Chronic diseases and health promotion

Part Three. What works: the evidence for action

Chapter Two. Review of effective interventions

Conclusion. Story of Zahida Bibi

Chronic diseases are already the major cause of death in almost all countries, and the threat to people's lives, their health and the economic development of their countries is growing fast. Yet, as this part of the report has shown, the knowledge exists to deal with this threat and to save millions of lives. Effective and cost-effective interventions, and the knowledge to implement them, have been shown to work in many countries.

If existing interventions are used together as part of a comprehensive, integrated approach, the global goal for preventing chronic diseases can be achieved. The only question is how governments, the private sector and civil society can work together to put such approaches into practice. If they do so in the ways outlined in the next part of the report, the global goal for chronic disease prevention and control will be achieved and millions of lives will be saved.

"I waited too long": Zahida Bibi, 65 years old, Pakistan

Zahida Bibi 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. Many of the complications of diabetes, such as leg amputation, can be prevented by good health care.

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.

Zahida Bibi has been living with diabetes for twenty years
Zahida Bibi has been living with diabetes for twenty years
WHO/Chris de Bode

As is often true for people living with diabetes, Zahida recently developed serious complications which could have been avoided. One of her legs was amputated below the knee, as a result of an ulcer on her foot going untreated. "The doctor told me that it was connected with diabetes and that I waited too long and should have come to him at the first signs of infection," she says with regret.

Zahida holds her local hospital responsible for not having detected raised blood glucose in the first place, but admits that she should have reported the ulcer on her foot to her doctor much sooner. Now 65 years old, she is slowly recovering at home from the physical and emotional effects of surgery with the help of her son and daughter-in-law.