Global prevention and control of NCDs: limitations of the standard approach

The five-target 25 ? 25 strategy for tackling the emerging global epidemic of non-communicable diseases (NCDs) focuses on four diseases (CVD, diabetes, cancer, and chronic respiratory disease), four risk factors (tobacco, diet and physical activity, dietary salt, and alcohol), and one cardiovascular preventive drug treatment. The goal is to decrease mortality from NCDs by 25 per cent by the year 2025. The standard approach to the 25 ? 25 strategy has the benefit of simplicity, but also has major weaknesses. These include lack of recognition of: (i) the fundamental drivers of the NCD epidemic; (ii) the missing NCDs , which are major causes of morbidity; (iii) the missing causes and the causes of the causes ; and (iv) the role of health care and the need for integration of interventions.