In First Year, Global Fight Against NCDs Gathers Momentum

Cancers, cardiovascular diseases, chronic lung diseases and diabetes -- four of the biggest killers among the group together known as non-communicable diseases (NCDs) -- have emerged as one of the greatest social and economic development challenges of this century. From a global health perspective, NCDs now account for more deaths every year than AIDS, tuberculosis, malaria and all other causes combined -- they result in roughly two out of three deaths worldwide.

On the first anniversary of the United Nations High-Level Meeting on NCDs where the world formally acknowledged the urgent need for action on these under-recognized diseases, it makes sense to assess how far we've come, as well as how much further we need to go. At that meeting, countries unanimously adopted a political declaration that committed them to reduce the toll of NCDs by strengthening national responses and increasing international collaboration.

It's been a remarkable year. During the past 12 months, health workers, policymakers and activists rallied around the High-Level Meeting to build a robust civil society movement, which has continued to gather momentum.

Two studies in 2011 opened the world's eyes to the cost of NCDs: a World Economic Forum/Harvard University study estimated that the cumulative economic loss from the four major NCDs will amount to a staggering $30 trillion by 2030, and a World Health Organization (WHO) analysis showed that the costs of key public health interventions (such as tobacco control and salt reduction) are affordable in all countries, and would cost just cents per day per person. These studies showed that the costs of inaction far outweigh the costs of action.

Then, in May 2012, at the annual meeting of health ministers at WHO, all countries agreed to a significant "25 by 25" target -- a 25 percent reduction in mortality from NCDs by year 2025. And we are encouraged that the Rio+20 Declaration "The Future We Want," acknowledged NCDs and recognized that the goals of sustainable development can only be achieved in the absence of a high prevalence of both debilitating communicable diseases and NCDs.

Despite this progress, much more remains to be done, and it needs to be done urgently. Not only do NCDs account for 36 million deaths a year, their impact is in all countries and is on the rise. Indeed, they take their heaviest toll on the poorest populations in low- and middle-income countries: more than 80 percent of all deaths from NCDs take place in these countries.

Fortunately, these diseases are largely preventable. According to the WHO, about 80 percent of heart disease and type 2 diabetes and up to 40 percent of cancers can be prevented by maintaining a healthy lifestyle: by eliminating tobacco, avoiding harmful alcohol, engaging in adequate physical activity and eating a healthy diet.

Looking ahead, we recognize that in these harsh economic times governments may have difficulty prioritizing NCDs in their health and development agendas. However, it is important to continue to acknowledge that both the causes and consequences of NCDs extend far beyond the health sector. NCDs are too big an issue for any one entity or government agency to tackle on its own. Multi-sectoral, collaborative and bold action is needed.

Steps are being taken to tackle NCDs across UN agencies, and countries are being encouraged to develop national NCD plans. We are hopeful that the WHO will soon establish clear, ambitious and realistic global targets, supported by action plans, that a monitoring and accountability framework will be set up and several UN agencies will work together to address NCDs. We are optimistic that governments will engage their ministries of health, finance, transportation, urban design and agriculture -- among others -- to prioritize and invest in prevention, surveillance and strengthening their health systems to deal with NCDs. We expect that international development institutions will also begin to prioritize NCDs in their work. And, all of society including the private sector, non-profits and civil society should be fully engaged in this fight.

But it is not only governments and institutions that have to deliver: the fight against NCDs must involve individuals and families. The rise in NCDs is driven by complex changes in the patterns of our daily lives. Achieving the needed long-term changes in behavior to reverse the trend is challenging. While policy changes will deliver the biggest impact in the near-term, long-term success will depend on individual behavior change. We must mobilize people to make lifestyle changes that will prevent and minimize the impact of these diseases and change the environment to make the healthy choice the easy choice.

Significant questions remain about how to best tackle NCDs. Watch this space for a series of opinion articles reminding world leaders as they come to New York to attend the United Nations General Assembly, to continue to keep NCD issues top of mind.

We know the challenges ahead are difficult but there is hope. Success -- whether it comes from creating policies or environments that support healthy choices or encouraging individual behavior change -- depends on our abilities to make the necessary changes -- and we can. Nothing less than our very best will do to ensure that our children inherit a better world with brighter, healthier futures. The NCD movement is gathering momentum to realize this vision.

Sir George Alleyne is director emeritus of the Pan-American Health Organization. Dr. Nils Daulaire is director of the Office of Global Affairs in the U.S. Department of Health & Human Services and serves as the U.S. Representative on the World Health Organization's Executive Board.

This is one in a series of articles being published to mark the first anniversary of the 2011 United Nations High-Level Meeting on Non-Communicable Diseases on Sept. 19. The series is coordinated by the non-profit organization Arogya World in partnership with the Young Professionals Chronic Disease Network and will be housed at