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Global cardiovascular health: urgent need for an intersectoral approach
Valentin Fuster1, Bridget B Kelly, Rajesh Vedanthan
1Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain. valentin.fuster@mountsinai.org
Insights
Cardiovascular disease (CVD) is a global health challenge, especially in low- and middle-income countries (LMICs). Effective CVD control requires simultaneous, multi-sectoral interventions across policy, communication, and healthcare delivery.
Area of Science:
- Global Health
- Cardiovascular Disease Prevention
- Public Health Policy
Background:
- Cardiovascular disease (CVD) is the primary cause of death globally, disproportionately affecting low- and middle-income countries (LMICs).
- Despite calls to action, LMICs face inadequate investment and implementation of CVD prevention and management strategies.
- The Institute of Medicine's report, 'Promoting Cardiovascular Health in the Developing World,' highlights the critical need for global action.
Purpose of the Study:
- To comment on the Institute of Medicine's report on global cardiovascular health.
- To emphasize the intersectoral approach necessary for effective CVD intervention strategies worldwide.
- To outline key domains and levels for implementing comprehensive CVD control measures.
Main Methods:
- Analysis and commentary on the Institute of Medicine's report on cardiovascular health in developing nations.
- Identification of three primary intervention domains: policy, health communication, and healthcare delivery.
- Argument for a two-level intersectoral approach: simultaneous activation of all domains and synergistic combination of interventions within each domain.
Main Results:
- Effective global CVD control necessitates activating policy, health communication, and healthcare delivery interventions concurrently.
- Within each intervention domain, a synergistic combination of strategies is crucial for optimal impact.
- Collaboration among diverse public and private sector actors (e.g., health, agriculture, finance, education) is essential for aligning interventions.
Conclusions:
- Addressing the global burden of cardiovascular disease is achievable through a coordinated, intersectoral strategy.
- Simultaneous engagement across policy, communication, and healthcare delivery, coupled with synergistic actions within each, is vital.
- Broad stakeholder collaboration across multiple sectors is indispensable for successful global CVD prevention and management.
Abstract:
Cardiovascular disease (CVD) is the leading cause of mortality worldwide, with more than 80% of CVD deaths occurring in low- and middle-income countries (LMICs). There have been several calls for action to address the global burden of CVD, but there remains insufficient investment in and implementation of CVD prevention and disease management efforts in LMICs. To catalyze the action needed to control global CVD, the Institute of Medicine recently produced a report, Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health. This paper presents a commentary of the Institute of Medicine's report, focusing specifically on the intersectoral nature of intervention approaches required to promote global cardiovascular health. We describe 3 primary domains of intervention to control global CVD: 1) policy approaches; 2) health communication programs; and 3) healthcare delivery interventions. We argue that the intersectoral nature of global CVD interventions should ideally occur at 2 levels: first, all 3 domains of intervention must be activated and engaged simultaneously, rather than only 1 domain at a time; and second, within each domain, a synergistic combination of interventions must be implemented. A diversity of public and private sector actors, representing multiple sectors such as health, agriculture, urban planning, transportation, finance, broadcasting, education, and the food and pharmaceutical industries, will be required to collaborate for policies, programs, and interventions to be optimally aligned. Improved control of global CVD is eminently possible but requires an intersectoral approach involving a diversity of actors and stakeholders.
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