Conclusion
Addressing noncommunicable diseases and injuries is not something that low- and middle-income countries can leave to the future. These conditions already account for a substantial share of the disease burden in most countries and are likely to increase further as these countries make progress in controlling infectious diseases and reducing the high rates of mortality and morbidity associated with childbearing and infancy.
Prevention, often through multisectoral public policies, is key, whether it involves educational efforts to promote healthier lifestyles, food regulations that discourage the use of unhealthy fats and oils by food manufacturers, urban transportation policies that encourage bicycling and wearing helmets, fiscal policies that tax tobacco and alcohol products, or cultural activities aimed at reducing social stigma attached to developmental disabilities. For the burden that remains, many cost-effective interventions are available and should be promoted. Where treatments are unavailable or not cost-effective, research is needed.
Prevention, care and treatment, and research are all activities that are facilitated by the presence of a strong and functioning health care system. If countries can successfully strengthen their health systems to improve the coverage of interventions that reduce infectious disease and maternal and neonatal conditions, building further capacity to address the demands that noncommunicable diseases will impose should be possible. The next two chapters address the range of policies available to build and strengthen health care systems so that they can meet these challenges.
Notes
1This section is based on DCP2, chapters 30, 33, 44, and 45.
2 Diabetes data combine both type 1 (an autoimmune disease that results from destruction of the pancreatic cells, leading to an absolute insulin deficiency) and type 2 (characterized by insulin resistance, in which target tissues do not use insulin properly, and inadequate insulin secretion from the pancreas), plus gestational diabetes. Type 2 diabetes, which has some of the same risk factors as CVD, now accounts for approximately 85 to 95 percent of all diagnosed cases of diabetes.
3This section is based on DCP2, chapter 29
4This section is based on DCP2, chapter 34.
5This section is based on DCP2, chapter 39.
6This section is based on DCP2, chapters 44 and 46.
7 High-risk alcohol use is defined differently for men and women. For men it is defined as consuming an average of more than 40 grams per day of pure alcohol, and for women the figure is more than 20 grams per day. This gender-specific difference reflects biological differences in metabolizing alcohol.
8This section is based on DCP2, chapter 47.
9This section is based on DCP2, chapters 31 and 32.
