Donors have for too long been tone-deaf to the increasingly robust scientific basis of the global threat caused by chronic diseases, says Dr Richard Horton, Editor of The Lancet, in his Comment which opens The Lancet Chronic Diseases Series.
Since The Lancet published its first series and call to action on Chronic Diseases in 2005, when global efforts to control chronic diseases were described as "the neglected development goal", progress has been made -- largely thanks to WHO's consistent advocacy for the non-communicable disease agenda, which was given a huge injection of energy with the agency's 2005 report Preventing chronic diseases: a vital investment.
Dr Horton says: "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."
He adds: "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 favour broader behavioural and health-system reforms to avert chronic diseases such as diabetes, specific data on cost-effectiveness remain to be gathered. Policymakers face a difficult judgement 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."
Praising WHO's leadership on the chronic disease agenda, Dr Horton also argues: "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."
He concludes by saying that, along with the recent Lancet Series on Global Mental Health, "this latest report on chronic disease lays down the scientific foundations to build civil society and advocacy, and so change national and global policy. 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."
This paper associated with this release can be found at http://www.eurekalert.org/jrnls/lance/CDcomment.pdf
Journal
The Lancet