Derek Yach, M.B.Ch.B., M.P.H., from the World Health Organization, Geneva, Switzerland, presented the special communication today at a JAMA media briefing at the National Press Club in Washington, D.C.

According to background information provided by the authors: "Chronic diseases are the largest cause of death in the world, led by cardiovascular disease (17 million deaths in 2002, mainly from ischemic heart disease and stroke) and followed by cancer ( 7 million deaths), and chronic lung diseases (4 million), and diabetes mellitus (almost 1 million). These leading diseases share key risk factors: tobacco use, unhealthful diets, lack of physical activity, and alcohol use."

Yach and colleagues write that the "global prevalence of all the leading chronic diseases is increasing, with the majority occurring in developing countries and projected to increase substantially over the next 2 decades." The authors note that "between 1990 and 2020, mortality [death] from ischemic heart disease in developing countries is expected to increase by 120 percent for women and 137 percent for men." The authors add that risks for chronic diseases are also rising with higher rates of smoking and obesity levels among adolescents in developing countries.

"Chronic diseases have not simply displaced acute infectious ones in developing countries. Rather, such countries now experience a polarized and protracted double burden of disease. India, the second most populous country, has the highest number of diabetics in the world and annual coronary deaths are expected to reach 2 million by 2010. At the same time, around 2.5 million children in India die from infections such as pneumonia,
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Contact: David Porter
porterd@who.int
11-41-791-2111
JAMA and Archives Journals
1-Jun-2004