Report at a Glance
Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health
Cardiovascular disease (CVD), once thought to be confined primarily to industrialized nations, has emerged as a major health threat in developing countries. Cardiovascular disease—especially coronary heart disease and stroke—now accounts for nearly 30 percent of deaths in low and middle income countries each year and is accompanied by significant economic repercussions. Yet most governments, global health institutions, and development agencies have largely overlooked CVD as they have invested in health in developing countries.
The risk factors for CVD are well known, and the actions needed are deceptively simple: eat a healthy diet, be physically active, avoid tobacco, and seek health care regularly. However, the reality is much more complex. Behavior change is difficult, individual choices are influenced by broader social and environmental factors, and many people do not have the resources for or access to appropriate health care. It also can be difficult for governments and other organizations to promote these actions. Many health and development priorities compete for scarce resources, and implementation capacity for policies, programs, and health services is often inadequate. Context is also critical—strategies that have worked in one setting may not work in another.
Recognizing the gap between the compelling evidence of the global CVD burden and the investment needed to prevent and control CVD, the National Heart, Lung, and Blood Institute (NHLBI) turned to the Institute of Medicine (IOM) for advice on how to catalyze change. The IOM convened a committee to assess current knowledge and strategies and recommend promising ways to reduce the global burden of CVD.The committee’s report is intended foremost as a guide for the NHLBI to set goals and priorities for its investments in global CVD, including strategic partnerships with other U.S. government agencies and international stakeholders. More broadly, the report identifies ways in which the global health agenda can evolve to be more inclusive of chronic diseases, including CVD.
One primary goal in meeting the challenges of CVD in the developing world is to create environments that promote heart healthy lifestyle choices and help reduce the risk of chronic diseases. An equally important goal is to build public health infrastructure and health systems with the capacity to implement programs that will effectively detect and reduce risk and manage CVD. The report identifies a set of "essential functions" that will be required to meet these goals. Successfully carrying out these functions, described below, will require resources—financial, technical, and human—and the combined efforts of multiple players sustained over many years.