Prevention and control of chronic diseases

Chronic diseases—cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes—are the leading global causes of death. Mental illnesses, injuries, osteoarthritis, and chronic kidney diseases also contribute substantially to disability but are often excluded from consideration. Of 58.8 million deaths globally, 60% were attributed to chronic diseases in 2004.1 Even in sub-Saharan Africa, where infectious diseases remain the major disease burden, with AIDS as the single leading cause of death, chronic diseases account for 25% of all deaths. Deaths from chronic diseases are projected to increase dramatically between now and 2030⇓.2

Chronic diseases are a heterogeneous group but many share underlying causes. Direct causes and risk factors for chronic disease, such as high blood pressure, diabetes, and raised blood lipids, are linked to lifestyle factors—for example, smoking, unhealthy eating, and physical inactivity. Although it is not unusual to blame individuals for their behaviours, societal factors often determine these behaviours.3 Such factors include the promotion of tobacco; the high levels of saturated and trans-fats, sugars, and salt hidden in processed foods; and urbanisation. Lack of progress on the control of chronic diseases is one of the major obstacles to achieving the health related millennium development goals.4

Myths about chronic disease have contributed to their neglect. A first …