rates of unrecognized and inadequately addressed CVD and related chronic diseases in both men and women in low and middle income countries are cause for immediate action.

In the past several decades increasing attention has been given to the emergence of chronic diseases as a threat to low and middle income countries. Substantive efforts to more accurately document and draw attention to the economic and health burden have led to a growing recognition that CVD and related chronic diseases need to be on the health agenda for all nations. At the international level, there have been several landmark documents produced to translate this recognition into calls for action and to develop strategies and policy frameworks.

Despite this progress, there remains a profound mismatch between the compelling evidence documenting the health and economic burden of CVD and the lack of concrete steps to increase investment and implement CVD prevention and disease management efforts in developing countries. To help catalyze the action needed, the U.S. National Heart, Lung, and Blood Institute (NHLBI) sponsored this study of the evolving global epidemic of CVD. The Institute of Medicine convened the Committee on Preventing the Global Epidemic of Cardiovascular Disease: Meeting the Challenges in Developing Countries to assess the current tools for CVD control and the knowledge and strategies pertinent to their implementation. The committee was charged with evaluating the available evidence to offer conclusions and recommendations to reduce the global burden of CVD, with an emphasis on developing guidance for partnership and collaborations among a range of public- and private-sector entities involved with global health and development.

In response to its charge, the committee undertook an examination of the current state of efforts to reduce the global epidemic of CVD based on a review of the available literature and of information gathered from various stakeholders in CVD and global health. In this analysis, the committee evaluated why there has not been more action to address chronic diseases and assessed the available evidence on intervention approaches to prevent and manage CVD, emphasizing knowledge and strategies pertinent to their implementation in low and middle income countries. Through careful consideration of the evidence and a thorough deliberation process, the committee drew conclusions about the necessary next steps to move forward.

Prior reports have identified general priorities and recommended a wide range of possible actions for a multitude of stakeholders; indeed, the findings and conclusions of this report reinforce many of those messages and priorities. In this report’s recommendations, however, the committee has emphasized advancing the field beyond messages about broad conceptual solutions and has identified a limited set of specific actions targeted to specific stakeholders. These actions are intended to encourage a sufficient



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