Global prevention and control of NCDs: Limitations of the standard approach

Neil Pearce^{1

2}, Shah Ebrahim¹, Martin McKee³, Peter Lamptey¹, Mauricio L Barreto⁴, Don Matheson², Helen Walls^{1

5

6}, Sunia Foliaki², J Jaime Miranda⁷, Oyun Chimeddamba⁸, Luis Garcia-Marcos^{9

10}, Andy Haines¹¹, Paolo Vineis¹²

Affiliations

¹ Centre for Global NCDs, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
² Centre for Public Health Research, Massey University, Wellington, New Zealand.
³ European Centre on Health of Societies in Transition (ECOHOST), London School of Hygiene and Tropical Medicine, London, UK.
⁴ Instituto de Saude Coletiva, Federal University of Bahia, Bahia, Brazil.
⁵ Leverhulme Centre for Integrative Research on Agriculture and Health, London, UK.
⁶ The Australian National University, Canberra, Australia.
⁷ CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
⁸ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine (SPHPM), Monash University, Melbourne, Australia.
⁹ Respiratory and Allergy Units, Arrixaca University Children's Hospital, University of Murcia and IMIB-Arrixaca Research Institute, Spain.
¹⁰ IMIB-Arrixaca Research Institute, Murcia, Spain.
¹¹ Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.
¹² MRC-PHE Center for Environment and Health, School of Public Health, Imperial College London, London, UK.

PMID: 26377446
PMCID: PMC7612864
DOI: 10.1057/jphp.2015.29

Global prevention and control of NCDs: Limitations of the standard approach

Neil Pearce et al. J Public Health Policy. 2015 Nov.

. 2015 Nov;36(4):408-25.

doi: 10.1057/jphp.2015.29. Epub 2015 Sep 17.

Authors

Affiliations

¹ Centre for Global NCDs, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
² Centre for Public Health Research, Massey University, Wellington, New Zealand.
³ European Centre on Health of Societies in Transition (ECOHOST), London School of Hygiene and Tropical Medicine, London, UK.
⁴ Instituto de Saude Coletiva, Federal University of Bahia, Bahia, Brazil.
⁵ Leverhulme Centre for Integrative Research on Agriculture and Health, London, UK.
⁶ The Australian National University, Canberra, Australia.
⁷ CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
⁸ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine (SPHPM), Monash University, Melbourne, Australia.
⁹ Respiratory and Allergy Units, Arrixaca University Children's Hospital, University of Murcia and IMIB-Arrixaca Research Institute, Spain.
¹⁰ IMIB-Arrixaca Research Institute, Murcia, Spain.
¹¹ Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.
¹² MRC-PHE Center for Environment and Health, School of Public Health, Imperial College London, London, UK.

PMID: 26377446
PMCID: PMC7612864
DOI: 10.1057/jphp.2015.29

Abstract

The five-target '25 × 25' strategy for tackling the emerging global epidemic of non-communicable diseases (NCDs) focuses on four diseases (CVD, diabetes, cancer, and chronic respiratory disease), four risk factors (tobacco, diet and physical activity, dietary salt, and alcohol), and one cardiovascular preventive drug treatment. The goal is to decrease mortality from NCDs by 25 per cent by the year 2025. The 'standard approach' to the '25 × 25' strategy has the benefit of simplicity, but also has major weaknesses. These include lack of recognition of: (i) the fundamental drivers of the NCD epidemic; (ii) the 'missing NCDs', which are major causes of morbidity; (iii) the 'missing causes' and the 'causes of the causes'; and (iv) the role of health care and the need for integration of interventions.

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Comment in

Inadequate collaboration: A challenge to reaching global targets for non-communicable disease control and prevention.
Christiani Y, Tavener M, Byles JE, Dugdale P. Christiani Y, et al. J Public Health Policy. 2016 Feb;37(1):114-7. doi: 10.1057/jphp.2015.44. Epub 2015 Dec 17. J Public Health Policy. 2016. PMID: 26675147 No abstract available.

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Global prevention and control of NCDs: Limitations of the standard approach

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Global prevention and control of NCDs: Limitations of the standard approach

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Medical