20 'Grand Challenges' in Chronic Non-Communicable Diseases Is Roadmap to Reduce Rising Toll of Slow Killer Illnesses
Several of the world's most eminent health scientists and organizations have published a landmark global consensus on the 20 foremost measures needed to curb humanity's most fatal diseases. Their study is featured in the November 22 issue of Nature.
Chronic, non-communicable diseases, including cardiovascular diseases (mainly heart disease and stroke), several cancers, chronic respiratory conditions and Type 2 diabetes are reaching world epidemic proportions.
The 19 authors of the Nature paper say chronic non-communicable diseases:
- Cause the greatest share of death and disability worldwide;
- Account for over 60 percent of deaths worldwide, four-fifths of those fatalities being citizens of low and middle income countries;
- Cause twice as many deaths as the combined total of HIV/AIDS, tuberculosis, malaria, maternal and peri-natal conditions and nutritional deficiencies.
"While infectious diseases are often associated with developing nations, the major burden of illness for most of them will soon be the non-communicable diseases, such as cancer, heart disease, diabetes and stroke, which afflict the developed countries," says Jeffrey P. Koplan, MD, MPH, director of the Emory University Global Health Institute. "The earlier the known risks for these diseases are addressed, the bigger the impact on their huge looming human and financial burden." Dr. Koplan is a study author and a member of the Grand Challenges executive committee.
Researchers used the structured consensus-building "Delphi" technique to create the "Grand Challenges in Chronic Non-Communicable Diseases (CNCDs)"--a distillation of informed opinions drawn from 155 panel members across 50 nations, carefully selected from recommendations.
The result is a list of the 20 most important challenges to restraining and reversing the toll of these slow killer illnesses. The list of Grand Challenges is accompanied by research priorities for meeting them, drawn from the study data and finalized by 27 leading world health figures guiding the project.
CNCDs, defined by the WHO as cardiovascular disease, type 2 diabetes, chronic respiratory diseases and certain cancers, are largely preventable. It's estimated that eliminating key risk factors (poor diet, physical inactivity, smoking) would prevent 80 percent of heart disease, strokes and Type 2 diabetes, and over 40 percent of cancer cases.
The initiative's leaders say their goals are "to galvanize the health, science and public policy communities into action on this epidemic," and to foster global debate, support and funding.
Leading partners behind the project are the McLaughlin-Rotman Center (MRC) for Global Health (University Health Network and University of Toronto), Toronto; the Oxford Health Alliance (OxHA), London; the UK Medical Research Council (UK MRC), London; the Canadian Institutes of Health Research (CIHR), Ottawa; and the US National Institutes of Health (NIH), Bethesda.
The 20 Grand Challenges are of equal precedence--there is no priority assigned within the list, says lead author Dr. Abdallah S. Daar of the McLaughlin- Rotman Center.
The Grand Challenges are grouped under six broad goals:
- Reorient health systems (e.g. Grand Challenge: "Allocate resources within health systems based on burden of disease");
- Mitigate health impacts of poverty and urbanization (e.g.: "Study and assess how poverty increases risk factors");
- Engage businesses and community (e.g.: "Make business a key partner in promoting health and preventing disease; Develop and monitor codes of responsible conduct with the food, beverage and restaurant industries");
- Modify risk factors (e.g.: "Deploy universally measures proven to reduce tobacco use and boost resources to implement the WHO framework Convention on Tobacco Control");
- Enhance economic , legal and environmental pol icies (e.g. "Study and address the impacts of poor health on economic output and productivity"); and
- Raise public and political awareness (e.g.: "Promote healthy lifestyle and consumption choices through effective education and public engagement").
The Grand Challenges in CNCDs complement the "Grand Challenges in Human Health," published in 2003 by the Bill and Melinda Gates Foundation and partners, an initiative focused mainly on infectious disease, especially in developing countries.
The Grand Challenges Global Partnership is being established with a secretariat at the Oxford Health Alliance (www.oxha.org ), funded for the first five years by OxHA members.
The founding partners:
- Oxford Health Alliance, UK;
- Medical Research Council, UK;
- Canadian Institutes of Health Research, Canada;
- Indian Council of Medical Research, India;
- The National Institutes of Health, USA;
- Ovations Chronic Disease Initiative, UK
The Partnership is intended as a platform for collaboration of global research funding organizations. An advocacy program to be developed will encourage adoption of the Challenges and Goals.
For details about the 20 Grand Challenges, research priorities for meeting them, and a list of the executive committee, scientific board and partner information, go to: http://www.whsc.emory.edu/news_fataldiseases.cfm.