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Global prevention and control of NCDs: Limitations of the standard approach

Abstract

The five-target ‘25 × 25’ strategy for tackling the emerging global epidemic of non-communicable diseases (NCDs) focuses on four diseases (CVD, diabetes, cancer, and chronic respiratory disease), four risk factors (tobacco, diet and physical activity, dietary salt, and alcohol), and one cardiovascular preventive drug treatment. The goal is to decrease mortality from NCDs by 25 per cent by the year 2025. The ‘standard approach’ to the ‘25 × 25’ strategy has the benefit of simplicity, but also has major weaknesses. These include lack of recognition of: (i) the fundamental drivers of the NCD epidemic; (ii) the ‘missing NCDs’, which are major causes of morbidity; (iii) the ‘missing causes’ and the ‘causes of the causes’; and (iv) the role of health care and the need for integration of interventions.

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Acknowledgements

This work was supported by the Wellcome Trust Institutional Strategic Support Fund, 097834/Z/11/B; the Health Research Council of New Zealand; and the Heart, Lung and Blood Institute of the US National Institutes of Health, Department of Health and Human Services, under Contract No. HHSN268200900033C.

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Correspondence to Neil Pearce.

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The standard approach to prevention and control of non-communicable disease, called ‘25x25’ has the benefit of simplicity, but also has major weaknesses described herein.

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Pearce, N., Ebrahim, S., McKee, M. et al. Global prevention and control of NCDs: Limitations of the standard approach. J Public Health Pol 36, 408–425 (2015). https://doi.org/10.1057/jphp.2015.29

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Keywords

  • non-communicable diseases (NCDs)
  • risk factors for NCDS
  • mortality