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Big Risks: the challenges and opportunities in addressing the biggest global causes of premature mortality

Guest Editors: Dr Raymond Hutubessy, Prof Gretchen Birbeck, Dr Juan-Manuel Anaya and Prof Alan Lopez

The forthcoming post-Millennium Development Goals era will bring about new challenges in global health. Low-and middle-income countries will have to contend with a dual burden of infectious and non-communicable diseases (NCDs). Moreover, injuries are a leading cause of health loss in populations throughout the world. Traditionally, global policy has tended to focus efforts on child health, HIV and TB. However, other 'big risks', which cause significant morbidity and mortality virtually everywhere among young and middle-aged adults have been ignored, despite their growing importance due to the increasing burden of NCDs in the today's globalized society.

Efforts to curtail their effect on premature mortality and morbidity in adults are dependent on four pillars of the health system response: reliably measuring premature mortality by cause and population exposure to major risk factors, developing cost-effective interventions against the biggest causes of mortality, financing the scale up these interventions throughout health systems, and ensuring efficient delivery and effective coverage of these interventions. Controversy, uncertainty and gaps in knowledge exist at every level of these health system responses. The academic community, including researchers and academic publishers, have a critical role in contesting and strengthening knowledge in order to identify more effective strategies to reduce exposure to these risks, better support the dissemination of evidence on the most appropriate intervention policies, and create much needed debate in these areas.

As part of a new focus for the Medicine for Global Health article collection, we will be considering all articles on the challenges and opportunities in addressing the biggest global causes of premature mortality. We would welcome submission of articles focusing on measurement issues, financing options and development and delivery of interventions aimed at reducing the burden of these big risks.

  1. Evidence-based policy ensures that the best interventions are effectively implemented. Integrating rigorous, relevant science into policy is therefore essential. Barriers include the evidence not being there; ...

    Authors: Christopher J. M. Whitty
    Citation: BMC Medicine 2015 13:301
  2. Verbal autopsy (VA) is recognized as the only feasible alternative to comprehensive medical certification of deaths in settings with no or unreliable vital registration systems. However, a barrier to its use b...

    Authors: Peter Serina, Ian Riley, Andrea Stewart, Abraham D. Flaxman, Rafael Lozano, Meghan D Mooney, Richard Luning, Bernardo Hernandez, Robert Black, Ramesh Ahuja, Nurul Alam, Sayed Saidul Alam, Said Mohammed Ali, Charles Atkinson, Abdulla H. Baqui, Hafizur R. Chowdhury…
    Citation: BMC Medicine 2015 13:302
  3. Non-communicable diseases (NCDs) place enormous burdens on individuals and health systems. While there has been significant global progress to guide the development of national NCD monitoring programs, many co...

    Authors: Hebe N. Gouda, Nicola C. Richards, Robert Beaglehole, Ruth Bonita and Alan D. Lopez
    Citation: BMC Medicine 2015 13:233

    The Erratum to this article has been published in BMC Medicine 2015 13:272

  4. Nigeria has made notable gains in improving childhood survival but the country still accounts for a large portion of the world’s overall disease burden, particularly among women and children. To date, no syste...

    Authors: Alexandra Wollum, Roy Burstein, Nancy Fullman, Laura Dwyer-Lindgren and Emmanuela Gakidou
    Citation: BMC Medicine 2015 13:208
  5. Smokeless tobacco is consumed in most countries in the world. In view of its widespread use and increasing awareness of the associated risks, there is a need for a detailed assessment of its impact on health. ...

    Authors: Kamran Siddiqi, Sarwat Shah, Syed Muslim Abbas, Aishwarya Vidyasagaran, Mohammed Jawad, Omara Dogar and Aziz Sheikh
    Citation: BMC Medicine 2015 13:194
  6. In 2010 falls were responsible for approximately 80 % of disability stemming from unintentional injuries excluding traffic accidents in adults 50 years and over. Falls are becoming a major public health proble...

    Authors: Jennifer Stewart Williams, Paul Kowal, Heather Hestekin, Tristan O’Driscoll, Karl Peltzer, Alfred Yawson, Richard Biritwum, Tamara Maximova, Aarón Salinas Rodríguez, Betty Manrique Espinoza, Fan Wu, Perianayagam Arokiasamy and Somnath Chatterji
    Citation: BMC Medicine 2015 13:147
  7. While the Millennium Development Goals (MDGs; 2000–2015) focused primarily on poverty reduction, hunger and infectious diseases, the proposed Sustainable Development Goals (SDGs) and targets pay more attention...

