Tackling Heart Disease at the Global Level

Abstract

This article reflects on the United Nations' recent statement on the prevention and control of noncommunicable disease, the disproportionate burden of these diseases in low- to middle-income countries (with a particular focus on noncommunicable forms of heart disease), and the practical difficulties of tackling such a historically underresourced and complex health problem. ### Perceptions Are Everything Like many of us, I have spent more than a decade of my research career trying to persuade the lay public and, indeed, many health care workers and administrators, that cardiovascular disease (CVD) and its major component heart disease is a major burden to rival that of the common forms of cancer. The American Heart Association's “Go Red for Women” campaign is indicative of our collective fight to address common misperceptions about the risk of heart disease in women and its often fatal consequences.1 Even when presenting compelling evidence of the disproportionate number of men and women who lose their life prematurely (many suddenly and with little warning2) to acute myocardial infarction and chronic heart failure relative to the common malignancies,3 the response is underwhelming. Is this so surprising, given the entrenched branding of cancer sufferers as predominantly young “survivors” in a heroic battle to overcome a life-long disease? The broad misperception of heart disease, of course, is often limited to male-dominated “heart attacks” that leave the “victim” deceased (and therefore unable to tell their battle to survive) or the idea of an instant “cure” thanks to modern-day technology—the external and implantable cardiac defibrillator being the most recognizable of these. There is no “right or wrong” in our efforts to highlight serious public health issues and educate the public and health administrators alike to the enormity of the problem. The terminal malignancy that killed my own father at an early age deserves equal attention to …