Global status report - WHO

1 Tobacco use diabetes cancers unhealthy diets physical inactivity harmful use of alcoholcardiovascular diseaseschronic respiratory diseasesunhealthydietsGlobal status report on noncommunicable diseases 2010 tobacco use diabetes cancers unhealthy diets physical inactivity harmful use of alcoholcardiovascular diseaseschronic respiratory diseasesGlobal status report on noncommunicable diseases 2010 The Global status report on Noncommunicable Diseases is the fi rst report on the worldwide epidemic of cardiovascular diseases, cancer, diabetes and chronic respiratory diseases, along with their risk factors and determinants.

2 Noncommunicable diseases killed 36 million people in 2008, and a large proportion of these deaths occurred before the age of 60, so during the most productive period of life. The magnitude of these diseases continues to rise, especially in low- and middle-income countries. This report reviews the current status of noncommunicable diseases and provides a road map for reversing the epidemic by strengthening national and Global monitoring and surveillance, scaling up the implementation of evidence-based measures to reduce risk factors like tobacco use, unhealthy diet, physical inactivity and harmful alcohol use, and improving access to cost-effective health-care interventions to prevent complications, disabilities and premature death.

3 This report , and subsequent editions, also provide a baseline for future monitoring of trends and for assessing the progress Member States are making to address the epidemic. The Global status report on Noncommunicable Diseases was developed as part of the implementation of the 2008 2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases, which was endorsed by the World Health Assembly in status report on noncommunicable diseases 2010tobaccouseesphysicalinactivityarmful useofalcoholcardiovasculardiseaseschroon nicrespiratorydiseeaassesdiabetescancers unhealthydietshaGlobal statusreport on noncommunicable diseases nicable dise20102010 ISBN 978 92 4 156422 9 WHO2000200320042008 Global Strategy for the Prevention and Control of Noncommunicable DiseasesWHO Framework Convention on Tobacco ControlGlobal Strategy on Diet.

4 Physical Activity and HealthAction Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases2010 Global Strategy to Reduce the Harmful Use of AlcoholThe world has a sound vision and a clear road map to address NCDsWHO Library Cataloguing-in-Publication DataGlobal status report on noncommunicable diseases disease - prevention and control. disease - epidemiology. disease - mortality. of illness. of health Health 978 92 4 156422 9 (NLM classifi cation: WT 500)ISBN 978 92 4 068645 8 (PDF) World Health Organization 2011 Reprinted 2011 All rights reserved.

5 Publications of the World Health Organization are available on the WHO web site ( ) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: Requests for permission to reproduce or translate WHO publications whether for sale or for noncommercial distribution should be addressed to WHO Press through the WHO web site ( ).The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.)

6 Dotted lines on maps represent approximate border lines for which there may not yet be full mention of specifi c companies or of certain manufacturers products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied.

7 The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The Editor and principal writer of this report was Dr Ala Alwan, Assistant Director-General, Noncommunicable Diseases and Mental Health. The members of the core writing and coordination team were Ala Alwan, Tim Armstrong, Douglas Bettcher, Francesco Branca, Daniel Chisholm, Majid Ezzati, Richard Garfi eld, David MacLean, Colin Mathers, Shanthi Mendis, Vladimir Poznyak, Leanne Riley, Kwok Cho Tang and Christopher were also made by Tsouros Agis, George Alleyne, Francisco Armada, Nick Banatvala, Robert Beaglehole, John Beard, Monika Bloessner, Elaine Borghi, Ties Boerma, Freddie Bray, Eric Brunner, Vera da Costa e Silva, Melanie Cowan, Manuel Dayrit, Goodarz Danaei, Michael Engelgau, Ibtihal Fadhil.

8 Farshad Farzadfar, Mariel Finucane, David Forman, Silvia Franceschi, Gauden Galea, Luis Galvao, Hassan Ghanam, Jim Gogek, Vilius Grabauskas, Regina Guthold, Tieru Han, Corinna Hawkes, Hendrik Hogerzeil, James Hospedales, Samer Jabour, Gauri Khanna, Jacob Kumaresan, Richard Laing, Jerzy Leowski, John Lin, Alan Lopez, Haifa Madi, Gabriel Masset, Robert Moodie, Jai Narain, Chizuru Nishida, Sania Nishtar, Mercedes de Onis, Sameer Pujari, Pekka Puska, J rgen Rehm, Dag Rekve, Sylvia Robles, Manuel Jean Baptise Roungou, Badara Samb, Boureima Sambo, Rengaswamy Sankaranarayanan, Shekhar Saxena, Joachim Sch z, Eduardo Seleiro, Hai-Rim Shin, Gitanjali Singh, Gretchen Stevens, Edouard Tursan d Espaignet, Annemiek Van Bolhuis, and Cherian Varghese.

9 Advice and support were received from WHO Regional Directors and Assistant Directors-General. Other individuals provided technical assistance throughout the preparation of the report : Virginia Arnold, Alexandra Cameron, Barbara Campanini, Xuanhao Chan, Li Dan, Alexandra Fleischmann, Edward Frongillo, Louis Gliksman, Iyer Krishnan, Branka Legetic, Belinda Loring, Allel Louazani, Reynaldo Martorell, Timothy O Leary, Armando Peruga, Camille Pillon, Gojka Roglic, Margaret Rylett, Kerstin Schotte, Cecilia Sepulveda, Raj Shalvindra, Mubashar Sheikh, Jonathan Siekmann, David Stuckler, Andreas Ullrich, Godfery Xuereb, Ayda Yurekli, and Evgeny Zheleznyakov.

10 Tim France was copy editor of the report . Design and layout by Graphi printing of this publication was made possible through the generous fi nancial support of the Government of in status report on noncommunicable diseases 2010iiiContentsForeword vIntroduction viiExecutive summary 1 Chapter 1. Burden: mortality, morbidity and risk factors 9 Chapter 2. NCDs and development 33 Chapter 3. Monitoring NCDs and their risk factors: a framework for surveillance 41 Chapter 4. Reducing risks and preventing disease: population-wide interventions 47 Chapter 5. Improving health care: individual interventions 61 Chapter 6.