Achievement of the global goal of reducing mortality rates due to chronic diseases by an additional 2% per year would avert 36 million deaths by 2015 and deliver major economic benefits. In this final paper in The Lancet Chronic Diseases Series, Professor Robert Beaglehole, University of Auckland, New Zealand and colleagues call for urgent action from a host of key players to deliver a serious and sustained effort to prevent and control chronic diseases.
Of all global deaths in 2005, 60% were because of chronic diseases, principally cardiovascular diseases and diabetes (32%), cancers (13%), and chronic respiratory diseases (7%).
The total yearly cost of delivering the tobacco control, salt reduction, and drugs for people at high risk of cardiovascular disease packages in the 23 countries highlighted earlier in the Series/press release would be US$5.8 billion (2005 figures). The authors point out that global emphasis on chronic diseases has been on a few key modifiable risk factors for chronic diseases -- eg, unhealthy diets, physical activity, and tobacco use. They say: "Many nations that are economically advanced have achieved major reductions in the toll of chronic diseases, especially of cardiovascular diseases. Most studies of these achievements suggest that prevention and health services bring about these reductions more or less equally."
At national level, the authors urge countries to give high priority to policies and funded programmes to tackle chronic diseases, and, among other things, to ratify the Framework Convention on Tobacco Control and implement the Global Strategy on Diet, Physical Activity and Health (see paper). They urge national and international non-governmental organisations to work much more closely together and promote evidence-based advocacy to support national authorities.
The authors say: "We urge the food and drinks industry to rapidly work towards the reformulation of foods high in fat, salt, and sugar to produce healthier and less energy dense products; to bring the full power of their advertising, marketing, and promotional forces to support healthy habits; and to ensure that positive initiatives to promote healthy habits in high-income countries become the norm in low-income and middle-income countries. We urge the pharmaceutical industry ensure the availability, affordability, and accessibility of low-cost generic drugs for the management of people at high risk of chronic diseases, especially cardiovascular diseases."
A call is also made to civil society to engage more seriously with the threat posed by chronic diseases, and to ensure the needs of disadvantaged populations are met as a priority; and to academics to participate fully in development, implementation and assessment of programmes for chronic disease prevention and control. The authors say: "We urge academics to focus their research efforts on implementation research questions that are relevant to low-income and middle-income countries."
The authors call for stronger global leadership on chronic diseases from WHO, and call on it to progressively increase financial support for tackling chronic diseases. And regarding donor agencies, the authors say: "We urge the World Bank and regional banks, other development agencies, and foundations to formally recognise chronic diseases as a major impediment to development and increase their financial support for programmes for chronic disease prevention and control to a level that is commensurate with their burden."
The authors and experts worldwide have established The Chronic Disease Action Group to encourage, support, and monitor action to prevent and control chronic diseases. The authors conclude: "We call for urgent and intensified action from all stakeholders to respond to the chronic disease epidemics on the basis of all the available evidence, including that presented in this Series. The evidence is unequivocal: major and rapid health and economic gains are possible with only modest investments in prevention and control of chronic diseases."
This paper associated with this release can be found at http://www.eurekalert.org/jrnls/lance/CD5.pdf
Journal
The Lancet