-GAP) in 2015, most OECD and G20 countries developed their own national action plans (AMR-NAPs). This is the first paper that deploys natural language processing (NLP) techniques to systematically measure and compare the extent to which AMR-NAPs from 21 OECD and G20 countries align with the AMR-GAP in terms of the strategic objectives and interventions. We quantify the extent of alignment based on two NLP metrics: term-frequency (TF) and term-frequency-inverse document frequency (TF-IDF). Quantifying TF allows us to compare the relative prominence of strategic objectives and interventions, whereas quantifying TF-IDF enables us to identify interventions that occur more frequently in each AMR-NAP. Similar to the AMR-GAP, in our sample, terms associated with optimizing antimicrobial use in human and animal health have the highest frequency (TF = 0. 287), whereas terms linked to raising AMR awareness and education have the lowest frequency (TF = 0.066). Substantial cross-country variation exists in the distribution of interventions that are distinctly frequent in each AMR-NAP. We also report new evidence on the selected policy design and monitoring and evaluation features of these documents. Our results suggest a high degree of congruence between the AMR-GAP and AMR-NAPs, with notable diversity in the spate of interventions that OECD and G20 countries discuss in their action plans.

Tackling the cancer burden: the economic impact of primary prevention policies.

Cancer is a noncommunicable disease (NCD) with increasing incidence and therefore constitutes a major public health issue. To reduce the health and economic burden of cancer, policy-makers across the world have implemented a range of preventative interventions targeting risk factors with a known link to the disease. In this article, we examine the impact of six primary prevention interventions - related to physical inactivity, unhealthy diet or harmful alcohol use - on cancer-related health outcomes and healthcare expenditure. Here, we used the OECD Strategic Public Health Planning for NCDs (SPHeP-NCDs) model to quantify outcomes and costs for each intervention for years 2020-2050 across 37 countries. Results from the model indicate that all interventions could lead to a reduction in the number of new cancer cases, in particular those targeting harmful alcohol consumption. Introducing an alcohol tax, for instance, is estimated to reduce related cancer cases by 5619 a year or 174 193 by 2050. A breakdown of results by type of cancer revealed interventions had the largest impact on colorectal cancer with, on average, 41 140 cases avoided per intervention by 2050. In proportional terms, interventions had the greatest impact on new oesophageal and liver cancers. Findings from this article are designed to assist decision-makers efficiently allocate limited resources to meet public health objectives.

How will the main risk factors contribute to the burden of non-communicable diseases under different scenarios by 2050? A modelling study.

BACKGROUND: The future burden of non-communicable diseases (NCDs) depends on numerous factors such as population ageing, evolution of societal trends, behavioural and physiological risk factors of individuals (e.g. smoking, alcohol use, obesity, physical inactivity, and hypertension). This study aims to assess the burden of NCDs in Europe by 2050 under alternative scenarios. METHODS: This study combines qualitative and quantitative forecasting techniques to examine how population health in Europe may evolve from 2015 to 2050, taking into account future societal trends. Four scenarios were developed (one business-as-usual scenario, two response scenarios and one pessimistic scenario) and assessed against 'best' and 'worst'-case scenarios. This study provides quantitative estimates of both diseases and mortality outcomes, using a microsimulation model incorporating international survey data. FINDINGS: Each scenario is associated with a different risk factor prevalence rate across Europe during the period 2015-2050. The prevalence and incidence of NCDs consistently increase during the analysed time period, mainly driven by population ageing. In more optimistic scenarios, diseases will appear in later ages, while in the pessimistic scenarios, NCDs will impair working-age people. Life expectancy is expected to grow in all scenarios, but with differences by up to 4 years across scenarios and population groups. Premature mortality from NCDs will be reduced in more optimistic scenarios but stagnate in the worst-case scenario. INTERPRETATION: Population ageing will have a greater impact on the spread of NCDs by 2050 compared to risk factors. Nevertheless, risk factors, which are influenced by living environments, are an important factor for determining future life expectancy in Europe.

The short-term effect of BMI, alcohol use, and related chronic conditions on labour market outcomes: A time-lag panel analysis utilizing European SHARE dataset.

INTRODUCTION: Non-communicable diseases (NCDs) like cancer, cardiovascular disease, and diabetes have spread at a remarkable pace in European countries over the past decades. Overweight/obesity and alcohol use are two leading risk factors contributing to both economic and epidemiological burden associated with NCDs. In OECD countries, the impact of indirect costs of obesity varies between 0.20% and 1.21% of GDP. Indirect costs of alcohol use range from 0.19% (Portugal) to 1.6% (Estonia) of GDP. AIM: To assess the longitudinal impact of alcohol use and high body-mass index (BMI) on labour market outcomes in the European region by modeling the direct effect of high BMI and alcohol use, and the effect via associated diseases. METHODS: The impact of BMI, alcohol use, and associated diseases on employment likelihood, intent to retire early, days of absenteeism, and hours of work per week, were modelled via lagged Poisson and Zero-inflated Poisson regressions, adjusting for missingness via inverse probability weighting, as appropriate, using European SHARE data. RESULTS: Controlling for other chronic conditions, being overweight increases employment likelihood among men, but not among women. Obesity decreased female, but not male, employment chances. All chronic conditions linked with high BMI negatively affected employment likelihood, and increased the intention to retire early significantly. Alcohol use positively affects employment likelihood in women at all drinking levels relative to lifetime abstainers, but only in moderate (not heavy) male drinkers. There is super-additionality of impact of NCDs on absenteeism and hours worked, presenting a key economic argument to tackle NCD prevention and compression of morbidity. IMPLICATIONS: NCD prevention is not just important for employment and hours worked, but also for employee morale, especially given increasing retirement age in Europe and globally.