How the European Union legislations are tackling the burden of diabetes mellitus: A legal surveillance study

Introduction

Surveillance of the European Union's (EU) legislations on the prevention of diabetes mellitus (DM) is needed, to more effectively tackle the rising prevalence of DM.

Methods

This legal surveillance was carried out through a systematic search and screening, using EUR-Lex database to identify treaties, acts, and other legal documents for prevention of DM, non-communicable diseases (NCDs) and obesity, followed by their content analysis and assessment according to DM specific guidelines, target population and functional categories.

Results and discussion

We found 22 legislations aimed at preventing DM, NCDs and obesity, but only 5 out of them specifically addressed preventing DM. The aims of legislations covered a broad spectrum of themes indicated by DM specific guidelines, mostly initiatives of life-course approach in preventing DM, NCDs and obesity from the area of energy intake. The target group of most legislations was the general population; high-risk subgroups such as pregnant women were hardly ever the primary target group. Our results prove that the EU has made cross-sectoral legislative efforts to reduce the disease burden and prevent DM but does not exhaust all possibilities. However, given its persistently rising DM prevalence, it is imperative to make sure that DM is a top health priority for various EU authorities and is incorporated into new initiatives, policies and laws.

Analysis of Content, Social Networks, and Sentiment of Front-of-Pack Nutrition Labeling in the European Union on Twitter

In recent years, concerted political efforts have been made at the national and European Union (EU) level to promote the consumption of healthy foods. The European Commission (EC) expressed the need for a harmonized and mandatory front-of-pack nutrition labeling (FOPL) system at the EU level. The EC will adopt the proposal by the end of 2022. Our research work aims to understand the public discourse on FOPL in the EU via Twitter, by analyzing tweet content, sentiment, and mapping network characteristics. Tweet search and data collection were performed using the Twitter application programming interface (API), with no time or language restrictions. The content was coded with the QRS Nvivo software package and analyzed thematically. Automatic sentiment analysis was performed with QSR Nvivo, and network analysis was performed with Gephi 0.9.2. A total of 4,073 tweets were posted, mostly from the UK, Spain, and France. Themes that have emerged from the discussion on Twitter include the types of food labeling, food industry, healthy vs. unhealthy foods in the context of food labeling, EU regulation, political conflicts, and science and education. Nutri-Score dominated the discussion on Twitter. General topics were perceived negatively by Twitter users with more positive sentiments toward the food industry, while negative sentiments were observed toward the discourse of political conflicts. The network analysis showed that a centralized communication was hardly existed between countries. Our results reveal that the discussion of FOPL on Twitter is limited to a very limited group of people, and it seems necessary to inform a wide range of consumers about existing and upcoming FOPL schemes. Educational programs should empower consumers to understand what a healthy diet is and how it relates to FOPL, regardless of the existing labeling system.

The Pattern of Vector Control in Malaria Endemic Areas of Central Java Province

Malaria remains a public health problem in Indonesia, therefore, a study was conducted to guarantee a reduction in malaria cases and to support an elimination program. This study aims to determine the patternof vector control in malaria-endemic areas of Central Java Province from August to December 2016, through searching of reports and articles on malaria vector control. Malaria eradication efforts that were carried out included curative treatment and preventive action, by controlling the vector. Meanwhile, malaria vector control in Central Java Province from 2011 to 2015, includes insecticide-treated mosquito nets, larvae fish spreading, repellent use, indoor residual spraying, and larviciding. However, several obstacles to malaria vector control include, increase in the number of breeding sites, population movements from malaria endemic areas, presence of imported cases, geographic condition, attitude and behavior of people, policy differences in governance, and insufficient control budgets. Malaria is always present in Central Java Province, due to differences in vector control programme, mode of control, time, and budget. Therefore, malaria vector control policies depend on legislation, local regulation, cross-sectoral budget, support, and contribution.