ership and collaboration centered on clearly defined goals and outcomes; a lack of financial, individual, and institutional resources; and insufficient capacity to meet CVD needs in low and middle income countries, including health workforce and infrastructure capacity as well as implementation and enforcement capacity for policies and regulatory approaches.

Deeper reflection suggests that to prevent and control CVD in the developing world, a number of essential functions are needed to develop and implement effective approaches. Successfully carrying out these functions will require the combined efforts of many players over long periods of time. This chapter first describes these essential functions. This is followed by a discussion of the relative strengths and responsibilities for key players, proposing new or expanded accountabilities and responsibilities where needed and highlighting the need for more effective coordination of efforts to address CVD. Taken together, these functions and key stakeholders form a framework for implementing the actions needed to address the global epidemic of cardiovascular disease.


The effective implementation of efforts to address global CVD requires that certain actions be executed. The functions required to do this include advocacy and leadership at global and national levels, developing policy, program implementation, capacity building, research focusing on evaluating approaches in developing countries that are context specific and culturally relevant, ongoing monitoring and evaluation, and funding. All of these also require resources—financial, technical, and human. These functions and resource needs are described below, with examples of their role in CVD and indications of how they are tied to messages from previous chapters.

Advocacy and Leadership

Advocacy for policy change and for individuals to take actions in their everyday lives are not the same. Both approaches are critical and need to be led by recognized leaders who might be drawn from the community, academia, industry, or government. The first targets governments at local, national, and international levels to encourage policies that will support prevention and control efforts, which is discussed in more detail here. The second focuses on influencing and supporting individuals within their homes and communities to follow healthful lifestyles throughout their lives. National governments, nongovernmental organizations (NGOs), local media, and local governments can each be well placed to do this; these approaches were discussed in Chapter 5.

International advocacy efforts to raise awareness of the growing CVD

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