CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 5, June 2012
AFRICA
241
Editorial
New global target on non-communicable diseases:
a call to action for the global cardiovascular disease
community
JOHANNA RALSTON
For many years, cardiovascular disease (CVD) was regarded as a
lifestyle disease primarily affecting ageing, affluent populations.
This is reflected in the virtual absence of global policies
concerned with CVD control in poor and rich countries alike.
However, CVD and other non-communicable diseases (NCDs),
including cancer, chronic respiratory disease and diabetes,
account for nearly two-thirds (63%) of global deaths, with the
majority of deaths from NCDs (80%) occurring in low- and
middle-income countries (LMICs).
1
This represents a public health emergency requiring an urgent
worldwide response. Now with the World Health Organisation’s
(WHO) adoption of a global target to prevent premature NCD
mortality, the time has finally arrived for the global CVD
community to join forces in reducing CVD suffering and death
in all countries and among all populations.
The World Heart Federation and its members and colleagues
in the CVD community have been fighting the burden of diseases
for years, while also advocating for governments to act. In the
run up to the first-ever United Nations High-Level meeting on
NCDs, which took place on 19 September 2011, the World Heart
Federation worked with its 200 member organisations globally to
lobby for CVD and the other NCDs to be recognised as a priority
on the global health and development agendas.
World leaders finally heeded our calls to action and they
unanimously adopted a political declaration
2
agreeing to address
the prevention and control of NCDs worldwide, with an emphasis
on developing countries. The declaration highlights NCDs as a
major challenge for development in the 21st century, emphasising
that NCDs undermine social and economic development, and
threaten the achievement of global development and poverty-
eradication goals.
Just eight months later, governments agreed to take
responsibility for responding to the challenge of NCDs. At the
65th World Health Assembly, all 194 member states agreed
to adopt the first ever global NCD target: a 25% reduction in
premature mortality from NCDs by 2025.
3
The adoption of this
bold global target is the result of commitment, hard work and
a major lobbying effort from CVD activists. Most important
to note, the overall mortality target and additional targets to
be adopted later this year place CVD prevention and control at
the heart of the NCD agenda, with risk management, low-cost
treatment and care of CVD central to achieving the mortality and
risk-factor targets.
Many members of the African CVD community are to be
congratulated for their efforts to make these achievements
possible. In particular, Bongani Mayosi, chair of the World
Heart Federation Rheumatic Heart Disease Working Group
and, professor and head of the Department of Medicine at
the University of Cape Town, participated in a civil society
interactive hearing on NCDs at the United Nations in June 2011,
to inform preparations for the UN meeting in September. At that
High-Level meeting, Dr Kingsley Akinroye, then-president of
the African Heart Network and board member of the World Heart
Federation, spoke from the floor of the UN General Assembly
about the importance of strengthening national policies and
capacity to address the control of NCDs.
But we cannot rest now. The target represents a rallying cry
for further action by the CVD community. It automatically
elevates CVD on the global health policy agenda, providing an
‘opportunity springboard’ from which we can accelerate action
to reduce the global CVD burden. Because CVD is responsible
for a higher proportion of NCD deaths than cancer, chronic
respiratory diseases and diabetes combined (48 vs 36.5%),
1
world leaders will look to us and our efforts to help reduce the
CVD burden – and so our challenge is great.
The next 13 years are crucial, and in order to mount a
comprehensive response for achieving the target, the CVD
community must forge innovative partnerships with policy
makers, the private sector and healthcare professionals to create
strategies that prevent CVD at local, regional and national
levels. We need to look beyond the health sector and consider
the many factors that influence heart health (including healthy
eating, physical activity and tobacco consumption). We need
to serve as the catalyst for renewed, global efforts to encourage
heart-healthy behaviours. A concerted, global response is vital
– we won’t curtail this global epidemic by continuing the same
fragmented responses we have followed in the past. Everyone
has a crucial role to play, and we must lead the charge and propel
them to act.
To achieve the target, policy makers urgently need to take
action to help modify behavioural risk factors. Many CVD
prevention strategies exist, however governments must do more
to ensure that these are fully implemented and well articulated
in NCD plans, which the UN political declaration requires
governments to complete by the end of 2013. As an example,
one of the success stories in the fight against CVD is the
WHO’s Framework Convention on Tobacco Control (FCTC), a
treaty addressing issues around tobacco consumption, including
restricting sales and advertising.
National smoke-free legislation has been passed in Ghana,
