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    And it seems hard to imagine that sub-Saharan Africa wouldn’t be similarly affected.Moreover, an article in the same issue of Nature, which also questioned whether NCDs should receive as high a priority as communicable diseases in low-income settings, nevertheless, noted that if low-income countries would fail to mount an adequate response, NCDs could easily overwhelm underdeveloped and dysfunctional health systems.But what does any of this have to do with people who work in HIV and/or tuberculosis (TB) in resource-limited settings, where communicable diseases are still the most common cause of morbidity and mortality, and which account for far more of the years lost in life As already noted, the epidemiology overlaps significantly, and “the impact of these co-morbidities in Sub Saharan Africa is likely to be large”, predicted Young et al in one recent review.If nothing else, a growing burden of NCD could place severe demands upon the region’s weak health systems — and could clearly compete for the limited resources for health.90% of the world’s people who die prematurely from non-communicable diseases live in developing countries.” Annually, 8.1 million premature deaths (under the age of 60) from non-communicable diseases occur in developing countries. “Between now and 2030 we will see a massive increase in the burden of non-communicable diseases i.e.cancer; ischaemic heart disease; stroke; neuropsychiatric conditions, in particular, depression will demand a heavier toll; and so will diabetes.

    Contrary to what many people believe, NCDs are not just the afflictions of wealthy countries — with the changes in lifestyle and diet associated with globalisation, the burden of NCDs has been growing in low and middle-income countries — including parts of the world where there is also a high burden of HIV and TB.And this is an exponential increase,” said Dr Joseph Perriëns of the World Health Organization’s HIV Department at the 2010 HIV and Health Sciences pre-meeting (preceding the International AIDS Conference in Vienna).Growing calls for action against NCDs Responding to the increasing concern about non-communicable diseases, the WHO launched the 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Non-Communicable Diseases.Speaking at the HIV and NCD meeting, he pointed to data from Tanzania showing that age-adjusted stroke mortality rates in the eraly 1990s were already three to five times higher than the comparative rates in England and Wales.“It is not just the excess deaths that is a cause for concern, but there is a huge amount of prematurity which is a cause for alarm.

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