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Speech of Sec. Enrique T. Ona Philippine World Health Day 2013: Scientific Symposium on Controlling Hypertension and Reducing Salt Consumption

April 8, 2013


8 April 2013  |   1:30 PM    |   Bayleaf Hotel, Intramuros, Manila

Let me address all of you as my fellow health workers and dear friends.

First of all, I would like to greet everyone a Happy World Health Day! Every 7th of April marks the anniversary of the founding of the World Health Organization (WHO) in 1948. And each year, WHO selects a theme highlighting a priority area of public health concern in the world. For this year, the theme for World Health Day 2013 is controlling high blood pressure, a condition which affects more than one in three adults worldwide.

This theme is timely and relevant as all nations in the world suffer from non- communicable diseases represented by the “fatal four” diseases, namely: cardiovascular disease, cancer, diabetes, and chronic respiratory disease. Globally, cardiovascular diseases are the number one cause of death. They account for approximately 17 million deaths in the world today each year. And I think this figure has been repeated by the two previous speeches in the opening this morning at the World Health Organization presentation to our President.

Complications of high blood pressure, also called hypertension or raised blood pressure, account for more than nine million of these deaths, including about half of all deaths from heart disease and stroke. The number of people with high blood pressure rose from something like 600 million in 1980 to almost 1 billion in 2008 based on WHO data.

In the Philippines, there is also an alarming increase of non- communicable diseases. In 2009, the Philippine Health Statistics Data shows that about 35% of total deaths or 167,000 Filipinos died from heart attack and stroke. Half of these tragic deaths are related to high blood pressure. To date, there are almost 14 million Filipino adults aged 20 and above that are hypertensive and this is according to a study of Food and Nutrition Research Institute of the Department of Science and Technology (FNRI- DOST).


Furthermore, in 2008, the National Statistics Office of the Philippines reported that cardiovascular disease, cancer, diabetes, and chronic respiratory disease were responsible for 54% of all deaths in the Philippines. And disturbingly, 30 to 50 percent of deaths occurred prematurely, that is before 60 years of age.

Unlike infectious diseases, NCDs are highly multi- factorial in nature brought about by modifiable as well as non- modifiable risk factors. Of course, we cannot change under normal circumstances our age, our gender, and even hereditary factors but we can change our unhealthy behaviors, which are an unbalanced diet, a lack of physical activity, smoking, harmful use of alcohol together and stressful lifestyles.

Sodium intake is another factor involved in the development of high blood pressure. A research cited in the Centers for Disease Control and Prevention shows a dose-dependent relationship between consuming too much salt and elevated blood pressure. When salt intake is reduced, blood pressure begins decreasing for most people within a few days to weeks.

However, Filipinos eat too much sodium, commonly consumed as salt. Average salt consumption among Filipinos is said to be high at about 10grams/capita/day in reference to the WHO recommendation of only half of that. High salt consumption was noted to be more prevalent especially in rural areas, but overweight and obesity were notably higher in urban areas.


Sodium is a part of everyone's diet, but how much is too much? Under ideal conditions, the minimum sodium requirement is about 1,500 milligrams (mg) of sodium each day. This is less than a teaspoon of table salt. The maximum recommended level of sodium intake is about 2,300 mg per day.Decreasing sodium intake to within recommended limits could prevent supposedly thousands of deaths annually and I think we have to validate this for the Filipinos.

Aside from reducing salt intake, early detection and treatment of hypertension is important. Detecting high blood pressure is the first step in preventing and controlling it; when people know their blood pressure level, they can take steps to control it. The Department of Healthjoins the World Health Day celebration with the battle cry, “Blood Pressure: Alamin at Kontrolin”to raise awareness and call for individual actions on addressing this malady.

The Department of Health recognizes the interplay of the social and environmental determinants on the prevalence of NCDs. Hence, with interagency collaboration several interventions have been promoted by the Department of Health.

Early health education on the importance of healthy lifestyle among children is important; thus, the DOH, NCD coalition and the Department of Education are working together to incorporate healthy lifestyle topics in the K to 12 curriculum. Currently, health subjects in schools are conducted twice a week. And also, our agency is coordinating with the UP College of Public Health to offer Health Promotion Specialist Certification Programamong our central and regional staff followed by LGUs starting next school year. 

