report, Pre-venting Chronic Diseases: A Vital Investment (1), showsthat non-communicable diseases (NCDs) dominated by di-abetes are causing double the deaths that are caused byinfectious diseases, maternal/perinatal conditions, and mal-nutrition combined. The report states that without action,388 million people globally will die from chronic diseaseslike diabetes and heart disease in the next decade.It is against this background that we are facing a globalthreat from the spectacular rise in the global prevalence oftype 2 diabetes and obesity and their consequences (2). Interms of diabetes, the number of cases has reached pan-demic proportions and will continue to increase sharply.TheInternationalDiabetesInstitutepreparedthedatafortheInternational Diabetes Federation’s Diabetes Atlas 2003report (3), which predicted that the number of people withdiabetes will almost double within just one generation, fromthe present 190 million to 335 million in 2025. The linkagebetween obesity and type 2 diabetes is very strong, in fact,so strong that the term diabesity is being used frequently tobetter describe the current twin epidemic (2).Unfortunately, most nations are poorly prepared to tacklethis twin epidemic effectively. Governments remain largelyunawareof,orarecomplacentabout,theexistingmagnitudeof the NCD challenge. More important is the fact that theyignore the future increases in obesity and diabetes and theirserious complications such as cardiovascular disease(CVD). Failure to act now on the direct costs of healthcareand the indirect costs from loss of productivity and frompremature morbidity and mortality is very likely to cripplethe health budgets of many nations, both developing anddeveloped.With this major international challenge in mind, in May2005, the Monash University-affiliated International Diabe-tes Institute, in conjunction with the Monash UniversityInstitute of Global Movements and the United Kingdom-based Nuffield Trust, held a meeting of 25 leading worldexperts from a number of disciplines at the Nuffield Trustheadquarters in London. The objective of the meeting wasto assess the impact of globalization on health in bothdeveloped and developing countries with respect to NCDssuch as CVD, diabetes, and obesity.The London conference focused on how the world hascome by a chronic disease health calamity that rivals oreven exceeds the emergence or reemergence of devastatingcommunicable diseases including severe acute respiratorysyndrome (SARS), acquired immune deficiency syndrome(AIDS), the Ebola virus, and our old enemy, tuberculosis(4). While governments around the world are busy prepar-ing for an avian influenza pandemic, they ignore the equallyinsidious threat of diabetes and other NCDs!In the brief period of several decades, many developingnations are faced with a double burden of communicablediseases and NCDs, placing enormous pressure for solu-tions on WHO and other international and regional non-governmental agencies. The NCD burden has now becomeone of the major threats to human health in the 21st century(1,4). A report on the London meeting’s discussions andconclusions is published in this issue of