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In a Comment (February, 2017), we argued that action on the conditions currently referred to as non-communicable diseases (NCDs) may be hampered by the inadequacy of their label. We received a remarkable amount of feedback on this suggestion, and in this Comment we synthesise the responses garnered from a Facebook poll, Correspondence letters, and a related . We also propose a new definition based on shared social drivers.
In November, 2016, at the fourth meeting of the Inter-agency and Expert Group on Sustainable Development Goal (SDG) Indicators in Geneva, a group of leading UN agencies, civil society actors, and independent experts issued a statement strongly supporting the Washington Group on Disability Statistics\' Short Set of Questions (WGSS) as the preferred method to use with the SDGs to number the world\'s herpes simplex virus 1 of people with a disability. Further support quickly followed at the UN World Data Forum in Cape Town. The UN Statistical Commission and the UN\'s Economic Commission for Europe\'s Council of European Statistics has recommended the WGSS for collection of disability information for the upcoming 2020 round of censuses, and the UK Department for International Development is promoting the method for use in its international development activities. These recommendations are the latest in a growing body of endorsements for a method that can be quickly and inexpensively added to censuses, surveys, and research efforts to generate disaggregated, internationally comparable data that provides new insights into how people with disabilities fare in global health and development efforts. Demand for such data is increasing. A billion people worldwide—15% of the world\'s population—live with a disability, and this population is disproportionately poorer and more marginalised than their non-disabled peers. Ratification of the UN Convention on the Rights of Persons with Disabilities by more than 160 countries since 2006, and the SDGs\' call to “leave no one behind” has substantially raised demand for accurate disability data.
WHO estimates that over 800 000 people die by suicide each year, with the majority of these deaths occurring in low-income and middle-income countries (LMICs). During the late 1990s and early 2000s an estimated 35% of suicides, or 300 000 deaths, were due to intentional pesticide self-poisoning. These numbers have since fallen, but WHO still considers pesticide self-poisoning to be one of the three most important means of global suicide. In order to achieve further reductions, prevention efforts will need to be multifaceted and work across three levels: patient, community, and nation. Improved medical management could reduce deaths after exposure; however, clinical trials have shown few benefits and many patients die before accessing health care. Improved storage of pesticides in households or community storage facilities may reduce access at moments of stress; this approach has been tested but has little supporting evidence of benefit thus far. It is also possible that home-based storage schemes will conversely increase access due to farmers shifting their pesticide stores from fields to their homes and the lockable storage devices highlighting the whereabouts of poisons (in boxes that are often left unlocked). The most effective prevention efforts so far have been legislative. The restriction of highly hazardous pesticide (HHP) use in agriculture has shown beneficial effects on pesticide suicides across Asia, most strikingly in Sri Lanka. Before the Green Revolution, which saw the introduction of high-yielding crop varieties into LMICs alongside the heavy marketing of pesticides and fertilisers from the 1960s onwards, the annual Sri Lankan suicide rate was quite stable at around 5 per 100 000 people older than 8 years (). With the introduction of HHPs in the 1960s, the suicide rate steadily rose to 24 per 100 000 in 1976, followed by a more dramatic rise after 1977 that coincided with Sri Lanka relaxing import trade restrictions. Between 1983 and 1995 the suicide rate plateaued, with a peak rate of 57 per 100 000 in 1995.