2014 on noncommunicable diseases GLOBAL REPORT STATUS GLOBAL STATUS REPORT on noncommunicable diseases 2014 “Attaining the nine global noncommunicable diseases targets; a shared responsibility” GLOBAL STATUS REPORT on noncommunicable diseases 2014 “Attaining the nine global noncommunicable diseases targets; a shared responsibility” Acknowledgements Under the aegis of Assistant Director General, Oleg Chestnov, the following people wrote and produced this report. Offi ce of the Director General (advice and guidance) Anarfi Asamoa-Baah, Deputy Director General, Chris Dye, Ian Smith Lead author Shanthi Mendis. Chapter leads Tim Armstrong, Douglas Bettcher, Francesco Branca, Jeremy Lauer, Cecile Mace, Shanthi Mendis, Vladimir Poznyak, Leanne Riley, Vera Da Costa E Silva, Gretchen Stevens Project manager Kwok Cho Tang WHO staff in Geneva and Lyon Yulia Bakonina, Freddie Bray, Nick Banatvala, Melanie Bertram, Peter Beyer, Monika Bloessner, Alison A’Isha Commar, Edouard Tursan D’Espaignet, Mercedes De Onis, Alexandra Fleischmann, Silvia Franceschi, Etienne Krug, Chizuru Nishida, Colin Mathers, Bente Mikkelsen, Armando Peruga, Dag Rekve, Jane Robertsen, Gojka Roglic, Yasuyuki Sahara, Ruitai Shao, Andreas Ullrich, Meindert Van Hilten, Temo Waqanivalu, Christopher P Wild WHO staff in regional and country offi ces Regional Directors: African Region-Luis Sambo, Region of the Americas-Carissa Etienne, Eastern Mediterranean Region- Ala Alwan, European Region- Jakab Zsuzsanna, South-East Asia Region-Poonam Singh, Western Pacifi c Region-Young-soo Shin Other staff : Ibtihal Fadhil, Renu Garg, Gauden Galea, Anselm Hennis, Branca Legitic, Samer Jabbour, Frederiek Mantingh, Hai-Rim Shin, Susan Mercado, Steven Shongwe, Slim Slama, Elena Tsoyi, Cherian Varghese External reviewers and others George Alleyne, Robert Beaglegole, David Bramley, Joy Carrington, Rajiv Chowdhury, Michael Engelgau, Majid Ezzati, Charlie Foster, Oscar Franco, Valentin Fuster, Gerald Gartlehner, Danaei Goodarz, Vilius Grabauskas, Ian Graham, Murad Hassan, John Harold, Corinna Hawkes, Carl Heneghan, Konstantin Kotenko, Liming Li, Alan Lopez, Gabriel Masset, Jean Claude Mbanya, George Mensah, Rob Moodie, Venkat Narayan, Sania Nishtar, Srinath Reddy, Jurgen Rehm, Mike Rayner, Peter Scarborough, Yackoob Seedat, Surendra Shastri, Priya Shetty, Sidney Smith, Isolde Sommer, Laurence Sperling, David Stuckler, Doug Webb, Kremlin Wickramasinghe, David Wood, Qiao Youlin, Salim Yusuf Administrative support Fabienne Besson, Maritha Osekre-Amey, Joel Tarel, Roelof Wuite Th e printing of this publication was made possible through the generous fi nancial support of the Governments of Norway and the Russian Federation WHO Library Cataloguing-in-Publication Data Global status report on noncommunicable diseases 2014. 1.Chronic Disease - prevention and control. 2.Chronic Disease - epidemiology. 3.Chronic Disease - mortality. 4.Cost of Illness. 5.Delivery of Health Care. 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Printed in Switzerland Contents Message from the Director-General vii Preface ix Abbreviations x Executive summary xi Introduction 1 Current status of the global agenda on prevention and control of noncommunicable diseases Chapter 1. Global target 1: 9 A 25% relative reduction in the overall mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases Chapter 2. Global target 2: 23 At least 10% relative reduction in the harmful use of alcohol, as appropriate, within the national context Chapter 3. Global target 3: 33 A 10% relative reduction in prevalence of insuffi cient physical activity Chapter 4. Global target 4: 45 A 30% relative reduction in mean population intake of salt/sodium Chapter 5. Global target 5: 53 A 30% relative reduction in prevalence of current tobacco use Chapter 6. Global target 6: 67 A 