Intended for healthcare professionals


Preventing and managing chronic diseases

BMJ 2019; 364 doi: (Published 31 January 2019) Cite this as: BMJ 2019;364:l459
  1. Rachel Nugent, vice president global NCDs
  1. RTI International, Seattle, WA 98104, USA
  1. rnugent{at}

Would reduce the cost of healthcare and spur economic growth

Few expenses will drain a family’s financial and emotional resources faster than a member being affected by a serious chronic disease. Chronic (non-communicable) diseases such as cancer, diabetes, cardiovascular disorders, and lung disease are expensive to treat, often require lifelong care, and get much worse if treatment is delayed or is of poor quality.

This is why non-communicable diseases (NCDs) are the second theme of The BMJ’s series on health, wealth, and profits.1

Across the globe, NCDs are increasingly concentrated in low income and middle income countries and within these, increasingly among middle class and near poor people, who are most vulnerable to loss of wages and lack of quality healthcare. As in the richer world, patients in developing countries often experience multiple chronic diseases—requiring more complex and specialist driven care and exponentially raising the cost of care. Each of these situations offers plenty for health ministers and their bureaucracies to worry about, but each holds the possibility of solutions that extend and improve life, reduce financial stress, raise productivity, and lower overall healthcare costs.


Two thirds of global mortality in 2016 was attributable to the four major NCDs mentioned above and a handful of other chronic conditions.2 The risk of dying prematurely (under age 70) from one of those diseases …

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