37 million deaths could be prevented by reducing 6 risk factors

After the UN General Assembly agreed to reduce deaths from the top four chronic diseases in 2011, the World Health Organization created targets for premature deaths from these diseases and their key risk factors. Now, research published in The Lancet reveals that reducing six modifiable risk factors to the agreed target levels could prevent over 37 million premature deaths over 15 years.

The four main non-communicable diseases (NCDs) are cardiovascular diseases, respiratory disease, cancers and diabetes, while the six modifiable risk factors are tobacco use, harmful alcohol use, salt intake, high blood pressure and blood sugar, and obesity.

Though the prospect of saving these millions of lives is promising, there is another, more worrying side of the finding: if these targets are not reached, 38.8 million deaths from the four main NCDs will likely occur in 2025.

This number is 10.5 million deaths more than the 28.3 million who died in 2010, researchers say.

The research team used country-level data regarding deaths and risk factors - along with epidemiological models - to estimate the number of deaths that could be prevented between 2010 and 2025.

The globally agreed target levels for reducing risk factors are:

• Tobacco use: 30-50% reduction
• Alcohol use: 10% reduction
• Salt intake: 30% reduction
• High blood pressure: 25% reduction, and
• Stopping the rise in obesity and diabetes prevalence.

Reduction in tobacco use, high blood pressure yields biggest benefits

After conducting their analysis, the researchers found that - if the targets for all six risk factors are met - there would be a reduction in risk of dying prematurely from the four main NCDs by 22% in men and 19% in women by the year 2025.

The researchers say political will and leadership are needed to make these health targets - and death reductions - a reality.

The team notes that around the world, this is the equivalent of delaying or preventing 16 million deaths in people between the ages of 30 and 70, and 21 million in people over the age of 70.

Reducing high blood pressure and tobacco use will likely bring the biggest benefits, say the researchers, who estimate a 50% reduction in smoking by 2025 will reduce risk of dying prematurely by over 24% in men and 20% in women.

More significant impacts will occur in low-to-middle-income countries since high-income countries are already in the process of working toward these targets through policy measures - including tobacco/alcohol taxes, bans on public smoking and salt-reduction guidelines for food.

It is possible to achieve most of the desired reduction in deaths from chronic diseases by tackling a small number of preventable risk factors.

The research team note that theirs is the first study to assess the impact that reducing the targeted risk factors worldwide will have on the UN's 25x25 target to reduce deaths from NCDs by 25% - relative to 2010 levels - by 2025.

"With political will and leadership, the 25x25 targets are well within reach. But despite robust evidence, well-proven cost-effective interventions and a compelling case for action made by [this study] to address risk factors for NCDs to save millions of lives, political apathy prevails.

Even with much discourse, meaningful and durable action against NCDs is scarce, with little accountability to achieve the promises made and the targets set at the General Assembly in 2011."

This study "shows the urgent need for greater policy push and injection of resources into low-to-middle-income countries to replicate the success stories and to avoid escalating numbers of chronic disease deaths in the poorest countries."