Abstract
The public health challenge of our generation and indeed generations to come is the effective management of the prevalence of non-communicable diseases. The task is fraught with complexity and plagued by paradox. On one hand we laud our efforts in increasing life expectancy but on the other we are stunned by dementia, the flipside of improved longevity. Depression has risen to prime place at the summit of morbidity tables in the West and obesity (in particular, child obesity) is on the rise. There is effective public health action aimed at smoking, physical activity uptake and obesity but the yield is slow and the process complex. Thrown into the mix is the powerful lobby of commercial interests opposed to real change and government inaction in tackling health inequalities. Noncommunicable disease account for 60% of annual deaths and will cost the global economy US$47 trillion over the next twenty years. With a concise review of mass public health action on targeted lifestyle choices, the author evaluates the future impact of NCDs in this most relevant of debates on the advance of chronic illness. ‘Non- Communicable Diseases (NCDs) En Marche’ seems a fitting contemporary title for this discourse; it symbolizes our current predicament with chronic or non-communicable diseases. NCDs are an enormous public health challenge and in many ways present a more formidable opponent than the old communicable disease foe. In the West, the leading cause of death and disease is ill health characterized by a protracted clinical course, linked to key life style choices or consumption behaviors and a rather complicated prevention strategy. NCDs now constitute 60% of global mortality, accounting for about 34 million deaths each year [1]. The focus of attention is how much prevention strategies can limit the scourge of NCDs in the western world? And how many of the unique hurdles can we scale on the way to reversing the ascend of NCD related ill-health?
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