The US National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health, which is a founding member of the Global Alliance for Chronic Disease, has decided to go forward strongly and improve its plan to target chronic diseases in developing countries by collaborating with a leading health and wellbeing corporation. Together, they plan to build numerous centers of excellence (COEs) across the world. The details of this partnership have been published in a comment Online First and in this week’s edition of The Lancet.

The article in the comment is written by Dr Elizabeth G Nabel, director of NHLBI, Bethesda, MD, USA; Simon Stevens, executive vice president of UnitedHealth Group; and Dr Richard Smith, director of the UnitedHealth Chronic Disease Initiative. It mentions that cancer, type 2 diabetes, cardiovascular and chronic respiratory diseases are the major problems that face the developing nations with an astonishing 80 percent of chronic disease related deaths occuring in these poorer nations. These diseases are also responsible of causing more than half of all the deaths worldwide. The authors continue by saying: “If present trends continue unabated, annual deaths from chronic diseases will reach 41 million by 2015, and almost half of these will be in people younger than 70 years. Since the major causes of chronic diseases are known, half of these deaths are preventable.”

NHLBI has developed a partnership with UnitedHealth group, producing an association of COEs worldwide, including in Bangladesh, China, Guatemala, India, Kenya, Peru, South Africa-Tanzania, Tunisia, and the US-Mexico border. The authors say: “Each COE includes a research institution in a developing country paired with at least one partner academic institution in a developed country. The research goals span a range of activities tailored to regional needs and disease effect…Clearly, not only do chronic diseases know no boundaries, they also travel together. Thus, the consortium aims to broaden study beyond individual diseases, in keeping with WHO’s recommendation to address chronic diseases as they group in a real-world setting.”

The first COEs in the South Africa-Tanzania and China sites developed portable tools that can be used in the field to determine risk of chronic disease. The South African site is near completion putting emphasis on straightforward and comprehensive chronic disease management guidelines that can be used by nurses and community health workers. Some COEs, such as those in India-Bangalore, Guatemala, Tunisia, and along the US/Mexico border, are working with whole small communities; helping in redesigning entirely, including schools and workplaces so that choices are simple and practical. In general, the early results of the first COEs are very promising.

In conclusion, the authors mention: “The NHLBI and the UnitedHealth Group will work in partnership with…other entities to enhance synergy and to avoid duplication. To that end, the NHLBI is a founding member of the Global Alliance for Chronic Disease, a new alliance of six initial national biomedical research funders to address research needs in the chronic non-communicable diseases.

“Now is the time for sustained and coordinated scientific leadership to focus global efforts on combating the social, economic, and political toll of chronic disease. The NHLBI and UnitedHealth Group collaboration is an important piece of this public health initiative that is so vital for our global citizenry.”

“Combating chronic disease in developing countries”
Elizabeth G Nabel, Simon Stevens, Richard Smith
DOI: 10.1016/S0140-6736(09)61074-6
thelancet

Written by Stephanie Brunner (B.A.)