Including emergency and acute care as a global health priority

Recently, the United Nations (UN) General Assembly met in New York to discuss a topic of critical importance, the prevention and control of non-communicable diseases (NCDs). This meeting provided an important update to the 2000 World Health Assembly, which presented a global strategy to combat NCDs, resting upon the pillars of surveillance, primary prevention, and strengthened health care. Unfortunately, over the past decade limited advocacy from health-delivery fields has led to an agenda that emphasizes prevention while giving inadequate attention to strengthening health care. Though prevention is essential, acute care specialties that provide frontline treatment for sudden or unexpected illness or injury, like emergency medicine, need to take immediate and sustained action to highlight the importance of the services they provide. Aligning key players to support developing countries in planning for the best mix of acute and preventive services is an urgent priority with the potential to save and improve millions of lives.We have many compelling reasons to get involved. The UN reports that 36 million people died from NCDs in 2008, representing 63% of the 57 million global deaths that occurred during that year. Eighty percent of the NCD deaths were caused by four conditions: cardiovascular diseases, diabetes, cancers, and chronic respiratory diseases. An increasing proportion of these deaths are occurring in developing countries as they move through the epidemiologic transition. UN projections show that by 2030, non-communicable diseases will cause five times as many deaths as communicable diseases worldwide [1,2].Steps by the global community to combat NCDs have not adequately addressed the need to strengthen our ability to provide acute care. The WHO Framework Convention on Tobacco Control [3], the Global Strategy on Diet, Physical Activity and Health [4], the Global Strategy to Reduce the Harmful Use of Alcohol [5], and the 2008-2013 Action Plan for the Global St