25×25 strategy for the burden of non-communicable diseases
Authors: Damian Hoy, Lyn March, Anthony Woolf, Peter Brooks
Journal: The Lancet Global Health (2014)

We congratulate Neil Pearce and colleagues on their Comment about the 25×25 strategy.1Pearce N Ebrahim S McKee M et al.The road to 25×25: how can the five-target strategy reach its goal?.Lancet Glob Health. 2014; 2: e126-e128Summary Full Text Full Text PDF Scopus (34) Google Scholar This strategy is a global target of a 25% relative reduction in mortality from non-communicable diseases by the year 2025. Global policy should be updated to show the current and future global health scenario with inclusion of non-communicable diseases that reach beyond the traditional top broad-cause groups (ie, cardiovascular disease, stroke, chronic lung diseases, cancer, and diabetes), and which also take into account non-fatal burden. More than anywhere, this issue is crucial for low-income and middle-income countries where in the recent Global Burden of Disease study, 2010,2Murray CJ Vos T Lozano R et al.Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010.Lancet. 2012; 380: 2197-2223Summary Full Text Full Text PDF PubMed Scopus (6098) Google Scholar in terms of broadcause non-communicable disease groups, mental and behavioural disorders and musculoskeletal disease rank in the top four groups (table). In the case of musculoskeletal diseases, of all 291 conditions, three of the top ten disorders in developing countries, in terms of both burden and disability, were musculoskeletal disorders. Good musculoskeletal health and mobility is fundamental for the prevention of other non-communicable diseases and essential for independent and productive lives at all ages. Musculoskeletal problems are common comorbidities with other non-communicable diseases, and this combination further reduces function, and impedes efforts to prevent further damage (eg, efforts such as increased physical activity).3Centers for Disease Control and PreventionArthritis—data and statistics—comorbidities.http://www.cdc.gov/arthritis/data_statistics/comorbidities.htmDate: March 3, 2014Google Scholar, 4Loza E Jover JA Rodriguez L Carmona L Group ES Multimorbidity: prevalence, effect on quality of life and daily functioning, and variation of this effect when one condition is a rheumatic disease.Semin Arthritis Rheum. 2009; 38: 312-319Summary Full Text Full Text PDF PubMed Scopus (95) Google ScholarTableBurden from NCDs in low-income and middle-income countries, Global Burden of Disease, 20102Murray CJ Vos T Lozano R et al.Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010.Lancet. 2012; 380: 2197-2223Summary Full Text Full Text PDF PubMed Scopus (6098) Google ScholarBurden (million DALYs)Cardiovascular and circulatory diseases214Mental and behavioural disorders141Cancers130Musculoskeletal diseases119Chronic respiratory diseases101Diabetes, urogenital, blood, and endocrine diseases99Neurological disorders57Digestive disorders (except cirrhosis)27Cirrhosis of the liver25Other NCDs broadcause group107Total1020NCD=non-communicable disease. DALY=disability-adjusted life years. Open table in a new tab NCD=non-communicable disease. DALY=disability-adjusted life years. Many opportunities exist for global health policy and programmes to include and address the burden of non-communicable diseases beyond the traditional broadcause groups. Research is needed on how to best deal with all non-communicable diseases in a way that addresses the broader determinants, adheres to principles of development effectiveness,5High Level Forum on Aid Effectiveness. Busan partnership for effective development co-operation; Busan, Republic of Korea; Nov 29–Dec 1, 2011.Google Scholar and explores and promotes collaboration and integration with work that is already being done on the traditional top broadcause non-communicable disease groups and health systems generally. We are at a crucial point in time when the burden from musculoskeletal diseases and other non-communicable diseases can be mitigated, but urgent action is needed. Pearce and colleagues1Pearce N Ebrahim S McKee M et al.The road to 25×25: how can the five-target strategy reach its goal?.Lancet Glob Health. 2014; 2: e126-e128Summary Full Text Full Text PDF Scopus (34) Google Scholar make important and sensible recommendations for this through inclusion in strategies such as the 25×25 strategy. We declare no competing interests. The road to 25×25: how can the five-target strategy reach its goal?In September, 2011, at the UN high-level meeting on non-communicable diseases (NCDs), the world's leaders committed to tackling this emerging global epidemic.1 The need was urgent, in view of how NCD risk factors are increasing in most low-income and middle-income countries (LMICs).2,3 8 months later, the World Health Assembly set a target of a 25% relative reduction in NCD mortality by 2025.4 Known as the 25×25 strategy,5 this goal is now incorporated into WHO's Global NCD Action Plan 2013–2020. Full-Text PDF Open Access