Int J Health Serv. 2013;43(3):437-58. doi: 10.2190/HS.43.3.d.
The promotion of noncommunicable diseases (NCDs) as a global health priority started a decade ago and culminated in a 2011 United Nations high-level meeting. The focus is on four diseases (cardiovascular and chronic respiratory diseases, cancers, and diabetes) and four risk factors (tobacco use, unhealthy diet, physical inactivity, and harmful alcohol use). The message is that disease and death are now globalized, risk factors are overwhelmingly behavioral, and premature NCD deaths, especially in low- and middle-income countries, are the concern. The NCD agenda is promoted by United Nations agencies, foundations, institutes, and organizations in a style that suggests a market opportunity. This "hard sell" of NCDs contrasts with the sober style of the World Health Organization's Global Burden of Disease report, which presents a more nuanced picture of mortality and morbidity and different implications for global health priorities. This report indicates continuing high levels of premature death from infectious disease and from maternal, perinatal, and nutritional conditions in low-income countries and large health inequalities. Comparison of the reports offers an illustration of the World Health Organization at its worst, operating under the influence of the private sector, and at its best, operating according to its constitutional mandate.
将非传染性疾病（NCDs）作为全球卫生重点的推广工作始于十年前，最终在 2011 年联合国高级别会议上达到高潮。重点关注四种疾病（心血管和慢性呼吸道疾病、癌症和糖尿病）和四种风险因素（烟草使用、不健康饮食、身体活动不足和有害酒精使用）。信息是，疾病和死亡现在已经全球化，风险因素主要是行为性的，中低收入国家的过早 NCD 死亡尤其令人关注。联合国机构、基金会、研究所和组织以一种暗示市场机会的方式推动 NCD 议程。这种 NCD 的“强推”与世界卫生组织全球疾病负担报告的冷静风格形成鲜明对比，后者更详细地说明了死亡率和发病率，并对全球卫生重点产生了不同的影响。该报告表明，低收入国家的传染病和孕产妇、围产期和营养状况导致的过早死亡以及巨大的卫生不平等现象仍在持续。两份报告的比较说明了世界卫生组织在最坏的情况下是如何在私营部门的影响下运作的，以及在最好的情况下是如何根据其宪法授权运作的。
