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1 Global status report on noncommunicable diseases Global status report on noncommunicable diseases 2010. The Global status report on Noncommunicable Diseases is the first report on the worldwide epidemic of cardiovascular diseases, cancer, 2010. diabetes and chronic respiratory diseases, along with their risk factors and determinants. 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, tobacc scaling up the implementation of evidence-based measures to reduce o us e risk factors like tobacco use, unhealthy diet, physical inactivity and dise ases ar harmful alcohol use, and improving access to cost-effective health- ul chronic c res as care interventions to prevent complications, disabilities and premature pi iov death.

2 This report , and subsequent editions, also provide a baseline ra card to phy for future monitoring of trends and for assessing the progress Member ry l ful use of alcoho diseases sica States are making to address the epidemic. The Global status report on Noncommunicable Diseases was developed as part of the l inactivity 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 2008. m ha r tes be a di ca nc rs e ts unhealthy die Global status report on noncommunicable nicable dise diseases 2010. ISBN 978 92 4 156422 9.

3 Tobacc o us e ases dise ar ul chronic c res as pi iov r at card ory phy ol use of alcoh d is sical i eases nactivity m fu l h ar es t be a di ca nc rs e s unhealthy diet WHO. WHO Library Cataloguing-in-Publication Data Global status report on noncommunicable diseases 2010. disease - prevention and control. disease - epidemiology. disease - mortality. of illness. of health Health Organization. ISBN 978 92 4 156422 9 (NLM classification: WT 500). ISBN 978 92 4 068645 8 (PDF). World Health Organization 2011 Reprinted 2011. All rights reserved. Publications of the World Health Organization are available on the WHO web site ( ).

4 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.)

5 Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific 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 letters. All 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.

6 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 world has a sound vision and a clear road map to address NCDs The Editor and principal writer of this report was Dr Ala Alwan, Assistant Director-General, Noncommunicable Diseases and Mental Health. Global Strategy for the Prevention The members of the core writing and coordination team were Ala Alwan, Tim Armstrong, Douglas Bettcher, Francesco Branca, Daniel Chisholm, Majid Ezzati, Richard Garfield, David MacLean, Colin Mathers, Shanthi Mendis, Vladimir 2000 and Control of Noncommunicable Diseases Poznyak, Leanne Riley, Kwok Cho Tang and Christopher Wild.

7 Contributions were also made by Tsouros Agis, George Alleyne, Francisco Armada, Nick Banatvala, Robert WHO Framework Convention on Tobacco Control 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, Farshad Farzadfar, 2003. 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.

8 Gitanjali Singh, Gretchen 2004. Stevens, Edouard Tursan d'Espaignet, Annemiek Van Bolhuis, and Cherian Varghese. Global Strategy on Diet, Physical Advice and support were received from WHO Regional Directors and Assistant Directors-General. Activity and Health 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 2008. Peruga, Camille Pillon, Gojka Roglic, Margaret Rylett, Kerstin Schotte, Cecilia Sepulveda, Raj Shalvindra, Action Plan for the Global Strategy for the Prevention and Mubashar Sheikh, Jonathan Siekmann, David Stuckler, Andreas Ullrich, Godfery Xuereb, Ayda Yurekli, and Evgeny Control of Noncommunicable Diseases Zheleznyakov.

9 Tim France was copy editor of the report . Design and layout by Graphi 4. 2010. The printing of this publication was made possible through the generous financial support of the Government of Canada. Global Strategy to Reduce the Harmful Use of Alcohol Printed in Italy. Global status report on noncommunicable diseases 2010. Contents Foreword v Introduction vii Executive 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.

10 Chapter 5. Improving health care: individual interventions 61. Chapter 6. Tackling NCDs: the capacity of countries to respond 72. Chapter 7. The way forward: taking action based on evidence and lessons learnt 84. Annexes 90. Annex 1. Methods used for country estimates in Chapter 1 and Annex 4 90. Annex 2. List of countries by WHO Regions and 2008 World Bank Income Groups 92. Annex 3. Maps showing the Global distribution of estimated NCD-related mortality and selected risk factors 95. Annex 4. Country estimates of NCD mortality and selected risk factors, 2008 100. NCD mortality: 2008 comparable estimates of NCD mortality (total NCD Deaths in 000s; % of NCD Deaths occuring under the age of 70.)