Table 2 Cost effective interventions for the prevention and control of NCDs as reported in the WHO Global Action Plan 2013–2020
Clinical | Risk factor/disease (DALYs in millions; % global burden) | Interventions (bold are ‘best buys’, others are ‘good buys’) | Averted burden | CE | Implementation cost | Feasibility (health system constraints) |
|---|---|---|---|---|---|---|
Tobacco use (>50m DALYs;3.7% global burden) | Raise tax on tobacco | Combined effect: | CE | Very low cost | Highly feasible; strong framework (FCTC) | |
Ban tobacco advertising | 25–30 million DALYs (>50% tobacco burden) | |||||
Ban smoking in public/work places | ||||||
Health warning on danger of smoking | ||||||
C | Offer counselling to smokers | Quite CE | Quite low cost | Feasible (PHC) | ||
Harmful use of alcohol (>50m DALYs; 4.5% GB) | Restrict access to retailed alcohol | Combined effect: | Very CE | Very low cost | Highly feasible | |
Enforce bans on alcohol advertising | 5–10 m DALYs (10–20% alcohol burden) | |||||
Raise taxes on alcohol | ||||||
Enforce drink-driving laws | Quite CE | Quite low cost | Intersectoral Feasible (PHC) | |||
Offer brief advice for hazardous drinking | ||||||
Unhealthy diet (15–30m DALYs; 1–2% GB) | Reduce salt intake | Salt reduction: | Very CE | Very low cost | Highly feasible | |
Replace transfat with polyunsaturated fat | 5 m DALYs | |||||
Promote public awareness about diet | ||||||
Restrict marketing of food and beverages to children | NA | Very CE | Very low cost | Highly feasible | ||
Replace saturated fat with unsaturated fat | ||||||
Manage food taxes and subsidies | ||||||
Provide health education in worksites | Less CE | Quite low cost | Highly feasible | |||
Promote healthy eating in schools | ||||||
C | Offer counselling in primary care | Quite CE | Higher cost | Feasible (PHC) | ||
Physical inactivity | Promote physical activity (mass media) | NA | Very CE | Very low cost | Highly feasible | |
(>30m DALYs;2.1% GB) | Promote physical activity (communities) Support active transport strategies | Not assessed | Not assessed globally | Intersectoral action | ||
Promote physical activity in worksites | Quite CE | Higher cost | Feasible (PHC) | |||
Promote physical activity in schools | Less CE | Higher cost | Feasible | |||
C | Offer counselling in primary care | |||||
C | CVD and diabetes (170 m D; 11% GB) | Counselling & multidrug therapy for CVD and diabetes if 10-year risk of CVD ≥30% | 60 m DALYs (35% CVD burden) | Very CE | Quite low cost | Feasible (PHC) |
C | Aspirin for acute myocardial infarction | 4 m (2% CVD B) | Feasible (PHC) | |||
C | Multidrug therapy if 10-year risk of CVD ≥20% | 70 m (40% CVD B) | Quite CE | Higher cost | Feasible (PHC) |