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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. Editorial

    What makes an academic paper useful for health policy?

    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; ...

    Christopher J. M. Whitty

    BMC Medicine 2015 13:301

    Published on: 17 December 2015

  2. Research article

    A shortened verbal autopsy instrument for use in routine mortality surveillance systems

    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...

    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…

    BMC Medicine 2015 13:302

    Published on: 16 December 2015

  3. Opinion

    Health information priorities for more effective implementation and monitoring of non-communicable disease programs in low- and middle-income countries: lessons from the Pacific

    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...

    Hebe N. Gouda, Nicola C. Richards, Robert Beaglehole, Ruth Bonita and Alan D. Lopez

    BMC Medicine 2015 13:233

    Published on: 21 September 2015

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

  4. Research article

    Benchmarking health system performance across states in Nigeria: a systematic analysis of levels and trends in key maternal and child health interventions and outcomes, 2000–2013

    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...

    Alexandra Wollum, Roy Burstein, Nancy Fullman, Laura Dwyer-Lindgren and Emmanuela Gakidou

    BMC Medicine 2015 13:208

    Published on: 2 September 2015

  5. Research article

    Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries

    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. ...

    Kamran Siddiqi, Sarwat Shah, Syed Muslim Abbas, Aishwarya Vidyasagaran, Mohammed Jawad, Omara Dogar and Aziz Sheikh

    BMC Medicine 2015 13:194

    Published on: 17 August 2015

  6. Research article

    Prevalence, risk factors and disability associated with fall-related injury in older adults in low- and middle-incomecountries: results from the WHO Study on global AGEing and adult health (SAGE)

    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...

    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

    BMC Medicine 2015 13:147

    Published on: 23 June 2015

  7. Research article

    The changing epidemiology of dengue in China, 1990-2014: a descriptive analysis of 25 years of nationwide surveillance data

    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...

    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…

    BMC Medicine 2015 13:100

    Published on: 28 April 2015

  8. Commentary

    The re-emergence of dengue in China

    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...

    Eng Eong Ooi

    BMC Medicine 2015 13:99

    Published on: 28 April 2015

  9. Research article

    Tuberculosis control strategies to reach the 2035 global targets in China: the role of changing demographics and reactivation disease

    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 ...

    Grace H Huynh, Daniel J Klein, Daniel P Chin, Bradley G Wagner, Philip A Eckhoff, Renzhong Liu and Lixia Wang

    BMC Medicine 2015 13:88

    Published on: 21 April 2015

  10. Research article

    Benchmarking health system performance across districts in Zambia: a systematic analysis of levels and trends in key maternal and child health interventions from 1990 to 2010

    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 ...

    Katherine Ellicott Colson, Laura Dwyer-Lindgren, Tom Achoki, Nancy Fullman, Matthew Schneider, Peter Mulenga, Peter Hangoma, Marie Ng, Felix Masiye and Emmanuela Gakidou

    BMC Medicine 2015 13:69

    Published on: 2 April 2015

  11. Research article

    Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence

    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...

    Emily Banks, Grace Joshy, Marianne F Weber, Bette Liu, Robert Grenfell, Sam Egger, Ellie Paige, Alan D Lopez, Freddy Sitas and Valerie Beral

    BMC Medicine 2015 13:38

    Published on: 24 February 2015

  12. Research article

    Validating estimates of prevalence of non-communicable diseases based on household surveys: the symptomatic diagnosis study

    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 ...

    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

    BMC Medicine 2015 13:15

    Published on: 26 January 2015

  13. Forum

    Remembering the forgotten non-communicable diseases

    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...

    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

    BMC Medicine 2014 12:200

    Published on: 22 October 2014

  14. Research article

    Alcohol consumption, drinking patterns, and ischemic heart disease: a narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers

    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...

    Michael Roerecke and Jürgen Rehm

    BMC Medicine 2014 12:182

    Published on: 21 October 2014

  15. Research article

    Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis

    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...

    Ali A Mokdad, Alan D Lopez, Saied Shahraz, Rafael Lozano, Ali H Mokdad, Jeff Stanaway, Christopher JL Murray and Mohsen Naghavi

    BMC Medicine 2014 12:145

    Published on: 18 September 2014