Global Heart RSS feed: Current Issue. Global Heart seeks to provide a forum for dialogue and education on matters that relate foremost to the prevention and control of cardiovascular diseases worldwide, with a special focus on countries with middle and lower economies. With the main focus being on prevention, manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent cardiovascular diseases and their antecedent factors. The emphasis should be on approaches that can be applied in settings with limited resources. Economic evaluations of successful interventions will be particularly welcome. Important negative findings will also be considered. While reports of hospital or clinic-based treatments will not necessarily be rejected, particularly if they have broad implications for cost-effective disease control or prevention, manuscripts that address community-based activities will be preferred. Submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations particularly those related to prevention are encouraged. WHF Members and personal subscribers can access the journal online here http://www.globalheart-journal.com/?rss=yesElsevier Inc.en © 2012 World Heart Federation (Geneva). Published by Elsevier Inc. All rights reserved. Global Heart2211-816071March 2012 © 2012 World Heart Federation (Geneva). Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.globalheart-journal.com/article/PIIS2211816012000427/abstract?rss=yesEditorial Board10.1016/S2211-8160(12)00042-7Global Heart 7, 1 (2012)2012-03-01Global Heart2012-03-0171S2211-8160(11)X0006-6iiihttp://www.globalheart-journal.com/article/PIIS2211816012000440/abstract?rss=yesTable of Contents10.1016/S2211-8160(12)00044-0Global Heart 7, 1 (2012)2012-03-01Global Heart2012-03-0171S2211-8160(11)X0006-6ivvhttp://www.globalheart-journal.com/article/PIIS2211816012000075/abstract?rss=yesA decade ago, the world prepared to confront one of the greatest public health and moral challenges in human history. The pages of medical journals were filled with debates about whether it was possible to act on anything close to the scale that was needed to tackle the scourge of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome. Many years and many lives were wasted as researchers and policymakers with the best of intentions invented a conflict between prevention and care and pointed to countless reasons, including high fixed costs, as well as human resources and infrastructural deficits, why the time was not yet ripe for the massive provision of lifesaving treatment to poor people in need worldwide.Meeting the Challenge of NCD: We Cannot WaitAgnes Binagwaho10.1016/j.gheart.2012.01.004Global Heart 7, 1 (2012)2012-03-01Global Heart2012-03-0171S2211-8160(11)X0006-6Preface12http://www.globalheart-journal.com/article/PIIS2211816012000166/abstract?rss=yesThe United Nations (UN) put its stamp of approval on noncommunicable diseases (NCD) as a global health priority at the High-Level Meeting on NCD in September 2011 and then handed the baton to member states to take the next steps in addressing this growing health problem. For a decade, the UN’s World Health Organization (WHO) has advanced the cause of NCD and, for much of that time, was alone with the megaphone. The early attention to NCD from the WHO Director General Gro Harlem Brundtland ultimately led to the Global Strategy on Diet, Physical Activity, and Health , the 2008–2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases , and other influential documents such as the WHO Expert Report on Chronic Disease . WHO has devoted a greater proportion of the funding within its discretion to NCD than member countries and other donors devote from extrabudgetary resources provided to WHO, and it succeeded in advocating for and then carrying off, in record time, a UN high-level meeting.An Evolving Approach to the Global Health Agenda: Countries Will Lead the Way on NCD Prevention and ControlRachel Nugent, Bridget B. Kelly, Jagat Narula10.1016/j.gheart.2012.02.003Global Heart 7, 1 (2012)2012-03-01Global Heart2012-03-0171S2211-8160(11)X0006-6Editor's Page36http://www.globalheart-journal.com/article/PIIS2211816012000178/abstract?rss=yesAs highlighted by the recent United Nations High-Level Meeting on Noncommunicable Diseases in September 2011, chronic diseases are increasingly recognized as a major health problem in low- and middle-income countries, where they are also accompanied by significant economic repercussions . Low- and middle-income countries face many