This post is written by President-Elect William Zoghbi, MD, FACC.   

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Yesterday and today, I am in New York City representing the ACC at the landmark United Nations (UN) Summit on Non-Communicable Diseases (NCDs).  ACC CEO Jack Lewin, MD, is accompanying me in advocating for the inclusion of cardiovascular disease (CVD) in the UN’s eight Millennium Development Goals, an imperative step to combating NCDs in the developing world. Driving leaders around the world to address this issue are the astonishing statistics surrounding NCDs: 82% of the 17.1 million deaths caused by CVD occur in the world’s poorest countries -- that’s 14 million deaths per year. Despite this, only 3 percent of global funding is allocated towards NCDs.  

The General Assembly kicked off the meeting by unanimously approving without a vote a political declaration that creates a plan of action for combatting NCDs. Although the declaration does not contain specific targets for reductions in morbidity and mortality, it does contain an agreement to develop a comprehensive global monitoring framework for NCDs in 2012, as well as a set of voluntary global targets and indicators. Other commitments included in the declaration are to:

• Accelerate the implementation of the Framework Convention on Tobacco Control
• Eliminate industrially-produced trans-fats in foods, and implement interventions to reduce consumption of salt, sugars and saturated fats
• Curb harmful use of alcohol
• Restrict the marketing to children of foods high in fats, sugar and salt.

The Declaration calls for increased resources for NCDs through domestic, bilateral and multilateral channels and it recognizes that resources devoted to dealing with NCDs are not commensurate with the magnitude of the problem. However, it falls short of any concrete commitment.

While imperfect, the declaration has galvanized the focus on this pandemic and is critical a first step to improving the health conditions of people worldwide.

Preventing Risk Factors Globally

Released simultaneously with the UN Summit, a Lancet paper, co-authored by ACC President, David Holmes, MD, FACC, focuses on key preventable risk factors for fighting NCDs in developing nations. Specifically, the article stresses the importance of investing in the following, calling them “best buys:”

• Tobacco control/elimination
• Sodium reduction
• Promoting healthy diet and exercise (low fat, sugar and alcohol intake, increased physical activity)
• Generic multidrug treatment for patients with high risk of NCDs

While significant attention has been paid to the above areas in developed nations, little education exists on these issues in the developing world. Worldwide, over 1.3 billion people smoke, 600 million have hypertension, and 220 million battle diabetes. These risk factors contribute to the estimated $500 billion per year NCDs cost in low-income and middle-income countries. Community programs -- such as Let’s Move, which was mentioned by U.S. Surgeon General Regina Benjamin, MD, during a lunch session as a program that could enable people to adopt healthier lifestyles -- are reported to have a 5-year return on investment of $5.60 for every dollar spent.

The Holmes, et al., paper is very clear on the need for worldwide unity and collaboration among leaders from the UN, World Health Organization (WHO), global and local governments, foundations, non-government organizations, and pharmaceutical companies, among others.

As a member of the Partner’s Group of the NCD Alliance, the ACC is epitomizing this collaboration by working with organizations such as the World Heart Federation and the Global Health Council to maximize international efforts to reduce the impact of NCDs. Given the success of NCDR in the U.S., Middle East and Asia, there is potential for developing nations to engage these tools to track their progress on CV care, ultimately improving their patients' outcomes.

Stay tuned for developments in the coming days as we continue to participate in the UN NCD Summit. Follow @ACCinTouch on Twitter for live updates and visit the American College of Cardiology Facebook page for photos and conversation revolving around the Summit. 

[youtuber youtube='http://www.youtube.com/watch?v=avuip0-SMaw']

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