BOX 1.1

Major Prior Global CVD Documents


The Victoria Declaration on Heart Health

This declaration, which was issued following the First International Heart Health Conference, was intended to give a sense of urgency to the prevention and control of CVD. It focused on exploring methods of applying existing knowledge about CVD prevention on a global scale, urging governments, research institutions, scientists, the media, and civil society to join forces in eliminating the CVD epidemic by adopting new policies, making regulatory changes, and implementing new population-level health promotion and CVD prevention programs. It further specified that the policy implementation should consist of the adoption of a public health approach to the prevention and control of CVD that was inclusive of all population groups and promoted “four cornerstones” of heart health (healthy dietary habits, a tobacco-free lifestyle, regular physical activity and a supportive psycho-social environment) (Advisory Board of the International Heart Health Conference, 1992).


The World Bank World Development Report: Investing in Health

This report examined the interplay among human health, health policy, and economic development. Like its predecessors, this report included the World Development Indicators, which offer selected social and economic statistics on 127 countries. This report advocated a three-pronged approach to government policies for improving health in developing countries. First, governments need to foster an economic environment that enables households to improve their own health. Second, government spending on health should be redirected to more cost-effective programs that do more to help the poor. Third, governments need to promote greater diversity and competition in the financing and delivery of health services. The report also highlighted the need to promote tobacco control and acknowledged the rising burden of chronic diseases in low and middle income countries. It recommended that basic public health interventions including chronic disease prevention could be a part of low and middle income countries’ essential clinical package (World Bank, 1993).


Disease Control Priorities in Developing Countries (DCP)


A companion document to the 1993 World Development Report, this book used a variety of measures to evaluate the effectiveness of interventions, including an important new metric for measuring disease outcomes: the disability-adjusted life year (DALY). The use of DALYs in both this document and the subsequent Global Burden of Disease report dramatically altered the way researchers measured disease burden because it quantified the toll of disabilities associated with diseases. This helped researchers fully realize the tremendous burden of chronic diseases, which cause years of disability and impair an individual’s ability to lead a healthy life. The report also provided quantitative evidence on demographic transition and the resulting growth in CVD in developing countries. It also generated initial estimates of

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