The Columbus effect: the donor community's "discovery" of non communicable diseases.

On 28-29 April, 2011 the First Global Ministerial on Healthy Lifestyles and Noncommunicable Diseases (NCDs) convened in Moscow to galvanize support and provide policy guidance for the forthcoming UN High-Level Meeting on NCDs in September 2011. Subsequently, the World Health Organization (WHO) drafted the "Moscow Declaration", placing itself at the global epicentre of NCD prevention and control, working collaboratively with its sole client in Member States, ministries of public health. The Declaration took no note of the extensive and ongoing activities of developing country owned and operated hospitals in the developing world and their clinical participation in NCD prevention and care for the past four decades. This article will review the global burden of NCDs in the developing world; the identification of NCDs by reliable sources decades before the "Moscow Declaration"; the role of hospitals in addressing them despite the absence of donor support; the considerable extant investments made by public and private entities in building inpatient and out-patient facilities; and how donors have overlooked the already established hospital-based industry within developing economies.