Chronic Disease

Abstract

Eighty percent of global deaths from heart disease, stroke, cancer, and other chronic diseases occur in low- and middle-income countries. This chapter discusses priorities for control of these chronic diseases as an input into the 2012 Copenhagen Consensus. This chapter and the accompanying Chapter 7 on infectious disease control build on the results of the 2008 Copenhagen Consensus chapter on disease control (Jamison et al ., 2008), and is best read as an extension of the latter chapter. This chapter also draws on the framework and findings of the Disease Control Priorities Project (DCP2). The DCP2 engaged over 350 authors and among its outputs were estimates of the cost-effectiveness of 315 interventions, including about 100 interventions for chronic diseases. These estimates vary a good deal in their thoroughness and in the extent to which they provide regionally-specific estimates of both cost and effectiveness. Taken as a whole, however, they represent a comprehensive canvas of chronic disease control opportunities. This chapter identifies five key priority interventions for chronic disease in developing countries which chiefly address heart attacks, strokes, cancer, and tobacco-related respiratory disease. These interventions are chosen from among many because of their cost-effectiveness, the size of the disease burden they address, their implementation ease, and other criteria. Separate but related 2008 Copenhagen Consensus chapters dealt with other major determinants of chronic diseases such as nutrition, (Behrman et al ., 2007), air pollution (Larsen et al ., 2008) and education (Orazem et al ., 2008). The health-related chapters for the 2012 Copenhagen Consensus focus on infectious diseases (Jamison et al ., 2012), sanitation and water (Rijsberman and Zwane, 2012), education (Orazem, 2012), hunger and undernutrition (Hoddinott et al ., 2012) and population growth (Kohler, 2012).

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