A healthy lifestyle pays off

When I am healthy, I have a thousand desires. When I am sick, I have but one desire! This statement illustrates that we often have to lose our health before we become aware of how important it is. The good news is that there are ways of maintaining or regaining our health. The magic word is prevention.

The magic word is prevention. Improved hygiene, malnutrition prevention, better living and working conditions and the introduction of vaccination were important achievements in the last two centuries and have contributed towards improving population health and preventing disease. Today we are facing new challenges. Even though modern lifestyles present many comforts, they also entail new problems. Sitting at the computer for hours on end has replaced physical work, we get a quick bite to eat while on the go and seek maximum kicks from new drugs. For decades, we have had smoking vaunted as the epitome of freedom. Cheap alcohol is available everywhere 24/7, and to get more physical activity we would have to find a slot in our bulging schedule.

Prevention must therefore begin in our everyday lives and face these challenges in the same way as brushing your teeth before bedtime is now a matter of course. Any success of this requires information, support, favourable conditions and simple "recipes". This is the approach taken by the contributions of the four prevention programmes.

Mix of measures in cooperation with numerous stakeholders

The Federal Council realised years ago that population health can be promoted through coordinated action on the part of stakeholders. For that reason, it has decided to establish the National Programmes on Alcohol, Tobacco, Diet & Physical Activity alongside the Package of Drug-Related Measures that was started in the 1990s. On behalf of the Federal Council, the FOPH determined the thrust of the programmes and prioritised measures. Partners from various disciplines were engaged, who shaped the programmes with their knowledge and strengths in the respective fields. This included primarily the cantons, the Federal Office of Sport (FOSPO), the Federal Food Safety and Veterinary Office (FSVO), the Swiss Alcohol Board (SAB), the Tobacco Control Fund (TPF) and the three federal commissions involved in prevention (tobacco, alcohol, drugs). Together with various trade associations and NGOs, they helped implement the programmes and steadily improved cooperation with each other over the years.

Successful prevention includes a balanced combination of different measures and regular exchanges between stakeholders. The programmes were aimed at increasing personal responsibility and individual health literacy. Scientific evidence, consumption figures and good-practice activities were recorded through monitoring and evaluation. The population was informed about risks and support services by way of campaigns. Yet knowledge alone is not enough; health-promoting framework conditions are also necessary. Building a safe cycle path and attractive spatial planning, for example, means that more people will go to work by bike or on foot rather than by car, with thed esired side effect of improving their circulation. Canteens take care to ensure a balanced range of meals, and companies offer sports classes to their employees. Foods containing less salt or sugar came onto the market thanks to voluntary measures on the part of industry. Statutory measures such as the Federal Act on Protection against Passive Smoking also had an important role to play in prevention.

Prevention works and is worthwhile

The intervention and information offerings that were prepared as part of the programmes made it possible to show those concerned how they can improve their physical and mental performance with simple measures in their everyday lives. People were also made aware that smoking cessation and moderate alcohol consumption increases their wellbeing and improves their quality of life. Using the stairs instead of taking the lift, an apple a day, and balanced meals in the canteen are small everyday contributions to health and individual wellbeing. By maintaining a healthy lifestyle, we will stay healthy longer and get more enjoyment out of life. Besides advantages for the individual, society also benefits. Healthy people are less of a burden to the solidarity-based health system, as they need fewer services or only use them much later. The effect of prevention activities on the healthcare system often becomes apparent only after some time. But these past eight years have nonetheless yielded various positive trends. The Federal Act on Protection against Passive Smoking is serving its purpose in that the proportion

tion of people exposed to harmful tobacco smoke has massively decreased. Within a short time, this led to a decrease of some 20% in heart attack-related hospitalisations. High-risk alcohol consumption also declined, especially among young people. The number of people who exercise regularly has risen in recent years, and the share of overweight adolescents has stabilised after being on the rise for years. Furthermore, over half the people who smoke want to stop. Thanks to the National Prevention Programmes on Alcohol, Tobacco, and Diet & Physical Activity, we have thus achieved a great deal in the past eight years. The Package of Drug-Related Measures (based on the Swiss four-pillar policy that is internationally regarded as exemplary) has provided those concerned with an extensive range of assistance in the areas of prevention, treatment and harm reduction. This has led to a significant decline in deaths and drug-related crime, better health of addicts and the disappearance of open drugs scenes.

Prevention is worthwhile from the economic point of view as well. Every franc invested in prevention work pays off many times over. In addition, there are benefits that are and remain priceless, namely longer-lasting health and improved quality of life.

The increasing importance of non-communicable diseases

The three programmes and the package of measures have been successfully concluded. Yet circumstances are constantly changing. Strategies and measures thus need to be adapted continually. A look at the diseases that are most widespread in industrialised nations dietand on the rise worldwide once again illustrates the importance of the tasks that await us.

About two-thirds of deaths are due to four diseases, namely cancer, diabetes, cardiovascular and respiratory diseases. In addition, people are being treated for chronic musculoskeletal diseases and mental disorders. Experts refer to these diseases as non-communicable diseases (NCD), which are responsible for 80% of today's healthcare costs. And since the number of older people is growing and the likelihood of suffering from chronic diseases increases with age, this trend is rising. These diseases therefore constitute the greatest challenge to our healthcare system, not least of all due to the significant impact in terms of costs. In an age of rising health insurance premiums, these are findings we cannot be indifferent to. In the light of this situation, it was clear to the Federal Council cable Diseases (NCD Strategy). The new strategy is designed to allow the resources of the Confederation, the cantons and private stakeholders to be deployed in an even more targeted manner, with activities being optimally coordinated and geared towards common goals. In addition to the NCD Strategy, the Strategy on Addiction was also developed. It constitutes an overarchingframework for orientation and action and describes the direction of Swiss drug policy for the coming years. With the National Strategy on Addiction, we are reacting to the fact that many substances and behaviours now occur simultaneously and new forms of dependency are appearing all the time. The strategy is based on the balance between personal responsibility and support for those who need it. Both strategies are linked to the four national programmes that drew to a close at the end of 2016.

The National Strategies' great potential lies in the interaction of the relevant stakeholders. The new strategies incorporate proven measures, but at the same time we want to address deficits identified in recent years. On the one hand, we will focus even more on practice and more directly target vulnerable or affected population groups. For even in Switzerland, which is known internationally for its exemplary healthcare system, origin, education and social status all too often determine health wellbeing. Healthcare is another important action area of the two strategies. People who are at greater risk of disease or are already ill are to be supported with needs-appropriate services to alleviate and improve their disease progression. Prevention is being integrated increasingly into the medical-care chain, with doctors, nursing staff and other health professionals playing a central role. Interfaces and cooperation within and outside the healthcare system are to be improved in order to ensure coordinated care. Besides promoting and maintaining physical health, mental health must also be ensured – because it is often associated with the risk factors alcohol, tobacco, drugs, diet and physical activity. Measures of the NCD Strategy and the Strategy on Addiction are therefore also coordinated with measures to prevent mental illness.

So the priorities are set. The experience of recent years shows us the way into the future. Human beings are the focus of our work, and their health is vital to us. We want them to live a healthy life for as long as possible. Day after day. We are convinced that the new NCD Strategy and the Strategy on Addiction which were introduced this year will make a significant contribution to the wellbeing of the population.