Figure 1 Prevalence of key risk factors among persons aged >50 years in selected low- and middle-income countries. Notes: Data compiled from Wu et al, 2015. Use of tobacco varies considerably from 7.7% in Ghana to 46.9% in India. Although the prevalence of tobacco smoking is declining in most countries, tobacco use is increasing in the African Region., Consumption of alcohol is highest in China (6.3%) and considerably lower in India and Mexico. However, alcohol use has increased drastically in Mexico since 2011, especially in women. Obesity is more common in South Africa, Russia and Mexico compared to China, India and Ghana. As per the “Organization for Economic Cooperation and Development” 2017 report, Mexico had the highest prevalence of obesity in the population aged 15–74 years (32.4%). Prevalence of hypertension varied from 33% (India) to 78% (South Africa).

Figure 2 Healthcare expenditure and outcomes in low- and middle-income countries. Notes: The EIU study compared healthcare outcomes and spending in 166 countries. “Disability Adjusted Life Years” and “Health-Adjusted Life Expectancy” were used as the main indicators to measure healthcare outcomes along with “average life expectancy at age 60” and “adult mortality rates”. A composite index score was generated from all the four indicators (higher scores indicate better healthcare outcomes). The countries were ranked based on healthcare outcomes (with 166 being the best) and spending per head (with 166 being the most expensive).

Figure 3 Critical challenges in combating NCD burden in low- and middle-income countries.

Figure 4 “Best Buys” identified by the World Health Organization (WHO). Notes: The Best Buy recommendations by WHO aims to encourage a healthy lifestyle by imposing restrictions on access and increasing excise on alcohol and tobacco and supports the education of the public regarding a healthy lifestyle and primary prevention of NCDs. The cost for a scaled-up implementation of these “best buys” strategies is quite low. In health gains, the return on the investment is many millions of avoided “premature” deaths, and for a nation’s economy, the return is several billions of dollars. Abbreviation: PUFAs, polyunsaturated fatty acids.

Figure 5 Think Tank Proposed Solutions for tackling NCDs in low- and middle-income countries. Notes: “Screening and risk assessment”, “optimised utilisation of human resources” and “education for all sectors” along with “utilisation of technology for inadequate effective health workforce” can help to fill in the gaps created by insufficient “effective health workforce availability and distribution” in LMICs. “Access to treatment” and “public–private partnerships” can bridge the gaps in the “universal health coverage” in LMICs. “Enforcing strict regulations and accountability” is the key solution for “gaps in the implementation of regulations” seen in most LMICs. “International initiatives to boost data collection” as well as “screening and risk assessment” can boost “systematic data collection and longitudinal surveillance data in LMICs”