Tackling the non-communicable disease epidemic: a framework for policy action in lowand middleincome countries

Health policy frameworks for the prevention and control of non -communicable diseases have largely been developed for application in high -income countries. Limited attention has been given to the policy exigencies in lower- and middle -income countries where the impacts of these conditions have been most severe, and further clarification of the policy requirements for effective prevention is needed. This paper presents a policy approach to prevention that, although relevant to high -income countries, recognizes the peculiar situation of lowand middle -income countries. Rather than a narrow emphasis on the implementation of piecemeal interventions, this paper encourages policymakers to utilize a framework of four embedded policy levels, namely health services, risk factors, environmental, and global policies. For a better understanding of the non -communicable disease challenge from a policy standpoint, it is proposed that a policy framework that recognizes responsible health services, addresses key risk factors, tackles underlying health determinants, and implements global non -communicable disease conventions, offers the best leverage for prevention.