Non-communicable diseases in low- and middle-income countries: context, determinants and health policy

Trop Med Int Health. 2008 Oct;13(10):1225-34. doi: 10.1111/j.1365-3156.2008.02116.x.


The rise of non-communicable diseases and their impact in low- and middle-income countries has gained increased attention in recent years. However, the explanation for this rise is mostly an extrapolation from the history of high-income countries whose experience differed from the development processes affecting today's low- and middle-income countries. This review appraises these differences in context to gain a better understanding of the epidemic of non-communicable diseases in low- and middle-income countries. Theories of developmental and degenerative determinants of non-communicable diseases are discussed to provide strong evidence for a causally informed approach to prevention. Health policies for non-communicable diseases are considered in terms of interventions to reduce population risk and individual susceptibility and the research needs for low- and middle-income countries are discussed. Finally, the need for health system reform to strengthen primary care is highlighted as a major policy to reduce the toll of this rising epidemic.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / prevention & control
  • Chronic Disease / epidemiology
  • Chronic Disease / mortality
  • Chronic Disease / prevention & control*
  • Developing Countries*
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / prevention & control
  • Female
  • Health Policy*
  • Health Transition
  • Humans
  • Life Style
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / prevention & control
  • Neoplasms / epidemiology
  • Neoplasms / prevention & control
  • Nutrition Policy
  • Obesity / complications
  • Quality Assurance, Health Care / standards*
  • Risk Factors