The June 4 issue of The Lancet issued a call for papers on the global burden of chronic diseases (see "Comment" reprinted below). I invite members of the ProCOR network to submit original research papers on the following
themes:
--Consequences of the unchecked increase in chronic disease for individuals and societies. --The case for urgent national and global action to prevent and control the rising burden of chronic disease. --Effective and feasible interventions within the context of an incremental, integrated approach to chronic disease prevention and control. --Work from China and India on their challenges and progress towards the prevention and control of chronic diseases.
I encourage members of the ProCOR network to submit contributions in order to strengthen this special series.
The deadline for submission of research articles is Aug 1, 2005. For more information visit www.thelancet.com or email editorial@thelancet.com
Richard Horton, Editor, The Lancet
Member, ProCOR International Advisory Council
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The Lancet
Volume 365, Issue 9475 , 4 June 2005-10 June 2005, Pages 1913-1914
Comment: Chronic diseases of adults-a call for papers
Robert Beaglehole (a), and Richard Horton (b)
(a)Chronic Diseases and Health Promotion, WHO, CH-1211 Geneva 27, Switzerland (b)The Lancet, London NW1 7BY, UK
This week The Lancet issues a call for papers on the global burden of chronic diseases. The Millennium Development Goals have rightly focused attention on the plight of the world's poorest children and mothers, and on select infectious disease epidemics. By contrast, chronic diseases-the leading cause of adult mortality in all regions of the world-are not yet on the international health agenda.
This year there will be about 60 million deaths worldwide. Approximately 35 million (60% of the total) will be due to chronic diseases of adults, principally heart disease, stroke, cancer, and diabetes. Approximately 16 million will occur in people younger than 70 years of age. These diseases are responsible for about 30% of the global burden of disease as measured by disability adjusted life years lost.
Many countries that have limited financial resources and poor health systems are facing an upsurge of chronic diseases. Four out of five chronic disease deaths occur in low-income and middle-income countries; one third of all cardiovascular disease deaths occur in India and China. Alarmingly, in transition countries such as Russia, chronic disease death rates are especially high in middle-aged people, causing major adverse consequences to the economies of families and societies.1
The chronic disease epidemics are driven by population ageing and social and environmental changes that increase the prevalence of common risk factors. Major initiatives are achieving some success in tobacco control, including the ratification of the WHO Framework Convention on Tobacco Control. The effects of these measures will be felt progressively, but for now, tobacco-induced epidemics are uncontrolled in most low-income and middle-income countries. The rapid transition in urbanising societies to diets that are high in fat, sugar, and salt, together with decreasing physical activity as the norm, have led to the global obesity pandemic. Obesity is driving the rapid rise in diabetes and may threaten future gains in life expectancy.2
To date, our response to these epidemics has been woefully inadequate. In several high-income countries, interventions have led to major improvements in the life expectancy and quality of life of middle-aged and older people. For example, death rates from coronary heart disease have fallen by up to 70% in the past three decades in Australia, New Zealand, the USA, and the UK. The challenge is to ensure that all populations, especially the most disadvantaged, benefit from effective preventive and treatment interventions.
The explanation for the global neglect of chronic disease is not straightforward but several misconceptions have contributed. Chronic diseases are held by some to be an unavoidable side-effect of social and economic development, diseases of affluence not warranting the attention of those seeking to provide aid to improve health. Others see them as the fault of individuals who make self-injurious choices, as though these were independent of society and entirely volitional. Yet others see chronic disease as an affliction of older men in high-income countries; and that the control of infectious disease epidemics should take priority in low-income and middle-income countries. All of these misconceptions can be rebutted with indisputable evidence-a third of deaths due to cardiovascular disease in the developing world occur in men and women of working age, mostly among the poor. They seriously distort the establishment of a balanced global health agenda.
The Lancet has commissioned a series of four papers on chronic diseases, to be published later this year. This series will demonstrate that the misconceptions we have described are not only fundamentally wrong but, if left unchecked, will produce dangerous results for individuals and societies alike. The series will make the case for urgent national and global action to prevent and control the rising burden of chronic disease and present a guide to effective and feasible interventions within the context of a stepwise, integrated approach to chronic disease prevention and control. In addition, this series will showcase work from China and India on their challenges and progress towards the prevention and control of chronic diseases.
We want to strengthen this series by publishing original research papers in each of the four issues devoted to the commissioned reviews. The deadline for submission of research articles is Aug 1, 2005.
We declare that we have no conflict of interest.
References
1 S Leeder, S Raymond and H Greenberg, A Race Against Time, Columbia University, New York (2004). 2 SJ Olshansky, DJ Passaro and RC Hershow et al., A potential decline in life expectancy on the United States in the 21st century, N Engl J Med 352 (2005), pp. 1138-45.
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