competing demands on their available resources, from basic development priorities to a range of important health needs. These countries currently have limited internal resources devoted to chronic diseases and receive little external funding to address this issue . Nonetheless, despite the many challenges, it is increasingly recognized that reducing the burden of chronic diseases in developing countries is not only achievable, but it is also critical to meeting global health and development goals. The Institute of Medicine (IOM) report, Promoting Cardiovascular Health in the Developing World , concluded that to accomplish this reduction in chronic disease burden would require:Exploring Country-Level Decision Making for the Control of Chronic Diseases: Reflections from an Institute of Medicine WorkshopBridget B. Kelly, Tracey Pérez Koehlmoos, Rachel Nugent10.1016/j.gheart.2012.02.004Global Heart 7, 1 (2012)2012-03-01Global Heart2012-03-0171S2211-8160(11)X0006-6Editorial Viewpoint712http://www.globalheart-journal.com/article/PIIS2211816012000105/abstract?rss=yesAbstract: The rationing problem is common to all health systems—the challenge of managing finite resources to address unlimited demand for services. In most low- and middle-income countries, rationing occurs as an ad hoc, haphazard series of nontransparent choices that reflect the competing interests of governments, donors, and other stakeholders. Yet in a growing number of countries, more explicit processes, with strengths and limitations, are under development that merit better support. Against this background, the purpose of the Center for Global Development Working Group, which is to examine how priorities are set currently, and to propose institutional arrangements that promote country ownership and improve health outcomes by more systematically managing this complex process of politics and economics, is discussed. Current global and national priority-setting practices in low- and middle-income countries, the potential for strengthened national institutions, and increased global support are reviewed. Recommendations for action are provided.Priority-Setting Institutions in Health: Recommendations from a Center for Global Development Working GroupAmanda Glassman, Kalipso Chalkidou, Ursula Giedion, Yot Teerawattananon, Sean Tunis, Jesse B. Bump, Andres Pichon-Riviere10.1016/j.gheart.2012.01.007Global Heart 7, 1 (2012)2012-03-01Global Heart2012-03-0171S2211-8160(11)X0006-6Recommendations & Guidelines1334http://www.globalheart-journal.com/article/PIIS2211816012000129/abstract?rss=yesAbstract: At the UN High-Level Meeting on non-communicable diseases (NCD) in September 2011, each member state was challenged to create a multisectoral national policy and plan for the prevention and control of non-communicable disease by 2013. Few low-income countries, however, currently have such plans. Their governments are likely to turn for assistance in drafting and implementation to multilateral agencies and Contract Technical Support Organizations recommended by development partners. Yet because many NCD seen in the lowest-income countries differ significantly from those prevalent elsewhere, existing providers of external technical support may lack the necessary experience to support strategic planning for NCD interventions in these settings. This article reviews currently available mechanisms of technical support for health sector planning. It places them in the broader historical context of post- World War II international development assistance and the more recent campaigns for horizontal “South-South” cooperation and aid effectiveness. It proposes bilateral technical assistance by low income-countries themselves as the natural evolution of development assistance in health. Such programs, it argues, may be able to improve the quality of technical support to low-income countries for strategic planning in the NCD area while directing resources to the regions where they are most needed.Transforming South–South Technical Support to Fight Noncommunicable DiseasesAaron D.A. Shakow, Gene Bukhman, Olumuyiwa Adebona, Jeremy Greene, Jean de Dieu Ngirabega, Agnès Binagwaho10.1016/j.gheart.2012.01.009Global Heart 7, 1 (2012)2012-03-01Global Heart2012-03-0171S2211-8160(11)X0006-6State-of-the-Art Review3545http://www.globalheart-journal.com/article/PIIS2211816012000087/abstract?rss=yesNoncommunicable diseases (NCD)—cardiovascular diseases (CVD), diabetes mellitus, cancer, and chronic obstructive