Primary prevention of CNCDs: Translating knowledge into action

Chronic non-communicable diseases (CNCDs) are the leading causes of death worldwide. In 2008, 36 million deaths (almost 2/3rd of the total 57 million deaths) were due to CNCDs with cardiovascular diseases, cancers, diabetes mellitus and chronic lung diseases as the leading causes. The burden of CNCDs is disproportionately borne by low- and middle-income nations with over 80% of deaths occurring there, with 29% occurring under the age of 60. With increasing urbanization, changes from traditional lifestyles and economic transition, these nations face an accelerating burden of these conditions with adverse impact on human, social and economic resources. Additionally, CNCDs further stress the underfunded and overburdened health care systems. For most CNCDs, in the absence of a permanent cure, secondary and tertiary prevention strategies appear to be the norm. However, the cost of these interventions continue to accelerate due to factors such as increasing numbers needing care, rising use of expensive technology, and improved longevity offered by interventions. Four behavioral risk factors, namely, tobacco use, a sedentary lifestyle, alcohol misuse and unhealthy diet account for a large proportion of CNCDs globally. Modification of these behavioral risk factors requires interventions that cut across different sectors of the society. This paper, using empirical evidence, focuses on the multi-sectoral approaches necessary for primary prevention of CNCDs and highlights “lessons learned” in terms of policy, programs and service initiatives. Unless such interventions are implemented with adequate resources, the increasing burden of CNCDs will continue to be an impediment to development of humans and nations.