Non-communicable diseases (NCDs) like coronary disease, adult-onset diabetes, and some cancers have attracted a great deal of attention and resources in wealthy and middle-income countries, where they have emerged as leading causes of death and disability among populations who eat too much, exercise too little, and are heavy consumers of tobacco and alcohol. “The NCDs that afflict people living on less than a dollar a day in countries like Rwanda or Haiti have received far less attention and have very different causes,” says Partners In Health physician Gene Bukhman. “For this ‘bottom billion,’ NCDs like rheumatic heart disease, type 1 diabetes, mental illnesses, epilepsy, and cervical cancer are often the result of lack of access to food, shelter, education, and health care interventions readily available in developed countries.”

When looking at a graph plotting out the diseases that most affect a population, communicable diseases like HIV and malaria are at the top of the curve, causing more deaths, but NCDs like epilepsy or heart disease are on the ‘long tail.’ No single condition has a dramatic prevalence but together they impose a heavy burden that is not effectively addressed by disease-specific strategies that have been used for communicable diseases.

On March 2-3, the Long Tail conference in Boston, U.S. will host 50 experts treating these illnesses, and speakers from the Government of Rwanda will speak about their efforts in NCDs control. Presentations by Julio Frenk, Dean, Harvard School of Public Health, and Felicia Knaul, Director of the Harvard Global Equity Initiative, authors on a recent call to action to address cancer in developing countries, will also be featured.

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