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Thursday, December 13, 2018

NCDs - The Lancet


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December 2018 | Wra
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2018 in review: a renewed call for urgent and prioritised action on NCDs
Dear Aloyzio
With the launch of the Lancet Taskforce on NCDs and Economics in April, Richard Horton and I wrote that 2018 must be the year for action against NCDs. And so it has been, both internationally and here at The Lancet. Over the past year, we have been delighted to bring you the best scientific research and the strongest evidence to motivate global action to curb years lived with NCD-related disability and premature mortality.
A first step in defeating NCDs is quantifying the burden. The 2017 Global Burden of Disease (GBD) Study demonstrates the rising global burden of premature mortality and from ischaemic heart disease, diabetes, cancers, and other NCDs, particularly in low-income and middle-income countries. The GBD Study papers highlight the increasing urgency for action against NCDs as they surpass infectious diseases as the leading cause of premature deaths. Indeed, GBD estimates that over half of all premature deaths could be avoided by controlling just four risk factors—high blood pressure, smoking, high blood glucose, and high body mass index.

The Lancet NCD Countdown 2030 provides further granularity to the global NCD burden and expands analysis from the SDG target 3.4 to include all premature deaths under the age of 80 years and all NCDs, as well as showing that only a handful of countries are making sufficient progress to meeting target 3.4 by 2030. To ensure that the global targets are met, accountability must remain central to efforts to reduce the NCD burden. The Lancet NCD Countdown will continue to report premature deaths annually, and in future iterations will provide in depth analysis of risk factor control, policy implementation, and fiscal solutions to tackling the burden.
2018 has also seen expansion of the WHO four-by-four NCD strategy, recognising that good mental health is fundamental to achieving SDG3—good health and wellbeing. Our Commission on global mental health and sustainable developmentprovides a framework for sustainable mental health and recommendations for integrating mental health services with other healthcare priorities and for investing in both services for and research into improving mental health.
Most importantly, global health communities must not and cannot operate in silos. The International AIDS Society-Lancet Commission: advancing global health and strengthening the HIV response in the era of the Sustainable Development Goals emphasises that health services must be fully integrated and patient-centred to address both the communicable disease and NCD burdens, particularly in low-income and middle-income countries. The update to the Lancet Commission on Investing in Health also acknowledges the recent epidemiological shift toward NCDs. The Commissioners propose new global action initiatives to achieve a grand convergence of health for NCDs, in addition to tuberculosis, maternal and child health, and HIV/AIDs.
Furthermore, the enormous and deadly burden of NCDs needs to be addressed not only on a global scale, but national governments must take responsibility. The Tsinghua-Lancet Commission on Healthy Cities in China reports worrying trends on increasing NCDs resulting from rapid urbanisation in Chinese mega cities. On a more positive note, the fifth report of the Lancet Standing Commission on Liver Disease in the UK reflects on progress made since the publication of the initial Commission report in 2014, as well as highlighting commercial determinants of liver disease, such as the alcohol and food industries, as targets for future campaigns.
Thank you for following In Focus: NCDs throughout 2018. This edition of the newsletter is the final, regular update on Lancet NCD initiatives, but our work does not end here. As the NCD movement presses onward, so shall we. As the Lancetfamily of journals continues to publish the best evidence to transform policy in this critical area, we will keep you updated of new initiatives. In the meantime, stay in touch with The Lancet by following us on Twitter, including use of #LancetNCDs. You can also freely register to receive our weekly Table of Contents alerts or any of our Lancet Updates.
Yours sincerely,
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Jennifer Sargent Senior Editor, The Lancet

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