Intended for healthcare professionals


Commentary: UN high level meeting on non-communicable diseases: an opportunity for whom?

BMJ 2011; 343 doi: (Published 23 August 2011) Cite this as: BMJ 2011;343:d5336
  1. David Stuckler, university lecturer in sociology1,
  2. Sanjay Basu, physician2,
  3. Martin McKee, professor of European public health3
  1. 1Department of Sociology, Cambridge University, Cambridge CB2 3RQ, UK
  2. 2Department of Medicine, University of California San Francisco, San Francisco CA, USA
  3. 3London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to: D Stuckler ds450{at}

In September, world leaders will meet at the United Nations in New York to discuss non-communicable diseases.1 A decade ago, at a similar meeting on HIV/AIDS, they created the Global Fund for HIV/AIDS, Tuberculosis and Malaria—a revolutionary new global health funding mechanism.2

The September meeting will focus on four leading conditions—heart disease, cancer, diabetes, and respiratory disease—that together cause more than half of all deaths in low and middle income countries.3 Without action, the number of premature deaths (age < 60) caused by non-communicable diseases is expected to rise from 3.8 million each year to 5.1 million in poor countries by 2030, trapping a generation of families in cycles of poverty and disease.4 5 6 As Thomas Frieden, director of the US Centers for Disease Control and Prevention, recently stated, developing countries must immediately tackle the rapid rise of non-communicable diseases because they will “kill four times as many people by 2020 as infectious diseases.”7

Hopes are high that the UN meeting will mark a turning point and avoid the belated response that hampered HIV strategies. Progress on HIV required not only technical discussions about which drugs work and how to make them cost effective; it also needed to tackle the broader ethical, social, and political dimensions of the HIV pandemic.8

Throughout the process, the imperative to act was presented as one of social justice. It emphasised that HIV was a manifestation of inequalities in power and resources. Efforts by drug companies to protect long term patents on antiretroviral drugs were met by activists fighting for access to treatment and declaring that human lives in poor countries were just as valuable as those in rich ones.

Misconception and neglect

Non-communicable diseases, by contrast, remain neglected despite their social parallels to HIV.9 10 11 As with HIV, …

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