The World Health Organization and the Globalization of Chronic Noncommunicable Disease.
Chronic noncommunicable diseases (NCDs) in low- and middle-income countries have recently provoked a surge of public interest. This article examines the policy literature-notably the archives and publications of the World Health Organization (WHO), which has dominated this field-to analyze the emergence and consolidation of this new agenda. Starting with programs to control cardiovascular disease in the 1970s, experts from Eastern and Western Europe had by the late 1980s consolidated a program for the prevention of NCD risk factors at the WHO. NCDs remained a relatively minor concern until the collaboration of World Bank health economists with WHO epidemiologists led to the Global Burden of Disease study that provided an “evidentiary breakthrough” for NCD activism by quantifying the extent of the problem. Soon after, WHO itself, facing severe criticism, underwent major reform. NCD advocacy contributed to revitalizing WHO's normative and coordinative functions. By leading a growing advocacy coalition, within which The Lancet played a key role, WHO established itself as a leading institution in this domain. However, ever-widening concern with NCDs has not yet led to major reallocation of funding in favor of NCD programs in the developing world.