pulmonary diseases—account for two-thirds of death and disability, globally, every year . CVD alone, including coronary artery and cerebrovascular disease, accounts for 30% of the global burden of disease. As many low- and middle-income countries (LMIC) progress through the epidemiologic transition and life expectancy increases, they are also undergoing globalization as well as economic reform . This globalization, which is coupled with urbanization and modernization, contributes to changes in the lifestyle and behavior of people living in LMIC and emerging economies (such as the former Soviet Union and Eastern European countries). These factors play a role in the heavy burden of NCD, as much as 80%, that now occurs in these countries .Policy Depot: A Tool to Build Global Capacity in Cardiovascular Health PolicyKeith Mason, Arun Chockalingam, Stephen Prudhomme, Sylvie Stachenko, Thomas Pearson10.1016/j.gheart.2012.01.005Global Heart 7, 1 (2012)2012-03-01Global Heart2012-03-0171S2211-8160(11)X0006-6Innovations & Concepts4751http://www.globalheart-journal.com/article/PIIS2211816012000142/abstract?rss=yesAbstract: Low and middle income countries are faced with a range of challenges related to providing efficient and affordable health care. With non-communicable diseases (NCD) on the rise, there is a growing need to be able to estimate resource requirements, costs and expected impact associated with various investment strategies related to prevention and control of NCD. In this article, recently developed costing and health impact models for non-communicable disease are reviewed, with a view to drawing out their main findings as well as methodological limitations. A key shortcoming is that earlier modelling efforts have taken a vertical approach to costing, when in reality a more integrated, horizontal approach is needed in order to effectively plan for scaled-up investment and system development. We subsequently describe how the integration of an NCD module into the joint United Nations OneHealth tool will enable low- and middle-income countries to bring NCD into an integrated process for national strategic health planning.Resource Needs for Addressing Noncommunicable Disease in Low- and Middle-Income Countries: Current and Future DevelopmentsKarin Stenberg, Dan Chisholm10.1016/j.gheart.2012.02.001Global Heart 7, 1 (2012)2012-03-01Global Heart2012-03-0171S2211-8160(11)X0006-6State-of-the-Art Review5360http://www.globalheart-journal.com/article/PIIS2211816012000099/abstract?rss=yesTo address the increasing burden from noncommunicable diseases (NCD) in Bangladesh, new epidemiologic and economic information for risk factors are needed. This work quantified the attributable risk from specific NCD risk factors and undertook a costing exercise for prevention of NCD risk factors. We used available data for Bangladesh and implemented an iterative questionnaire process with local experts to calculate risk factor population attributable fractions and establish resource requirements for NCD prevention. The burden analysis showed that myocardial infarction and stroke occurrence can be greatly reduced by risk factor control. From the costing, we found that $3.95 USD per capita is needed for a prevention program, which is 26% of the total expenditure on health. These estimates should facilitate advocacy for setting expenditure targets and identifying financing mechanisms to address NCD. The information supports the scaling-up of NCD prevention strategies in Bangladesh and serves as a model for work in developing country settings.Risk-Attributable Burden of Chronic Diseases and Cost of Prevention in BangladeshAndrew Mirelman, Tracey Pérez Koehlmoos, Louis W. Niessen10.1016/j.gheart.2012.01.006Global Heart 7, 1 (2012)2012-03-01Global Heart2012-03-0171S2211-8160(11)X0006-6Review6166http://www.globalheart-journal.com/article/PIIS2211816012000130/abstract?rss=yesIn September 2011, world leaders at the first-ever UN High-Level Meeting on Non-Communicable Diseases unanimously approved a Political Declaration to stem a rising tide of noncommunicable diseases (NCD), now the world’s leading killer . This declaration called for governments, industry, and civil society to develop multipronged plans to curb the risk factors behind the four main NCD: cardiovascular diseases; cancers; chronic respiratory diseases; and diabetes . The document highlighted the need for universal national health coverage and called for strengthened international cooperation