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Table 2 Cost effective interventions for the prevention and control of NCDs as reported in the WHO Global Action Plan 2013–2020

From: Screening for cardiovascular disease risk and subsequent management in low and middle income countries: challenges and opportunities

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)
  1. Abbreviations: C clinical intervention (i.e. all others are public health interventions), B burden, CA cancer, CE cost effective, CVD cardiovascular diseases, DALY or D disability adjusted years of life lost, FCTC framework convention on tobacco control, GB global burden, m million, NA not available, PHC primary health care
  2. Interventions in bold/blue are very cost effective (“best buys”), i.e. generate an extra year of healthy life for a cost that falls below the average annual income or gross domestic product per person