“I wish I had AIDS and not diabetes,” a man in Cambodia was heard to say. He was speaking to UN representative Princess Dina Mired of Jordan. The man was not commentating on the diseases themselves but highlighting the fact that with AIDS he could be treated for free in a modern facility whereas treatment for diabetes was unaffordable in his country.

Such is the plight of some patients with chronic diseases in low and middle income countries, that the UN general assembly unanimously voted to convene a special summit on non-communicable diseases—cancer, cardiovascular disease, respiratory illnesses, and diabetes—to be held in New York on 19-20 September.

Many hope that this meeting will force non-communicable diseases into the spotlight just as the first health related UN summit did for AIDS a decade ago. But non-communicable diseases do not have the high profile AIDS campaigners, gay activists, and celebrities ramping up pressure on governments to act.

The NCD Alliance, a group of international federations representing the four main non-communicable diseases, and public health professionals have quietly pieced together evidence for action on a group of chronic illnesses that the influential World Economic Forum has placed high on its list of global financial risks.1 One estimate is that $84bn (£51bn; €59bn) of economic output will be lost between 2005 and 2015 as a result of non-communicable diseases.2

But years of planning may be set to unravel. With only weeks to go before the summit, years of negotiations seem to be stalling. Discussions have stopped on the document that forms the spine of the summit, and charities are …