To ensure that our school children are eating healthy and balanced diet while in school, we will soon launch the Healthy Canteen Certification Program among private and public schools. And together with the National Nutrition Council (NNC) and the FNRI- DOST, we are crafting our own version of the Pinggan Ng Kalusugan (Healthy Plate) which is an easy-to-read guide for parents and health caregivers on preparing a well-balanced meal.  This will not replace the Filipino Food Pyramid Guide but rather further enhance it.

The DOH, FDA, NCD Coalition, Nutritionists-Dieticians’ Association of the Philippines together with the WHO is forming the guidelines for a voluntary Healthy Food Certification Program to set the limits on calorie, fat, sugar and salt content of a processed food product. This way, Filipino consumers will be given healthy options on food products. Also, the possibility of Mandatory Food Labelingis currently being studied. It is like putting traffic light codes on food products where red means unhealthy, yellow means somewhat unhealthy and green means that the product is healthy. This has been done by several countries and may be it is time to look into how this can be done in our country.

Our battle against sedentary lifestyle is long been ongoing with our Galaw Galaw Araw Arawexercise video using steps culled from several household chores like paglalaba, pagwawalis andpaghehelengsanggol, among others, as well as the Banat Ni Lolo, Hirit Ni Lolaexercise video for senior citizens. Also, with the initiatives of DepEd, DILG, some local government units (LGUs) and Ang Batang PinoyFoundation, the Dance For Health has started as a regular dance- aerobic exercise program in some LGUs. Asec.Tayag is the prominent figure actively promoting dancing for healthy lifestyle change.  Moreover, DOH works in partnership with the labor sector for the promotion of healthy lifestyle in workplaces in our program, iFLY - (KEEP FIT. LIVE WELL. STAY YOUNG.).

And the most recent DOH initiative is the Belly Good For Health Executive Edition, of which I am a participant and most likely one of the failures. The challenge among the DOH executives is to reduce weight and to achieve a normal waist circumference in 6 months with a schedule of workouts, fitness camps, and diet prepared by a personal fitness mentor despite our very heavy schedules.


To capsulize all these individual campaigns into one major program, the DOH is consulting various groups on what will become a Healthy Lifestyle Programto be lodged at National Center for Health Promotion. This program will focus on four (4) behavioral risk factors, namely: smoking, harmful use of alcohol, physical inactivity, and unhealthy diet. While waiting for the creation of this program, the National Center for Health Promotion launched last January 2013, the Healthy Lifestyle Movement Campaign targeting the youth and the workforce, and heavily using the web-based social media networks as well as the traditional media formats – TV, radio and print.

We hope to reduce the NCD problem in the country with the passage of the Sin Tax.Aside from the Sin Tax, DOH together with our partners, the LGUs, are accelerating efforts for promotion of 100% smoke- free public places.

The social cost of NCDs, hypertension in particular is more felt by the poorer segments of our society. In some countries, money spent on cardiovascular diseases alone can be one fifth of the total health expenditure. The catastrophic effects are devastating for both families and health systems: early death, disability, household disruption, loss of income, a diminished workforce, and medical care expenditures that take their toll on families, communities and national health budgets.

Hence, through our vision of Universal Health Care for all Filipinos, we are improving our health insurance coverage and utilization of its services, whichare being undertaken simultaneously with efforts to upgrade our health facilities and hospitals so that health care services to manage NCD caseswill be accessible and affordable particularly to the poor Filipino families. 

Philhealth- accredited health facilities provide outpatient services included in the Primary Care Benefit Package 1which is linked with Philippine Package Of Essential Non-Communicable Disease Interventions(Phil PEN).

Also, our national health insurance providesin-patient services to selected non- communicable diseases like hypertension and stroke in which poor Filipino patients can avail without spending a single centavo. In addition, Philhealth has expanded the Z BENEFIT PACKAGE to address NCDslike heart diseases andselected cancers.

For the past three years, a total of P15.4 billion was invested to upgrade, rehabilitate and construct health facilities through the Health Facilities Enhancement Program (HFEP) toimprove availability and access to quality health care services.

We are optimistic that through all of these health advocacies, we will achieve Universal Health Care for all Filipinos. Indeed, non- communicable disease is a disease of the society and not of the individual alone that is essentially preventable and quite controllable. And through our joint efforts we will win this challenge against hypertension and NCDs in the Philippines.

With that, I would like to congratulate the WHOon their 65th anniversary. And to all of you thank you to all your invaluable support in attaining our national health goals.

Good afternoon and Mabuhay tayong lahat!