World Health Organization member states gathered to draft the Global Action Plan for the prevention and control of noncommunicable diseases (NCDs). A global overarching target of a 25% reduction of premature mortality (between ages 30 and 70) from the four major NCDs (cardiovascular diseases, cancer, diabetes or chronic respiratory diseases) by 2025 was adopted. The primary aim of this mini-review is to identify the main barriers for reaching this plan using pertinent available evidence. The secondary aim is to reexamine the data with the dual purposes of amplifying beneficial effects of the voluntary global targets, and expanding the population to which they apply. This paper has identified five interrelated barriers: I) extremely low prevalence of ideal cardiovascular health, II) Gaps in affordability of essential medications, III) Gaps in health systems, IV) Low adherence to medications and V) Gaps in voluntary global targets. Conclusions: Modifications in the voluntary global targets are being proposed to produce greater effectiveness and extend reach. To this end, more ambitious risk factor targets for a larger proportion of the population and major efforts to strengthen healthcare systems are urgently needed.
Alberto Morales Salinas and Richard Kones
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