The role of local and regional authorities in prevention and control of NCDs: the case of Poland

BACKGROUND: Freedom from noncommunicable diseases is a component of the human right to health. The obligation to reduce the pandemic of civilisation diseases should result from the provisions of the constitution, national law and local regulations. This means that representatives of local and regional communities also take responsibility for limiting the pandemic of civilisation diseases. MAIN BODY: The goal of this debate is to examine the effectiveness of the decentralised polish model for dividing the competences of preventing and combating non-communicable diseases into three levels: local, regional and central. The representatives of regional and local communities are responsible for encouraging the inhabitants of their communities to change their lifestyle: eating habits, increase physical activity, remain outdoors more frequently, reduce stimulants, and apply prevention, namely undergo regular medical check-ups and provide the body with all the necessary nutrients. Limiting the proliferation of noncommunicable diseases also requires, in vertical terms, sound financial efforts on the part of local authorities. In the example of Poland, the claim about the effectiveness of the multi-level governance model which is presented in the literature will be verified. CONCLUSION: The excessive division of competences and the dispersion of resources between regional and local authorities may hamper the effective treatment and prevention of NCDs. A lack of cooperation between the central government, which carries out an independent policy on public health, and local authorities, which use only a portion of the public funds allocated to health, obstructs the debate on priorities at the societal level and does not encourage residents to take a stand on how to allocate extra funds.