Defining the Problem

Welcome to Module 1.

Welcome to Global Noncommunicable Diseases: Intersecting Health Challenges. Noncommunicable diseases now account for the majority of deaths worldwide, yet they often receive less attention than other global health priorities. These conditions develop over time, affect multiple systems, and require sustained responses that extend beyond clinical care into policy, financing, and health system design.

In this module, you will build a foundation for understanding NCDs and the global response to them. You will explore how these diseases are defined, how they are prioritized within global health frameworks, and how interventions are selected and delivered across different levels of the health system. You will also begin to interpret the data that informs these decisions.

As you move through this module, consider several key questions: Why have NCDs been historically underprioritized despite their scale? How do global frameworks shape national action? And how do we interpret health data, and use tools like GBD Compare, in ways that reflect the true burden of disease and support effective decision making?

Note: You can turn on closed captions by clicking the CC button on the video player navigation bar.

If you have trouble watching the lectures due to a slow Internet connection, try downloading the lecture or the transcript listed below each video. Right-click the link and select "Save Link as" to download.

Learning Objectives

After completing this module, you will be able to:

  • Define and correctly use NCD terminology.
  • Critique limitations of common NCD framing and definitions in global health.
  • Identify and categorize the major global NCDs.
  • Describe the global response to NCDs.
  • Explain the main interventions for NCD prevention and control.
  • Use the GBD Compare tool to find, compare, and clearly explain NCD burden results.

Video: Defining Noncommunicable Diseases (11 minutes)

In this lecture, Sarah Masyuko introduces how noncommunicable diseases are defined and the value of this definition for how health systems, policies, and priorities are shaped globally. We will explore how NCDs fit within the broader classification of diseases, review the major disease groupings and frameworks used in global health, and examine why these conditions now account for the majority of adult deaths worldwide. We will also focus on common misconceptions about NCDs and consider the shared risk factors and structural forces that drive their distribution across populations. 

As you watch, ask yourself: How does the way we define and group diseases influence what gets prioritized in your own health system?

Downloads: Video (26 MB), Audio (5 MB), Transcript

Reading: What's in a Name? A Call to Reframe Non-communicable Diseases (10 minutes)

In this reading, Allen and Feigl make the case that the term "non-communicable disease" is doing real harm. They argue that a name defined only by what it is not gives politicians, funders, and the public little reason to prioritize these conditions, even though NCDs are now the world's leading cause of death. The authors trace how this framing can obscure the shared social and commercial drivers behind many NCDs, and how language choices can shape funding decisions and policy attention.

As you read, ask yourself: How does the language used to describe NCDs in your own setting shape how much attention and resources they receive compared to infectious disease?

What's in a Name?

Video: Global Response to NCDs (9 minutes)

In this lecture, we will examine how the global community has responded to noncommunicable diseases over time and what gaps remain between commitments and action. Sarah Masyuko reviews key milestones such as the United Nations high-level meetings, the evolution from the four-by-four to the five-by-five framework, and the integration of NCD targets into the Sustainable Development Goals, while also analyzing the realities of financing, implementation, and political prioritization. We will explore why progress has been uneven despite increased attention, including the challenges of long time horizons, competing priorities between prevention and treatment, and the complexity of building systems that can manage chronic conditions.

As you watch, ask yourself: Where do the biggest barriers to NCD action show up in your own setting, and are they primarily technical, financial, or political?

Downloads: Video, (18 MB), Audio (4 MB), Transcript

Interactive Reading: Invisible Numbers (15 minutes)

This activity pulls key facts and figures from the WHO report Invisible Numbers: The True Extent of Noncommunicable Diseases and What to Do About Them. Read through the report linked above and then complete the activity.

Activity Instructions: There are five sections to this activity. Use the Next arrow at the top of the page to move to the next section or use the table of contents on the left to jump to a specific section. 

Video: Introduction to NCD Interventions (17 minutes)

In this lecture, we explore the landscape of interventions for NCDs, with a focus on the WHO's "best buys." David Watkins walks us through why demographic shifts are driving the growing NCD burden, introduces a conceptual model for where interventions can act, from social determinants through to physiological risk factors, and distinguishes interventions from implementation strategies. We will also examine the balance between prevention and treatment, and survey the WHO best buys across tobacco, alcohol, diet, cardiovascular disease, and cancer.

