Priorities for developing countries in the global response to non-communicable diseases

The growing global non-communicable disease (NCD) crisis is now killing 36 million people each year and needs urgent and comprehensive action [1]. Rapidly increasing globalization is accompanied by urbanization, population growth and ageing, and trends towards unhealthy lifestyles, including unhealthy diets, physical inactivity, obesity, and immoderate alcohol and tobacco use. Chronic NCDs are defined by the World Health Organization (WHO) as cardiovascular diseases (CVD), diabetes, chronic respiratory diseases, and cancer. This grouping of chronic NCDs reflects their association with common shared risk factors: harmful use of alcohol, tobacco use, physical inactivity and unhealthy diets [2]. Non-communicable diseases in low-income and middle-income countries currently account for 80% of the worldwide NCD mortality caused by CVD, cancers, diabetes and chronic lung diseases [3].Attention to NCDs is increasing for several reasons. First country-level data show that these conditions are contributing to epidemiological transition in a wide range of low- and middle-income countries [3]. Second, these data support estimated disease projections of a growing burden of morbidity and mortality associated with chronic NCDs. Third, NCDs have a huge negative economic impact [4] and represent a significant impediment to human development [5]. Fourth, recent progress in mobilising funds and improving the response to infectious diseases (especially HIV/AIDS, tuberculosis and malaria) has stimulated a broader global health outlook. These factors culminated in a United Nations (UN) High-Level Meeting on NCDs in New York in September 2011 [6].A worldwide goal for the prevention and control of NCDs has been proposed to complement existing MDG targets for communicable disease control, with the accompanying target of an additional 2% per year reduction in death rates attributable to the main chronic diseases (heart disease, stroke, cancer, diabetes, and chronic respiratory diseases) [7].