Seeing Red: How Sri Lanka is striving to stop NCDs

WHO/Sri Lanka/S Shahjahan

Shamima Marikar’s children are like most below the age of six: They have a taste for sugar that must be regulated and restrained.

Though the 35-year-old mom says her children are too young to understand sugar’s adverse health effects – from causing diabetes to contributing to heart disease – Sri Lanka’s new ‘traffic light’ labelling system is helping them understand one basic but important truth: Sugar is bad.

“Now when I advise my children about sugary drinks I have something to show them and make them understand which ones are high in sugar and which ones are not,” she says. “They have started to pick up on this and avoid items with a red label.”

As Shamima explains, the color-coded system – which was implemented in 2016 – is also advancing her own health literacy.

“Personally for me it has been a real eye opener. I never thought juice drinks had much sugar, but an orange or red label will make me ask ‘is it a healthy choice?’ before I buy it for my family,” she says. “It’s very useful.”

According to Sri Lanka’s Ministry of Health, Nutrition and Indigenous Medicine, advancing the health literacy of all people, at all ages, everywhere in the country, was precisely the point. The need to do so can be well understood. More than a quarter of Sri Lankans are now overweight. Nearly 6% are obese. More than 7% of adults are estimated to have raised blood glucose or are currently on medication for diabetes. Just below one in five Sri Lankans die prematurely from a noncommunicable disease (NCD), many of which are caused by excess weight.

Dr Razia Pendse, WHO Representative to Sri Lanka, says the labelling system is a great way to empower people to make informed, health-positive choices that will help address the country’s NCD burden.

“In Sri Lanka, as elsewhere, excess sugar, salt and fat in food and beverages are the primary culprits for the rise in the number of people that are overweight or obese. By ensuring clear and accurate nutritional information is provided on food and drink packaging, and by giving each product a green, orange or red label according to its sugar content, Sri Lanka’s government is helping consumers understand risks and make healthier choices,” she says.

The traffic light system is just one example of how Sri Lanka is working to halt and reverse its NCD burden. As per the country’s National Multisectoral Action Plan, endorsed by Prime Minister Sirisena in April 2016, policies to decrease alcohol and tobacco consumption, increase physical activity and create healthier schools and workplaces have been developed and implemented country-wide.

Dr Poonam Khetrapal Singh, Regional Director for WHO South-East Asia, says Sri Lanka’s diverse, multi-sectoral approach is exactly what is needed to drive Region-wide progress and achieve the 2025 targets, which include halting the rise in obesity and attaining a 25% relative reduction in premature mortality from cardiovascular disease, cancer, diabetes, and chronic respiratory diseases.

“To achieve our 2025 targets health systems must enhance the provision of services able to detect, manage and treat NCDs at the primary level. As per the Colombo Declaration endorsed at last year’s Regional Committee, Member countries are striving to make this happen,” she says.

“Nevertheless, given NCDs are primarily caused by unhealthy lifestyles, health systems alone cannot solve the problem – action across sectors is key. As demonstrated by its traffic light labelling system, Sri Lanka is taking the action needed to arrest and reverse its NCD burden. They are showing the Region – and the world – that change is possible.”

Indeed, though Shamima Marikar’s children may, like most below the age of six, have a taste for sugar, they are learning to resist and control the urge to consume it. When it comes to making healthier choices and avoiding NCDs, knowledge really is power.