to provide technical assistance and capacity-building to developing countries to effectively tackle NCD.Building on the AIDS Response to Tackle Noncommunicable DiseasePeter Lamptey, Rebecca Dirks10.1016/j.gheart.2012.01.010Global Heart 7, 1 (2012)2012-03-14Global Heart2012-03-1471S2211-8160(11)X0006-6Editorial Viewpoint6771http://www.globalheart-journal.com/article/PIIS2211816012000154/abstract?rss=yesAbstract: This article describes efforts from the Pan American Health Organization (PAHO) that have supported progress in country-driven planning and implementing of actions to address noncommunicable diseases (NCD), as well as mechanisms that PAHO has supported for countries in the Americas to share and build on each other’s experiences. The Regional Strategy and Plan of Action for NCD, approved by all member states in 2006, is the major frame for this work. The strategy has 4 lines of action: policy and advocacy; surveillance; health promotion and disease prevention; and integrated management of NCD and risk factors. Cross-cutting strategies include resource mobilization, communication, training, and networks and partnerships. The strategy is operationalized through biannual work plans for which countries link and commit to achieving specific objectives. PAHO then provides technical support toward achieving these plans, and countries report progress annually. The CARMEN (Collaborative Action for Risk Factor Prevention and Effective Management of NCD [Conjunto de Acciones para la Reducción y el Manejo de las Enfermedades No transmisibles]) Network provides a major platform for sharing, and the multisector Pan American Forum for Action on NCD has been launched to extend the network to include business and civil society. PAHO also supported civil society capacity building. Almost all member states have made substantial progress in implementing their national chronic disease programs, in most instances reporting exceeding the indicators of the strategic plan related to chronic diseases. From the Caribbean countries, leadership has been provided to achieve the historic UN High-Level Meeting on NCD in September 2011. The region is on track to meet the mortality reduction target set for 2013, though much remains to be done to further increase awareness of and resources for scaling up NCD prevention and control programs, given the huge health and economic burden, increasing costs, and worrying increases of some conditions such as obesity. Major challenges include getting NCD into social protection packages, building the human resource capacity, strengthening surveillance, achieving true intersectoral and multipartner action, given that most determinants of the epidemic lie outside the health sector, and increasing investment in prevention.NCD Prevention and Control in Latin America and the Caribbean: A Regional Approach to Policy and Program DevelopmentC. James Hospedales, Alberto Barcelo, Silvana Luciani, Branka Legetic, Pedro Ordunez, Adriana Blanco10.1016/j.gheart.2012.02.002Global Heart 7, 1 (2012)2012-03-01Global Heart2012-03-0171S2211-8160(11)X0006-6Review7381http://www.globalheart-journal.com/article/PIIS2211816012000117/abstract?rss=yesAt the Executive Board meeting of the World Health Organization (WHO) in January, the Non-Communicable Disease Alliance (NCDA), of which the World Heart Federation is a founding member, called on member states to:Invest time and resources in consulting on and ultimately approving a global monitoring and accountability framework and global targets for NCD at the 65th World Health Assembly; prioritize key global targets including approval of the overarching goal of reducing preventable deaths from NCD (by 25% by 2025) as well as those that meet strict WHO criteria of feasibility at country level, availability of data collection instruments, and evidence, including targets related to tobacco, salt, alcohol, blood pressure and transfats; ensure the inclusion of NCD in the post-2015 international development goal-setting process; support the establishment of a global partnership for NCD (with civil society participation); and ensure that WHO has the necessary resources to continue to promote and monitor global action to prevent and control NCD.Non-Communicable Disease Alliance Moving Forward: Follow-Up to the United Nations High-Level MeetingJohanna Ralston, Sidney C. Smith10.1016/j.gheart.2012.01.008Global Heart 7, 1 (2012)2012-03-01Global Heart2012-03-0171S2211-8160(11)X0006-6Editorial Viewpoint8386