Dele O Abegunde, Department of Chronic Diseases and Health Promotion, WHO
Colin D Mathers, Department of Measurement and Health Information Systems, WHO
Taghreed Adam, Monica Ortegon, Department of Health Systems Financing, WHO

Kathleen Strong, Department of Chronic Diseases and Health Promotion, World Health Organization, Geneva , Switzerland

The Lancet,  Volume 370, Number 9603, 8 December 2007

Available online at: http://www.thelancet.com/journals/lancet/article/PIIS0140673607616961/fulltext

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“…..This paper estimates the disease burden and loss of economic output associated with chronic diseases—mainly cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes—in 23 selected countries which account for around 80% of the total burden of chronic disease mortality in developing countries.

 In these 23 selected low-income and middle-income countries, chronic diseases were responsible for 50% of the total disease burden in 2005. For 15 of the selected countries where death registration data are available, the estimated age-standardised death rates for chronic diseases in 2005 were 54% higher for men and 86% higher for women than those for men and women in high-income countries.

If nothing is done to reduce the risk of chronic diseases, an estimated US$84 billion of economic production will be lost from heart disease, stroke, and diabetes alone in these 23 countries between 2006 and 2015. Achievement of a global goal for chronic disease prevention and control—an additional 2% yearly reduction in chronic disease death rates over the next 10 years—would avert 24 million deaths in these countries, and would save an estimated $8 billion, which is almost 10% of the projected loss in national income over the next 10 years…..”

Scaling up interventions for chronic disease prevention: the evidence

Thomas A Gaziano,   Harvard Medical School , Boston , MA , USA
Gauden Galea , WHO, Geneva , Switzerland
K Srinath Reddy,  Public Health Foundation of India , New Delhi , India
The Lancet,  Volume 370, Number 9603, 8 December 2007

Available online at: http://www.thelancet.com/journals/lancet/article/PIIS0140673607616973/fulltext

[Free subscription required]

“…….Interventions to prevent morbidity and mortality from chronic diseases need to be cost effective and financially feasible in countries of low or middle income before recommendations for their scale-up can be made. We review the cost-effectiveness estimates on policy interventions (both population-based and personal) that are likely to lead to substantial reductions in chronic diseases—in particular, cardiovascular disease, diabetes, cancer, and chronic respiratory disease. We reviewed data from regions of low, middle, and high income, where available, as well as the evidence for making policy interventions where available effectiveness or cost-effectiveness data are lacking.

The results confirm that the cost-effectiveness evidence for tobacco control measures, salt reduction, and the use of multidrug regimens for patients with high-risk cardiovascular disease strongly supports the feasibility of the scale-up of these interventions. Further assessment to determine the best national policies to achieve reductions in consumption of saturated and trans fat—chemically hydrogenated plant oils—could eventually lead to substantial reductions in cardiovascular disease.

Finally, we review evidence for policy implementation in areas of strong causality or highly probable benefit—eg, changes in personal interventions for diabetes reduction, restructuring of health systems, and wider policy decisions…..”