    Authors: Corinna Hawkes and Barry M. Popkin
    Citation: BMC Medicine 2015 13:143
  8. Dengue has been a notifiable disease in China since 1 September 1989. Cases have been reported each year during the past 25 years of dramatic socio-economic changes in China, and reached a historical high in 2...

    Authors: Shengjie Lai, Zhuojie Huang, Hang Zhou, Katherine L Anders, T Alex Perkins, Wenwu Yin, Yu Li, Di Mu, Qiulan Chen, Zike Zhang, Yanzi Qiu, Liping Wang, Honglong Zhang, Linjia Zeng, Xiang Ren, Mengjie Geng…
    Citation: BMC Medicine 2015 13:100
  9. The number of reports in the literature on dengue outbreaks in various parts of south China is increasing. This trend is likely contributed to by multiple factors, chief among which is the increase in trade an...

    Authors: Eng Eong Ooi
    Citation: BMC Medicine 2015 13:99
  10. In the last 20 years, China ramped up a DOTS (directly observed treatment, short-course)-based tuberculosis (TB) control program with 80% population coverage, achieving the 2015 Millennium Development Goal of ...

    Authors: Grace H Huynh, Daniel J Klein, Daniel P Chin, Bradley G Wagner, Philip A Eckhoff, Renzhong Liu and Lixia Wang
    Citation: BMC Medicine 2015 13:88
  11. Achieving universal health coverage and reducing health inequalities are primary goals for an increasing number of health systems worldwide. Timely and accurate measurements of levels and trends in key health ...

    Authors: Katherine Ellicott Colson, Laura Dwyer-Lindgren, Tom Achoki, Nancy Fullman, Matthew Schneider, Peter Mulenga, Peter Hangoma, Marie Ng, Felix Masiye and Emmanuela Gakidou
    Citation: BMC Medicine 2015 13:69
  12. The 2012 World Health Assembly set a target for Member States to reduce premature non-communicable disease (NCD) mortality by 25% over the period 2010 to 2025. This reflected concerns about increasing NCD mort...

    Authors: Ailiana Santosa, Joacim Rocklöv, Ulf Högberg and Peter Byass
    Citation: BMC Medicine 2015 13:65
  13. The smoking epidemic in Australia is characterised by historic levels of prolonged smoking, heavy smoking, very high levels of long-term cessation, and low current smoking prevalence, with 13% of adults report...

    Authors: Emily Banks, Grace Joshy, Marianne F Weber, Bette Liu, Robert Grenfell, Sam Egger, Ellie Paige, Alan D Lopez, Freddy Sitas and Valerie Beral
    Citation: BMC Medicine 2015 13:38
  14. Easy-to-collect epidemiological information is critical for the more accurate estimation of the prevalence and burden of different non-communicable diseases around the world. Current measurement is restricted ...

    Authors: Spencer L James, Minerva Romero, Dolores Ramírez-Villalobos, Sara Gómez, Kelsey Pierce, Abraham Flaxman, Peter Serina, Andrea Stewart, Christopher JL Murray, Emmanuela Gakidou, Rafael Lozano and Bernardo Hernandez
    Citation: BMC Medicine 2015 13:15
  15. Although the Framework Convention on Tobacco Control prioritizes monitoring of tobacco use by population-based surveys, information about the prevalence and patterns of tobacco use in sub-Saharan Africa is lim...

    Authors: Chandrashekhar T Sreeramareddy, Pranil Mansingh Pradhan and Shwe Sin
    Citation: BMC Medicine 2014 12:243
  16. The forthcoming post-Millennium Development Goals era will bring about new challenges in global health. Low- and middle-income countries will have to contend with a dual burden of infectious and non-communicab...

    Authors: Alan D Lopez, Thomas N Williams, Adeera Levin, Marcello Tonelli, Jasvinder A Singh, Peter GJ Burney, Jürgen Rehm, Nora D Volkow, George Koob and Cleusa P Ferri
    Citation: BMC Medicine 2014 12:200
  17. Alcohol consumption is a major global risk factor for mortality and morbidity. Much discussion has revolved around the diverse findings on the complex relationship between alcohol consumption and the leading c...

    Authors: Michael Roerecke and Jürgen Rehm
    Citation: BMC Medicine 2014 12:182
  18. Liver cirrhosis is a major yet largely preventable and underappreciated cause of global health loss. Variations in cirrhosis mortality at the country level reflect differences in prevalence of risk factors suc...

    Authors: Ali A Mokdad, Alan D Lopez, Saied Shahraz, Rafael Lozano, Ali H Mokdad, Jeff Stanaway, Christopher JL Murray and Mohsen Naghavi
    Citation: BMC Medicine 2014 12:145