lemma, ways must be found now to begin grappling with the issues, at least in a preparatory way.

The first step is to characterize the incidence, prevalence, determinants, and interventions in the area of adult diseases in local terms. There is a potential trap here, however. These diseases are so well known in developed countries that it will be tempting to simply transfer the understandings of and interventions for these diseases to developing country settings. That could be an epidemiologic mistake, since the character and determinants of those diseases could vary dramatically. It could also be impractical from an intervention perspective, since the diagnostic and therapeutic approaches used in developed country settings may surpass the resources of developing countries. Clearly, existing knowledge about diseases of adults in developed countries must be interpreted, applied, and extended carefully in developing country settings, an obvious area for close collaboration between the research and health system development communities of all countries.

The directions of action that are called for are similar to those noted in connection with Disease Control Priorities in Developing Countries: assisting those countries in building their capacities in research, policy making, health system development, and development of human resources for all levels of the health care system.



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