. "Appendix A: Five Steps for Setting Research Priorities." Control of Cardiovascular Diseases in Developing Countries: Research, Development, and Institutional Strengthening. Washington, DC: The National Academies Press, 1998.
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STEP 5:ASSESS THE ADEQUACY OF THE CURRENT LEVEL OF EFFORT
Chapters 3 and 4 of this report address current patterns of CVD prevention and care and current levels and types of supporting R&D in developing countries. The message of these chapters is clear and consistent: few international donors or developing country governments recognize the importance of the emerging CVD epidemic in the developing world. In addition, in the majority of countries that have taken initial steps to address the epidemic, the focus has been on technology development, including building and supporting urban care facilities for diagnosis and treatment of CVD. There is little to no emphasis on developing, assessing, or implementing interventions for primordial and primary prevention in developing world populations. In the very few instances where developing country governments have emphasized prevention—see, for example, the successful case study of Zambia cited in Chapter 3—the resulting health benefits have been profound.
The committee's recommendations represent a synthesis of the evidence presented in this report and a distillation of the more numerous recommendations detailed in Chapter 5. The committee hopes that these recommendations will result in prompt and effective action to control CVD in developing countries, and that this action will be assisted by the Forum on International Health R&D and by other international donors, national governments, and professional organizations. The potential health and economic benefits of effectively engaging in the global fight against CVD are many. To continue as is, with the current inadequate level of effort, invites significant peril. An alternative future is possible, in which developing countries invest early enough to prevent the enormous costs of a major epidemic of CVD such as that experienced by developed countries in the twentieth century.