Table 2.

Tentative suggestions and guidelines for the policy and programme transition to alleviating non‐transmissible disease risk

1. (Re)educate and sensitize the leadership and authorities at all policy levels (international, national, regional) with the evidence‐base for a concern for non‐transmissible disease epidemics and the role of early life nutritional strategies to blunt the risks of later‐life chronic diseases. Must be done in harmony with (not as counterpoint to) the established concerns for food insecurity and micronutrient malnutrition.

2. Move from the exclusive ‘Ministry‐of‐Health obsession’ to a broader, multisectoral coalition strategy that includes the governmental sectors of Agriculture, Trade and Commerce, Economy, Finances, Education and Culture and Recreation as well as the stakeholders in the private sector and civil society.

3. Avoid the temptation for ‘magic bullets’ and ‘one‐size‐fits‐all’ universal solutions promulgated by the international (multilateral and bilateral) agencies and interests, and locally individualize the formulas for changes in policies and programme efforts toward reducing chronic disease in later life.

4. Prioritize the most inexpensive‐to‐mount and/or the most cost‐ effective programmes initially in order to avoid ‘Sticker Shock’ for the constrained operating budgets of developing countries.

5. Exercise careful deliberations regarding the policy choices between universal, mass interventions (with the adverse consequences of creating entitlements for individuals neither at risk nor in the line of benefits) vs. selectively targeted interventions (with their dual drawbacks of stigmatization and perception of discrimination).

6. Continue to emphasize (and at the same time redirect) the education and empowerment of women in developing countries as the most proximal lever for effecting beneficial practices and attitudes in the home. This is preconditioned by campaigns to bring women to full literacy and scholastic parity with men, and assuring their economic rights within the household.

7. All that is simple is not safe. Emphasize and integrate a concern for ‘safety testing’ of interventions in both the short‐term of efficacy trials and in long‐term monitoring. The same measures may have benefits and risks all in the same, but with different time‐courses, with the benefits emerging early and the adverse effects manifesting later.