Elsevier

The Lancet

Volume 366, Issue 9496, 29 October–4 November 2005, Pages 1578-1582
The Lancet

Series
Preventing chronic diseases: how many lives can we save?

https://doi.org/10.1016/S0140-6736(05)67341-2Get rights and content

Summary

35 million people will die in 2005 from heart disease, stroke, cancer, and other chronic diseases. Only 20% of these deaths will be in high-income countries—while 80% will occur in low-income and middle-income countries. The death rates from these potentially preventable diseases are higher in low-income and middle-income countries than in high-income countries, especially among adults aged 30–69 years. The impact on men and women is similar. We propose a new goal for reducing deaths from chronic disease to focus prevention and control efforts among those concerned about international health. This goal—to reduce chronic disease death rates by an additional 2% annually—would avert 36 million deaths by 2015. An additional benefit will be a gain of about 500 million years of life over the 10 years from 2006 to 2015. Most of these averted deaths and life-years gained will be in low-income and middle-income countries, and just under half will be in people younger than 70 years. We base the global goal on worldwide projections of deaths by cause for 2005 and 2015. The data are presented for the world, selected countries, and World Bank income groups.

Introduction

An appreciation of the rising global burden of chronic, noncommunicable diseases has been developing for more than 20 years.1, 2, 3, 4 Physicians and health managers have applied effective measures, including behavioural interventions and pharmaceutical treatment, in the prevention and management of chronic diseases, but these are neither widely used nor equitably distributed. Further, a widening gap exists between the reality of the chronic disease burden worldwide and the response of national governments, civil society, and international agencies to this burden. In this paper, we review the mortality and chronic disease burden as estimated for 2005 and projected to 2015. We respond to the gap between information and action by proposing a global goal for prevention of chronic diseases. The global goal is designed to rally partners from all sectors of society to avoid needless suffering and death.

Section snippets

Projections of mortality for 2005 and 2015

WHO provides consistent estimates of deaths by age, sex, and cause for all member countries based on a systematic review and analysis of available evidence from surveys, censuses, sample registration systems, population laboratories, and vital registration on levels and trends in child and adult mortality. The most recent regional and global estimates for mortality by cause are for the year 2002.5 More information on how these estimates were made is available online.6

WHO has prepared updated

Global mortality and burden of disease

We estimate that, globally, about 58 million people will die in 2005. This value is projected to rise to 64 million in 2015. Figure 1 shows the distribution of these deaths across three major cause groups: communicable, maternal, perinatal conditions, and nutritional deficiencies (group 1), chronic, non-communicable, diseases (group 2) and injuries (group 3). At a more detailed cause group level, cardiovascular disease is the leading single cause of death worldwide.

The table shows the projected

Discussion

We present the mortality and burden of disease projections for chronic diseases using the WHO 2002 mortality estimates as a baseline. For regions with limited death registration data, such as the eastern Mediterranean region, sub-Saharan Africa, parts of Asia, and the Pacific, there is considerable uncertainty in estimates of deaths by cause. For some countries, only limited information on mortality is available from sources such as the Demographic and Health Surveys and from cause-specific

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