Chronic diseases and health promotion

Part Three. What works: the evidence for action

Chapter Two. Review of effective interventions

This is Part Three of WHO report "Preventing chronic diseases: a vital investment"

Key messages

Comprehensive and integrated action is the means to prevent and control chronic diseases. This chapter describes and gives examples of the types of interventions, for the whole population or for individuals, that will enable countries to achieve major reductions in premature chronic disease deaths. The chapter outlines the evidence showing that chronic diseases can be prevented and controlled using available knowledge. Moreover, it shows that the solutions are not only effective but can be highly cost-effective even in settings with few resources.

  • A small shift in the average population levels of several risk factors can lead to a large reduction of the burden of chronic diseases.
  • Population-wide approaches form the central strategy for preventing chronic disease epidemics, but should be combined with interventions for individuals.
  • Many interventions are not only effective but are also suitable for resource-constrained settings.

Face to face with chronic disease: diabetes

This chapter tells the story of Zahida Bibi, 65 years old, Pakistan, who has been living with diabetes since the age of 45 and for several years was unaware that she had the disease. "I was feeling tired and dizzy all the time. I was also having trouble remembering things and had to urinate a lot," she recalls.

Zahida had consulted a doctor once, but was told that her blood test was normal. After that, Zahida ignored her symptoms for eight long years before seeking medical care again, this time in Islamabad, 70 km from her home town. A second blood test finally established the nature of the problem and she started feeling much better almost immediately after taking her first shot of insulin (see page 18).