The 2011 United Nations High-Level Meeting on Non-Communicable Diseases: The Africa agenda calls for a 5-by-5 approach

G A Mensah, B M Mayosi


The High Level Meeting of the 66th Session of the United Nations General Assembly was held in September 2011. The Political Declaration issued at the meeting focused the attention of world leaders and the global health community on the prevention and control of noncommunicable diseases (NCDs). The four major NCDs (cardiovascular diseases, cancer, diabetes and chronic respiratory diseases) and their four risk factors (tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol) constitute the target of the ‘4-by-4’ approach,
which is also supported by national and international health organisations.

We argue that while preventing these eight NCDs and risk factors is also important in Africa, it will not be enough. A ‘5-by-5’ strategy is needed, addressing neuropsychiatric disorders as the fifth NCD; and transmissible agents that underlie the neglected tropical diseases and other NCDs as the fifth risk factor. These phenomena cause substantial preventable death and disability, and must therefore be prioritised.

Authors' affiliations

G A Mensah, Department of Medicine, Groote Schuur Hospital and University of Cape Town

B M Mayosi, Department of Medicine, Groote Schuur Hospital and University of Cape Town

Full Text



mental and neurological diseases

Cite this article

South African Medical Journal 2013;103(2):77-79. DOI:10.7196/SAMJ.6347

Article History

Date submitted: 2012-09-27
Date published: 2012-11-08

Article Views

Abstract views: 2391
Full text views: 3482

Comments on this article

*Read our policy for posting comments here