What are the priorities for prevention and control of non-communicable diseases and injuries in sub-Saharan Africa and South East Asia?

BMJ 2012; 344 doi: (Published 02 March 2012) Cite this as: BMJ 2012;344:e586
  1. D Chisholm, health economist1,
  2. R Baltussen, senior scientist2,
  3. D B Evans, director1,
  4. G Ginsberg, health economist3,
  5. J A Lauer, economist1,
  6. S Lim, associate professor4,
  7. M Ortegon, researcher5,
  8. J Salomon, associate professor6,
  9. A Stanciole, economist7,
  10. T Tan-Torres Edejer, team coordinator1
  1. 1Department of Health Systems Financing, World Health Organization, Geneva, Switzerland
  2. 2Department of Primary and Community Care, Radboud University, Netherlands
  3. 3Department of Medical Technology Assessment, Ministry of Health, Jerusalem, Israel
  4. 4Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
  5. 5School of Medicine, Universidad del Rosario, Bogotá, Colombia
  6. 6Department of Global Health and Population, Harvard School of Public Health, Boston, USA
  7. 7World Bank, Washington, DC, USA
  1. Correspondence to: D Chisholm chisholmd{at}

Last year’s UN high level meeting sought to galvanise the international community into scaling up its response to the escalating global burden of non-communicable diseases. With resources tight, D Chisholm and colleagues examine which interventions should be given priority for action and investment

The millennium development goals adopted in 2000 laid down a core development agenda to which key international partners have since closely adhered, while a special session of the UN General Assembly held in 2001 on HIV/AIDS paved the way for a large and sustained international response to that emerging epidemic.1 Ten years on, high level delegates recently attended a second special session of the UN General Assembly on health, this time to discuss what to do about the rising epidemic of non-communicable diseases (NCDs) and how to integrate them into future development activities.2

A key issue for debate—both for delegates at the summit and for subsequent roll-out by countries—concerns the policies and strategies that could or should form the backbone of a renewed commitment to tackling non-communicable disease. Several criteria influence the selection of global or national strategies for prevention and control, including the current and projected burden of disease, cost effectiveness, fairness, and feasibility of implementing interventions, and political considerations. We have conducted a series of analyses focusing on cost effectiveness of interventions (see 4 5 6 7 8 Here we draw together our findings with a view to identifying those strategies that offer the best value for money in tackling non-communicable diseases and injury in low income settings. The analyses complement an earlier BMJ series on the cost effectiveness of interventions focused on attainment of the millennium development goals.9

Comparative analysis of value for money in health

We have assessed the costs and effects of over 500 single or combined interventions for the prevention and control of non-communicable …

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