Early Life Opportunities for the Prevention of Noncommunicable Disease in Developing Countries
Non-communicable disease (NCD), particularly cardiovascular disease, diabetes, cancer and obstructive lung disease, causes 35m deaths/year, 60% of all deaths globally. 80% of these deaths occur in low- and middle income countries. NCD is increasing alarmingly (WHO estimates a 17% increase over the next decade globally, with a 27% increase in Africa, 25% in the Eastern Mediterranean and the highest number of deaths in the Western Pacific and South-East Asia). NCD constitutes a serious threat to human productivity, a substantial economic burden and a major challenge to the fabric of society in many parts of the world. There are several components to the increase in NCD: lifestyle change with socio-economic improvement, reductions in infectious disease and changing population structure with increased life expectancy and falling birth rates. Overall, the global public health burden is shifting rapidly towards NCD, especially in the developing world where it may magnify the economic dependency of low income countries.
Prevention of NCD is now recognised to require a life-course approach, starting in early life because interventions in adults may come too late. NCD prevention was not part of the Millennium Development Goals. However, the UN General Assembly agreed in May 2010 to convene a Summit of world leaders on the prevention of NCD in developing countries in September 2011.
China represents one of the countries in which the burden of NCD will be greatest. Current data indicate that 100 m people are suffering diabetes, and twice that number show signs of pre-diabetes, in China. Given the considerable research in public health, epidemiology, underlying mechanisms and biomarkers, and translational clinical medicine being undertaken in the partner institutions of the WUN, it was important for WUN to present a concerted view on the prevention of NCD. An expert group met in Shanghai in May 2011 for this purpose. At the request of WHO, this group, comprising academics from WUN and in the developing world, aid agencies and the private sector, formulated a consensus statement on early life opportunities for addressing NCDs.