Combating non-communicable diseases

Non-communicable diseases account for most of the global burden of disease. This share is forecast to grow in the decades ahead, particularly in low income and middle income countries.1 In the countries of eastern Europe, chronic non-communicable diseases among people of working age drive high rates of adult mortality.2 3 This obviously concerns the lives of the affected individuals and their families, but who else should be concerned about this?

Non-communicable diseases have not been considered sufficiently important to be included among the health related targets of the Millennium Development Goals, leading some to question the relevance of these goals for Europe's transitional countries.4 The resources earmarked for them are extremely low. Despite the obvious epidemiological trends, few countries have implemented comprehensive policies for preventing and controlling non-communicable diseases.5

The public health community has not made a sufficiently strong case for the importance of non-communicable diseases. Decision makers are unaware of the full health and economic burdens attributable to these diseases. This lack of awareness may have held back the actions needed to curb this rising toll.

A cynical, but not uncommon, response argues that, because deaths from non-communicable diseases occur mainly towards the end of an individual's working life, any relevant expenditure on public health would simply lengthen the lives of those who have already delivered their lifetime contribution to society. This argument is flawed (...)