The ESC goes global: policies to prevent all chronic diseases.

Chronic non-communicable diseases (NCDs) account for 86% of deaths in the WHO European Region. They include heart disease, stroke, diabetes, kidney disease, cancers, respiratory, and liver diseases. Four major health determinants—tobacco, poor diet, alcohol, and lack of physical activity—account for most of the chronic illness and deaths in Europe. All these factors need to be successfully addressed to prevent disease and promote health. The scientific evidence for the adverse health effects of smoking is overwhelming, especially for common cancers, chronic obstructive pulmonary diseases, diabetes, and cardiovascular disease (CVD). About half of all continuing smokers will be killed by their addiction. Poor diet can cause obesity, type 2 diabetes, CVD, hypertension, and common cancers. –7 Increasing fruit and vegetable intake to 600 g/day could prevent over 135 000 CVD deaths each year. Alcohol excess accounts for over 7% of all ill-health and premature deaths in Europe, especially through liver damage, accidents, and addiction. Sedentary lifestyles promote osteoporosis, depression, type 2 diabetes, overweight and obesity, and some cancers. –11 The European Chronic Disease Alliance. Ten not-for-profit European organizations representing over 100 000 health professionals have formed the European Chronic Disease Alliance (ECDA) to combat chronic diseases. The ECDA mission is to reverse the alarming rise in chronic diseases by providing concrete evidence-based policy recommendations to lobby for immediate political action. The Alliance has produced very concrete recommendations for policy makers to address the four identified risk factors at both national and EU levels. Globally, NCDs represent a major cause of poverty and an urgent issue in developing countries. Worldwide, the chronic disease epidemic accounts for over 60% of deaths in lowand middle-income countries. Global problems, global solutions: The UN high-level meeting Non-communicable diseases are too big a problem to be solved by national governments alone. The World Heart Federation (WHF) and theNCDAlliancearenowworking toplaceNCDsat the topof theglobal agenda,bypromoting amultisector response, to include theprivate sector. The World Economic Forum, WHO Geneva, and the Harvard School of Public Health are currently working together on economic studies to quantify the health and social costs of NCDs. The report, expected in August 2011, will inform the participants at the UN High-Level Summit on NCDs. This September 2011 Summit follows the UN General Assembly, in May 2010. It offers the best opportunity to put NCDs on the global agenda. The Summit aims to secure commitment from Heads of Governments for a coordinated global response and substantially increased financial resources for NCDs. It will recommend measurable targets for tobacco control, healthier diets, alcohol control, and increased physical activity. The specific targets will be used to produce commitments from governments to take action on NCDs, for which they can be monitored and held accountable through regular reporting. These actions together could save millions from premature death and debilitating disease.