Surveillance - Overview

Chronic diseases are the major cause of death and disability worldwide. In the WHO Region for Africa, chronic diseases are projected to account for 23% of all deaths over the next 10 years. A small set of common risk factors are responsible for most of the main chronic diseases .

Eight major risk factors are responsible worldwide for more than 60% of mortality and at least 50% of morbidity. Four of them are behavioural (use of tobacco, alcohol, unhealthy diets, and physical inactivity). They have important gender dimensions and particularly affect poor populations in low- and middle-income countries. Although emphasis has been placed on treating the adverse effects of these risk factors, much less attention has been devoted to prevention and gender-responsive ways of dealing effectively with these health determinants. Tobacco use is the leading cause of preventable deaths worldwide, with at least 50% of tobacco-attributable deaths occurring in developing countries. Tobacco use and poverty are closely linked and prevalence rates are higher among the poor. Fortunately, measures that are both successful and cost effective are available for reducing tobacco use. Every year, alcohol consumption is linked to 1.8 million deaths globally and 58.3 million years of life lost. In developing countries with low overall mortality, alcohol use is the leading risk factor, accounting for 6.2% of the total burden of disease. Globally, 17% of the population are estimated to be physically inactive and an additional 41% to be insufficiently active to benefit their health. It has been estimated that the resultant annual death toll is 1.9 million. 26.7 million (1.8%) DALYs worldwide are attributable to low fruit and vegetable intake.

WHO has responded to this growing burden by giving higher priority to NCD prevention, control and surveillance in its programme of work. The guiding principles of this response are:

• For Surveillance
  • Identification and description of the key NCD risk factors, using recommended WHO definitions
  • A standardized approach for conducting surveillance of risk factors to allow international comparisons within and between countries
  • Continuous risk factor surveillance
  • Providing data for policy
• For Prevention
  • High priority for primary prevention
  • Comprehensive and integrated public health action
  • Intersectoral action
  • A life course perspective
  • Stepwise implementation based on local considerations and needs.