Scaling up chronic disease prevention interventions in lower- and middle-income countries

Abstract

Chronic diseases are increasingly becoming a health burden in lower- and middle-income countries, putting pressure on public health efforts to scale up interventions. This article reviews current efforts in interventions on a population and individual level. Population-level interventions include ongoing efforts to reduce smoking rates, reduce intake of salt and trans-fatty acids, and increase physical activity in increasingly sedentary populations. Individual-level interventions include control and treatment of risk factors for chronic diseases and secondary prevention. This review also discusses the barriers in interventions, particularly those specific to low- and middle-income countries. Continued discussion of proven cost-effective interventions for chronic diseases in the developing world will be useful for improving public health policy.

Figure 1

Data are from the New England Cost-Effectiveness Registry. QALY, quality-adjusted life year. From Cohen et al. 2008 (14) with permission.

Figure 2

Relationship between cigarette consumption and excise tax rate in South Africa, 1980–2006. From Van Walbeek (98).

Figure 3

Percentage of the use of medications versus per capita health expenditures. From Yusuf et al. 2011 (114). ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; CHD, coronary heart disease.