Expanding Priorities -- Confronting Chronic Disease in Countries with Low Income

NEJM -- Expanding Priorities -- Confronting Chronic Disease in Countries with Low Income: "In a ceremony held at the New York Public Library on June 26, 2006, Microsoft founder and global health philanthropist Bill Gates expressed his belief that 'there is no reason we can't cure the top 20 diseases.'1 To achieve this ambitious objective, however, international health organizations will need to greatly expand their efforts, especially in low-income countries, to prevent and treat noncommunicable chronic diseases.

Although there are many ways to classify diseases and to evaluate the burden of disease, it is clear that by any measure, several noncommunicable chronic diseases have a place in the global top 20. For example, cardiovascular disease alone accounts for nearly 30% of all deaths worldwide and 10% of all years of healthy life lost to disease (called 'disability-adjusted life-years'; see graphs).2 In low-income and lower-middle-income countries (countries with a per capita gross national product of less than $3,255 in 2004), the corresponding figures are similar to the global ones — 27% and 9%, respectively."/.../