Gaining health : analysis of policy development in European ...

Chapter 4
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• tobacco control
• food and nutrition
• alcohol control
• physical activity.
At the same time as a new government initiative in 2006,
three broad strategy documents were launched and partially
adopted on important elements of policies to tackle
NCD:
• the National Cancer Control Programme;
• the National Heart Health Programme; and
• the National Infant and Child Health Programme.
Currently the interrelationship between these topic-based
programmes, the public health strategy and other sub-policies
is not explicitly regulated and the coordination mechanisms
are also unclear.
2.6.1. Cancer
In 2006, the Government initiated the development of a
long-term National Cancer Control Programme, requesting
the professional associations working in the field to draft
a programme document. The main reason was the extremely
unfavourable epidemiological situation in Hungary
compared to other countries. At present, there are about
300 000 cancer patients; 33 530 people died of malignant
neoplastic diseases in 2003. Cancer is the second most
frequent cause of death following CVD. Hungary declares
in the document to be determined to permanently reduce
malignant neoplastic diseases through complex, coordinated
national action that includes all affected disciplines and addresses
all involved groups of people.
The programme document includes an analysis of the epidemiological
situation. Established by the World Bank, the
National Cancer Registry began operating in line with international
guidelines in 2000. The National Cancer Registry
receives regular data on cancer from 198 medical facilities.
The Programme is based on the assumption that one of the
most important of the many reasons behind the unfavourable
epidemiological situation is the insufficiency of primary
prevention, and that the educational system must play a
crucial role in imparting relevant information. The role of
health policy, as the drafting group understands it, is to initiate
the dissemination of information on prevention through
the schools, and to promote media coverage through
articles and programmes, of knowledge on risk factors and
on ways of controlling them. It also needs to support antitobacco
groups and other NGOs and social organizations in
their educational and information dissemination efforts. This
way of thinking clearly reflects a more naïve and medicalized
approach than that reflected in the spirit of the NPHP.
The document indicates as key areas of primary prevention:
• tobacco and alcohol consumption
• obesity
• viral and bacterial infections and parasitic infestations.
The draft programme gives high priority to secondary prevention
for recognizing cancer and precancerous states with
no signs or symptoms, in order to prevent serious consequences
later. The method to be used is screening, including:
• mass screenings (organized, coordinated and controlled
for quality by NPHMOS):
--
breast screening
--
cervical screening
--
colorectal screening
• ad hoc screenings:
--
oral cavity screening
--
prostate gland screening
--
skin screening
--
fluorography.
According to the document, in the field of cancer patient
care, effective and up-to-date cancer therapy and diagnos-
Case studies: policy development in countries for tackling noncommunicable diseases