Renaming non-communicable diseases
Authors: Guanyang Zou, Kristof Decoster, Barbara McPake, Sophie Witter
Journal: The Lancet Global Health (2017)

Reframing non-communicable diseases (NCDs) to “spur a sense of urgency” and “focus attention on effective system-wide interventions”1Allen LN Feigl AB What's in a name? A call to reframe non-communicable diseases.Lancet Glob Health. 2017; 5: e129-e130Summary Full Text Full Text PDF PubMed Scopus (42) Google Scholar makes sense. With almost three-quarters of NCD deaths now occurring in low-income and middle-income countries (LMICs), the increasing burden of NCDs already has severe economic consequences that impoverish families, jeopardise health systems, and hinder social and economic development.2World Health OrganizationGlobal status report on noncommunicable diseases. 2010http://www.who.int/nmh/publications/ncd_report2010/en/Google Scholar However, development assistance still does not prioritise NCD prevention and control for a number of reasons. Foreign policy is commonly based on national interest and NCDs are not popularly understood to pose tangible threats to donor countries. Donor agencies appear to find investing in infectious disease control easier to justify to tax payers.3Tang S Ehiri J Long Q China's biggest, most neglected health challenge: non-communicable diseases.Infect Dis Poverty. 2013; 2: 7Crossref PubMed Scopus (48) Google Scholar In times of increasing nationalism, isolationism, and protectionism, focusing a substantial part of development cooperation on NCDs will be even more challenging. NCDs should gain more traction in the development agenda as a fundamental socioeconomic development and justice issue. The rise of NCDs is driven by globalisation, through unfair trade and irresponsible marketing (eg, those targeted at children), and unplanned urbanisation. These increase people's exposure to shared risk factors (eg, junk food, tobacco smoke).2World Health OrganizationGlobal status report on noncommunicable diseases. 2010http://www.who.int/nmh/publications/ncd_report2010/en/Google Scholar Other social determinants—poverty in particular—increase people's exposure to risk factors, while NCDs may keep people trapped in chronic poverty.2World Health OrganizationGlobal status report on noncommunicable diseases. 2010http://www.who.int/nmh/publications/ncd_report2010/en/Google Scholar NCDs and injuries collectively constitute over a third of the disease burden among the poorest populations.4Bukhman G Mocumbi AO Horton R Reframing NCDs and injuries for the poorest billion: a Lancet Commission.Lancet. 2015; 386: 1221-1222Summary Full Text Full Text PDF PubMed Scopus (43) Google Scholar The highly inequitable distribution and impact of NCDs and their risk factors2World Health OrganizationGlobal status report on noncommunicable diseases. 2010http://www.who.int/nmh/publications/ncd_report2010/en/Google Scholar also warrant the attention of development policy. Reframing NCDs as “biosocial and development diseases” (BDDs) will direct more attention to underlying drivers (such as environment and public policies), which go beyond the traditionally recognised behavioural, metabolic, and physiological risk factors. Reframing NCDs alone will not change the behaviour and policies of international donors, at least in the short term. In the long run, however, reframing NCDs along the lines we suggest should facilitate NCD control movements and vital alliances for poverty reduction, social justice, global health equity, and planetary health. This could in turn lead to more international funding for NCDs, through traditional routes and new mechanisms such as those associated with fairer global taxation. In short, reframing NCDs will help to place BDDs more centrally within the Sustainable Development Goal (SDG) agenda,5United Nations, Sustainable Development Goals. https://sustainabledevelopment.un.org/sdgs (accessed Jan 28, 2017).Google Scholar where they belong. Indeed, although NCDs fall, ostensibly, only under SDG target 3.4, the links and possible synergies with other SDG goals and targets are many, and probably more numerous than for other diseases. We declare no competing interests. Renaming non-communicable diseasesThe call by Luke Allen and Andrea Feigl (February, 2017)1 to reframe non-communicable diseases (NCDs) is welcome. The lack of focus on these increasingly important causes of morbidity, impairment, and mortality, with their commensurate increasing consumption of health and societal resources and reduced economic contribution, is inappropriate and damaging for all the reasons Allen and Feigl cogently argue. Few things that are described in the negative as what they are not obtain the understanding or action they deserve. Full-Text PDF Open AccessWhat's in a name? A call to reframe non-communicable diseasesThe global health community does not spend much time on branding, which perhaps explains why existing classifications for the three largest groups of diseases are both outdated and counterproductive. The first Global Burden of Disease study1 described infectious diseases, non-communicable diseases (NCDs), and injuries. This grouping reflected a predominantly infectious disease burden in low-income and middle-income countries, which has since tilted towards NCDs. A name that is a longwinded non-definition, and that only tells us what this group of diseases is not, is not befitting of a group of diseases that now constitute the world's largest killer. Full-Text PDF Open Access