The classical portrayal of poor health in tropical countries is one of infections and parasites, contrasting with wealthy Western countries, where unhealthy diet and behaviours cause non-communicable diseases (NCDs) such as heart disease and cancer. Using international mortality data, we show that most NCDs cause more deaths at every age in low- and middle-income tropical countries than in high-income Western countries. Causes of NCDs in low- and middle-income countries include poor nutrition and living environment, infections, insufficient taxation and regulation of tobacco and alcohol, and under-resourced and inaccessible healthcare. We identify a comprehensive set of actions across health, social, economic and environmental sectors that could confront NCDs in low- and middle-income tropical countries and reduce global health inequalities.
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We thank R. Beaglehole, S. Blundell, R. Nugent, F. Piel, M. Parkins and M. Thun for comments and recommendation of background literature.
Nature thanks F. Assah, P. Byass, B. Singer and the other anonymous reviewer(s) for their contribution to the peer review of this work.
The authors declare no competing interests.
Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Ezzati, M., Pearson-Stuttard, J., Bennett, J.E. et al. Acting on non-communicable diseases in low- and middle-income tropical countries. Nature 559, 507–516 (2018). https://doi.org/10.1038/s41586-018-0306-9
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