Demonstration projects for the integrated prevention and control of noncommunicable diseases (INTERHEALTH programme): epidemiological background and rationale. INTERHEALTH Sterring Committee.

Noncommunicable diseases--cardiovascular and cerebrovascular disease, pulmonary diseases, liver disease, cancer, diabetes, osteoporosis and trauma--constitute the major cause of death in developed countries and are predictably emerging as significant threats to health in countries at intermediate stages of the epidemiological transition. Based on the philosophy that diseases with common risk factors (inadequate prevention/control services, smoking, fat/salt diet, alcohol use, etc.) require common preventive strategies, the INTERHEALTH demonstration projects are designed to build regional capacities and to exchange social and medical technologies for broad-gauged noncommunicable disease prevention and control. Projects are at various stages of planning and implementation in all WHO regions: Africa (Mauritius, United Republic of Tanzania); the Americas (Chile, Cuba, United States); Eastern Mediterranean (Cyprus); Europe (Finland, Malta, USSR); South-East Asia (Sri Lanka, Thailand); the Western Pacific (Australia, China, Fiji, Japan). This article presents selected data which illustrate the long-term mortality trends and present noncommunicable disease risk-factor levels in participating countries at different stages of the epidemiological transition. The shift towards noncommunicable diseases as a cause of death is readily apparent and combinations of risk factors are present in each of the populations studied in the baseline phase of this research and demonstration programme. The use of data to estimate the noncommunicable disease-related mortality burden from different lifestyles and risk factors is illustrated and findings from the most advanced demonstration studies are briefly outlined.