Donors Need To Respond To The Reality Of Chronic Disease Worldwide

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Main Category: Public Health
Article Date: 05 Dec 2007 - 0:00 PDT

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Chronic diseases worldwide have not caught the attention enough of donor nations and institutions, according to Dr. Richard Horton, Editor, The Lancet, in a Comment published in this week's issue of The Lancet - Chronic Disease Series.

In 2005, The Lancet published its first series and a call to action, "Chronic Diseases in 2005". At that time, worldwide efforts to tackle chronic diseases were seen as "the neglected development goal". Thanks largely to the World Health Organization's (WHO's) consistent advocacy for the non-communicable disease agenda, things have started to move ahead.

Dr Horton writes "Thanks to a continued collaboration between The Lancet and a remarkable team of scientists from WHO, together with public health experts from the USA, India, Mexico, New Zealand, Australia, UK and Switzerland (all working under the independent umbrella of the Chronic Disease Action Group), we now launch a second, deeper, and we believe more nuanced report that aims to extend our understanding, not only of the impact of chronic diseases on human development but also of what can be achieved through interventions at the population and individual levels to prevent and treat some of these conditions."

"As one might expect, the cost-effectiveness evidence for tobacco control, salt restriction, and drug treatment for high-risk cardiovascular disease is compelling in low-income and middle-income countries. Gaps remain, however, in the evidence to support policies to reduce dietary saturated and trans fat. And although arguments about causality and probable benefit would favor broader behavioral and health-system reforms to avert chronic diseases such as diabetes, specific data on cost-effectiveness remain to be gathered. Policymakers face a difficult judgment call. What level of evidence should they require before intervening? The authors of The Lancet report argue that evidence is not dichotomous - it is not merely present or absent. Instead, our reasoning is a continuum that should, under certain conditions, trigger action combined with careful evaluation."

"The World Bank, foundations, the private sector, and governments need to play catch-up. A few enlightened nations, such as the UK and Canada, are enthusiastically responding to invitations to act."

As was the case in this year's Lancet Series on Global Mental Health, Horton concludes that this latest report on chronic diseases lays down the first stone to building the scientific foundations of civil society and advocacy.

He wrote "The value of independent science generated through innovative collaborations across countries and between institutions, mediated through established scientific reporting channels, has the potential to transform our approach to some of the most intractable health challenges facing humankind."

-- www.thelancet.com

Written by - Christian Nordqvist

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