Globally most people die from noncommunicable diseases. Especially in developing countries noncommunicable diseases are on the rise, effecting especially poorer societal segments. The noncommunicable diseases contribute greatly to societal and economic losses and inequities in health status. The North Karelia Project was started in Finland to prevent noncommunicable diseases and with the main aim to curb the high mortality from cardiovascular diseases. In collaboration with the community, the health sector, the food industry and mass media, initiatives were started to promote a healthy diet, physical activity and reduce smoking. Over the last 25 years, the age adjusted mortality rate among men of 25-64 years of age from cardiovascular diseases fell by 73%, from lung cancer by 71% and total mortality fell 49%. Each country should plan and implement its own prevention programs, but lessons can be learned from the North Karelia Project. The paper discusses some key lessons and recommendation from the project for countries and for global work. In the last few years WHO has started to up-grade its work to fight noncommunicable diseases. Some initiatives are presented and discussed.