86TheWorldHealthReport2003 These facts are familiar and hardly surprising. What is surprising, however, is that in some developing countries, CVDs have also become the first and second leading causes, responsi- ole for one-third of all deaths(see Figure 6.1) In fact, twice as many deaths from CVD now occur in developing countries as in developed countries. Overall, in developing countries, CVD ranks third in disease burden(after injuries and neuropsychiatric disorders). Even in high-mortality developing countries, CVD is ranked rery high. A particular cause of concern is the relatively early age of Cvd deaths in developing coun tries compared with those in the developed regions(2 ). One in two of the CVD-related deaths in India occur below the age of 70 years, compared with one in five in economically well developed nations. In both rural and urban areas of the United Republic of Tanzania, stroke mortality rates are three times higher than those in England and wales. What is not often recognized is that, globally, CVDs account for as many deaths in young and middle-aged adults as Hiv/aIDs This does not mean that communicable diseases have quietly gone away, require less funding, or are now safely under control. The advent of HIVIAIDS shattered that hope(see Chapter 3). Malaria and tuberculosis are among other enormous threats that remain and are growing In addition, as pointed out in Chapter 5, new infectious diseases have been emerging at the rate of one a year for the last 20 years or more: SARS is the latest. So it is legitimate that public health communities remain vigilant towards infectious diseases, and that this vigilance be- gins with primary health care, in accordance with the Declaration of Alma-Ata. However, the world cannot afford to lose sight of the growing social and economic threats posed by Cvd and other noncommunicable diseases Ironically, CVDs are now in decline in the industrialized countries first associated with them But from that irony stems hope: the decline is largely a result of the successes of primary prevention and, to a lesser extent, treatment. What has worked in the richer nations-and ure 6.1 Deaths attributable to 16 leading causes in developing countries, 2001 Cardiovascular diseases alignant neoplasms Injuries Chronic respiratory diseases HIVIAIDS Diarrhoeal diseases Tuberculosis Digestive diseases Childhood diseases Diabetes mellitus口 Diseases of the genitourinary system n Low-mortality developing countries Neuropsychiatric disorders High-mortality developing countries 12000 Deaths(000)86 The World Health Report 2003 These facts are familiar and hardly surprising. What is surprising, however, is that in some developing countries, CVDs have also become the first and second leading causes, responsi￾ble for one-third of all deaths (see Figure 6.1). In fact, twice as many deaths from CVD now occur in developing countries as in developed countries. Overall, in developing countries, CVD ranks third in disease burden (after injuries and neuropsychiatric disorders). Even in high-mortality developing countries, CVD is ranked very high. A particular cause of concern is the relatively early age of CVD deaths in developing coun￾tries compared with those in the developed regions (2). One in two of the CVD-related deaths in India occur below the age of 70 years, compared with one in five in economically well￾developed nations. In both rural and urban areas of the United Republic of Tanzania, stroke mortality rates are three times higher than those in England and Wales. What is not often recognized is that, globally, CVDs account for as many deaths in young and middle-aged adults as HIV/AIDS. This does not mean that communicable diseases have quietly gone away, require less funding, or are now safely under control. The advent of HIV/AIDS shattered that hope (see Chapter 3). Malaria and tuberculosis are among other enormous threats that remain and are growing. In addition, as pointed out in Chapter 5, new infectious diseases have been emerging at the rate of one a year for the last 20 years or more: SARS is the latest. So it is legitimate that public health communities remain vigilant towards infectious diseases, and that this vigilance be￾gins with primary health care, in accordance with the Declaration of Alma-Ata. However, the world cannot afford to lose sight of the growing social and economic threats posed by CVD and other noncommunicable diseases. Ironically, CVDs are now in decline in the industrialized countries first associated with them. But from that irony stems hope: the decline is largely a result of the successes of primary prevention and, to a lesser extent, treatment. What has worked in the richer nations – and 0 2000 4000 6000 8000 10 000 12 000 Maternal conditions Neuropsychiatric disorders Diseases of the genitourinary system Diabetes mellitus Malaria Childhood diseases Digestive diseases Tuberculosis Diarrhoeal diseases Perinatal conditions HIV/AIDS Chronic respiratory diseases Respiratory infections Injuries Malignant neoplasms Cardiovascular diseases Low-mortality developing countries High-mortality developing countries Deaths (000) Figure 6.1 Deaths attributable to 16 leading causes in developing countries, 2001