As you watch, ask yourself: Which of these intervention categories are already in use in your own setting, and where do you see the biggest gaps?

Downloads: Video (32 MB), Audio (7 MB), Transcript

Discussion (10 minutes)

Welcome to the course! Please post a brief introduction to the forum using the following two prompts:

  1. Introduce yourself: Give a 1-sentence introduction of your professional background.
  2. Reflection: Share one or two major successes in tackling NCDs in your country, and one or two ongoing challenges.

After posting, read through your classmates' introductions and reply to at least one person who shares a similar challenge or interest. Please post to the discussion forum by Sunday, 4 October, at 11:59 pm PT.

Go to Discussion

Video: Primer: How to Think About Health Statistics (15 minutes)

In this lecture, we build a foundation for interpreting health statistics used throughout the course. David Watkins explains key concepts such as counts, rates, and ratios, and reviews how incidence, prevalence, and mortality differ and why those differences matter for chronic diseases. We also examine how population structure shapes the patterns you see in data, including the importance of age standardization, and how risk-attributable estimates are generated and interpreted. 

Downloads: Video (31 MB), Audio (7 MB), Transcript

Demonstration: Introduction to GBD Compare (22 minutes)

In this demonstration, David Watkins walks through GBD Compare, an online tool for visualizing data from the Global Burden of Disease study. He explains how to navigate the cause and risk factor hierarchies, and use key features like the plot, map, patterns, and tree map tabs to explore mortality, disability, and risk factor data by country and over time.

As you watch, ask yourself: Which of these features could help you explore the NCD burden in a country or setting relevant to your own work?

Downloads: Video (18 MB), Audio (4 MB), Transcript

Reading: Course Project Description (5 minutes)

During this course, you will work on a course project: a five-part assignment that builds toward a policy brief you could use in your own work. Make sure to read the overview to understand how the parts fit together and when each is due.

You will work on and turn in Part 1 at the end of Week 2.

There is also a Resource Hub where you can go to find useful resources for your project. Make sure to bookmark this page to easily access it. 

Reading: Module Summary (5 minutes)

In this module, we explored how noncommunicable diseases are defined and where they sit within the broader global health landscape.

Sarah Masyuko walked us through the three-group framework used across global health statistics, grouped NCDs alongside communicable and maternal conditions and injuries, and explained why the four major NCDs: cardiovascular disease, cancer, diabetes, chronic kidney disease, and chronic respiratory disease, account for the large majority of NCD deaths. She also cleared up common misconceptions, including the assumption that NCDs are purely a matter of individual choice, and highlighted the shared social, environmental, and commercial drivers that shape NCD risk across populations.

We then turned to how the global community has responded to NCDs over time. David Watkins reviewed the milestones that have shaped the current agenda, from the 2011 UN High-Level Meeting through the shift from the four-by-four to the five-by-five framework, and outlined where NCDs sit within the Sustainable Development Goals, particularly SDG 3.4. He also examined why progress has lagged, pointing to the long time horizon of prevention efforts, the tension between prevention and treatment, the complexity of chronic care, workforce and logistical constraints, and persistent gaps in political prioritization and financing.

The module also built a framework for thinking about how interventions are chosen and delivered. David Watkins traced the pathway from distal drivers like income and education, through behavioral and environmental risk factors, to the physiological risk factors that connect most directly to disease. He distinguished interventions, which change health outcomes or risk directly, from implementation strategies, which improve how those interventions are delivered and used. He also made the case for balancing prevention with treatment, since even strong prevention efforts will not eliminate the need for care, and closed with an overview of the WHO best buys across tobacco, alcohol, diet, cardiovascular disease, and cancer. 

Finally, we built the statistical foundation needed to interpret NCD data. David Watkins introduced the core concepts of counts, rates, and ratios, distinguished incidence, prevalence, and mortality, and explained how age standardization supports comparisons across countries or over time. He also walked through risk-attributable mortality and its limitations. We then saw these concepts applied directly in a walkthrough of GBD Compare, a tool we can use to explore cause and risk factor data for our own countries. Together, these five lectures gave us the shared vocabulary and framework we will draw on for the rest of the course, from naming NCDs accurately to reading the data behind them and identifying where a response might be most effective.

Quiz (10 minutes)

The quiz is due Sunday, 4 October, at 11:59 pm PT.

Late submissions will not be penalized.

Go to Quiz