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure, according to national circumstances Chapter 7. Global target 7: 79 Halt the rise in diabetes and obesity Chapter 8. Global target 8: 95 At least 50% of eligible people receive drug therapy and counselling (including glycaemic control) to prevent heart attacks and strokes Chapter 9. Global target 9: 105 An 80% availability of the aff ordable basic technologies and essential medicines, including generics, required to treat major noncommunicable diseases in both public and private facilities iii Global status report on NCDs 2014 Chapter 10. 113 Development and implementation of national multisectoral action plans to attain national targets Chapter 11. 123 Th e way forward to attain NCD targets: key messages Annexes 133 Annex 1. 134 Global monitoring framework, including 25 indicators and nine voluntary global targets for the prevention and control of noncommunicable diseases Annex 2. 137 Methods used for estimating the NCD mortality and risk factor data Annex 3. 142 List of countries by WHO Regions and World Bank Income Groups Annex 4. 149 Country estimates of noncommunicable disease mortality and selected risk factors, 2010 (baseline) and latest available data 4.1 Premature NCD Mortality 150 Probability of dying between exact ages 30 and 70 from any of cardiovascular disease, cancer, diabetes, or chronic respiratory disease, 2010 and 2012 4.2 NCD mortality 154 Comparable estimates of NCD mortality (total NCD deaths in 000s; % of NCD deaths occurring under the age of 70; and age-standardized death rate for NCDs per 100 000), 2012 4.3 Alcohol 162 Comparable estimates, per capita consumption, heavy episodic drinking and prevalence of alcohol use disorders (population aged 15+ years), 2010 and 2012 4.4a Insufficient physical activity 172 Comparable estimates of prevalence of insuffi cient physical activity (adults 18+ years), 2010 4.4b Insufficient physical activity 180 Comparable estimates of prevalence of insuffi cient physical activity (adolescents 11-17 years), 2010 4.5 Tobacco 184 Comparable estimates of prevalence of current tobacco smoking (population aged 15+ years), 2010 and 2012 4.6 Body mass index 200 Comparable estimates of mean body mass index (adults 18+ years), 2010 and 2014 iv Contents 4.7a Overweight and Obesity 208 Comparable estimates of prevalence of overweight and obesity (population aged 18+ years), 2010 4.7b Overweight and Obesity 224 Comparable estimates of prevalence of overweight and obesity (population aged 18+ years), 2014 4.8a Raised blood glucose 240 Comparable estimates of prevalence of raised blood glucose (population aged 18+ years), 2010 4.8b Raised blood glucose 248 Comparable estimates of prevalence of raised blood glucose (population aged 18+ years), 2014 4.9a Raised blood pressure 256 Comparable estimates of prevalence of raised blood pressure (population aged 18+ years), 2010 4.9b Raised blood pressure 264 Comparable estimates of prevalence of raised blood pressure (population aged 18+ years), 2014 Index 273 v Message from the Director-General Dr Margaret Chan Director-General World Health Organization The world has reached a levels of government, policy development that decisive point in the history involve all government departments, and progress of noncommunicable diseases (NCDs) and has towards universal health coverage. an unprecedented opportunity to alter its course. Th e primary target audience of this report are WHO Member States have agreed on a time-bound Ministers of Health. Th e report provides informa- set of nine voluntary global targets to be attained tion on voluntary global targets and how to scale by 2025. Th ere are targets to reduce harmful use of up national eff orts to attain them, in a sustainable alcohol, insuffi cient physical activity, salt/sodium manner. Th e 2010 baseline estimates