A fragmented world map represents health challenges in low-income countries, with healthcare workers building bridges between them.

Triple Threat: Tackling Diseases and Accidents in Low-Income Countries

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Lena Kashyap in Health & Wellness October 2026 • 3 min read.

"Why low and middle-income countries face a unique health challenge and how to overcome it."


For many years, low and middle-income countries have struggled with communicable diseases. Now, they face a triple threat: non-communicable diseases (NCDs) and road traffic accidents.

Non-communicable diseases like cardiovascular diseases, mental illnesses, diabetes, chronic obstructive pulmonary diseases, and cancers are becoming increasingly prevalent in these countries. The World Health Organization estimates that by 2020, NCDs will account for 80% of the global disease burden and 70% of deaths, with the majority of this impact in low and middle-income nations.

This shift from communicable diseases to NCDs and road traffic accidents is driven by economic development, urbanization, and changing lifestyles. If these conditions aren't addressed promptly, they will severely strain healthcare systems and hinder economic progress.

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The Global NCD Burden

WHO reports that cardiovascular diseases, cancer, diabetes and chronic respiratory diseases, together with mental health conditions, cause nearly three quarters of deaths worldwide. The WHO EMRO data portal says NCDs alone cause almost 75% of deaths worldwide and identifies social, environmental, commercial and genetic factors as causes. The sources give similar estimates but differ in whether mental health conditions are included in the attribution.

The 25×25 Approach

Following the 2011 United Nations High-Level Meeting on NCDs, the World Health Assembly set a target of a 25% relative reduction in overall mortality from four conditions. The five-target “25×25” strategy focuses on cardiovascular disease, diabetes, cancer and chronic respiratory disease; its four risk factors are tobacco, diet and physical activity, dietary salt, and alcohol, alongside one cardiovascular preventive drug treatment. Its simplicity is an advantage, but the source also says the approach has major weaknesses without detailing them in the supplied summary.

The Prevention Imperative: Keeping Citizens Healthy and Productive

A fragmented world map represents health challenges in low-income countries, with healthcare workers building bridges between them.

Treating NCDs and injuries is expensive. Therefore, prevention programs are essential to keep citizens healthy and productive. Given the limited health infrastructure and workforce in low and middle-income countries, mid- and low-level health workers are crucial for promoting prevention services.

While low and mid-level health workers have proven effective in preventing NCDs in high-income countries, studies show their effectiveness is limited in low and middle-income countries.

  • Poor implementation could be the reason for limited effectiveness.
  • Proper system creation should be emphasized to yield better results.
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NCDs on the 2030 Agenda

The 2025 report “Progress on the prevention and control of non-communicable diseases” describes NCDs and mental health conditions as one of the most pressing challenges for global health and sustainable development. It was issued as Member States prepared for the fourth UN General Assembly high-level meeting on NCD prevention and control, scheduled for 2025. The report also points to the approaching 2030 deadline for the Goals.

Health Burden and Economic Stakes

WHO says tackling NCD risk factors can save lives and provide a huge economic boost for countries. UNDP describes cardiovascular disease, cancer, diabetes and chronic respiratory disease as major sources of preventable illness, disability and mortality worldwide. It also says NCDs place a significant burden on health systems and challenge universal health coverage and other development aims.

A Global Health Priority

A paper on NCDs and global health governance describes them as a serious threat in both developed and developing countries and says they deserve global health priority. A 2024 educational overview says communicable and noncommunicable disease categories shape global health policies, healthcare systems and lives worldwide. It frames the distinction around transmission modes, risk factors, preventive measures and examples.

To improve outcomes, low and middle-income countries should focus on developing robust systems for implementing prevention programs, leveraging their existing health workforce effectively.

Looking Ahead: A Call to Action

The current issue includes an editorial, original articles, case reports, and a letter to the editor. These articles cover non-communicable diseases and other topics.

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Burden and the 2030 Target

A PLOS ONE study published on December 10, 2025, identifies cardiovascular diseases, neoplasms, chronic respiratory diseases and diabetes mellitus as leading causes of death globally. It describes NCDs as a major health challenge threatening Sustainable Development Goal 3.4, which aims to reduce premature mortality by one third by 2030. The study says it aimed to quantify the current and projected burden.

NCDs Across Countries and Crises

A collection of case studies says NCDs affect nearly every country, from affluent nations to poverty-stricken and war-torn countries. People living with NCDs are at greater risk of severe COVID-19 illness, according to a case study of humanitarian health programmes in five countries. The study highlights adaptations made to those programmes to reduce exposure risk for people with NCDs.

Readers are encouraged to explore these articles and use their contents. Feedback and suggestions are welcome.

Addressing the triple burden of disease and accidents requires a comprehensive approach. By prioritizing prevention and strengthening healthcare systems, low and middle-income countries can protect their populations and foster sustainable development.

How global NCD priorities compare

The comparator describes NCDs as a global health priority across both developed and developing countries, extending the frame beyond the low- and middle-income focus of this article.[1]

Another comparator frames prevention and control as a development imperative because of NCDs’ socioeconomic costs, adding an economic rationale to the article’s focus on health-system pressures.[2]

The WHO global action plan was extended through 2030, placing NCD prevention and control within a longer policy horizon.[2]

A related implementation roadmap supports actions toward global targets for NCD prevention and management; it offers a policy framework rather than evidence about this article’s specific proposal.[2]

What access and prevention add to the picture

The emphasis on universal health coverage reflects an access problem: premature NCD deaths are concentrated in settings where health services are often limited.[2]

The consequences described reach beyond individuals to families and communities, while also posing a risk to health-system capacity.[2]

Monitoring targets and indicators is presented as a way to understand progress, not as proof that a particular intervention has succeeded.[2]

What implementation evidence still needs to show

  • Which actions within the roadmap contribute most to prevention and management, and how are their effects assessed?[2]
  • Do the indicators tracked for global targets capture whether access to services improves in places where it is limited?[2]

Sources

  1. Non-communicable diseases and global health governance ... (pmc.ncbi.nlm.nih.gov)
  2. WHO: Noncommunicable diseases – High-level action needed to ... (who.int)

About this Article -

Written with AI assistance from published research, and reviewed by the Mystum team. See our About page for more information.

Everything You Need To Know

1

What are the main health challenges faced by low and middle-income countries, according to this information?

Low and middle-income countries face a triple threat: communicable diseases, non-communicable diseases (NCDs), and road traffic accidents. The article emphasizes this as a unique health challenge. The shift towards NCDs, such as cardiovascular diseases, mental illnesses, diabetes, chronic obstructive pulmonary diseases, and cancers, coupled with the persistent issues of communicable diseases and the increasing incidence of road traffic accidents, creates a complex health burden.

2

Why are non-communicable diseases a significant concern?

The rise of non-communicable diseases is significantly concerning because they are projected to account for a large share of the global disease burden and deaths. The World Health Organization estimates that by 2020, NCDs will constitute 80% of the global disease burden and 70% of deaths, with most of this occurring in low and middle-income nations. This shift puts immense pressure on healthcare systems and hinders economic progress.

3

Why is prevention considered so important in this context?

Prevention is critical because treating non-communicable diseases and injuries is extremely costly. Prevention programs are essential to keep citizens healthy and productive. Given the limited health infrastructure and workforce in these countries, shifting the focus to prevention is a cost-effective strategy to alleviate the strain on healthcare systems and improve overall health outcomes.

4

What role do mid- and low-level health workers play in addressing these challenges?

Mid- and low-level health workers are crucial for promoting prevention services in low and middle-income countries. However, their effectiveness in preventing non-communicable diseases has been limited. To enhance outcomes, the focus should be on developing strong systems for implementing prevention programs and efficiently utilizing the existing health workforce.

5

What factors contribute to the rise of the triple threat?

The triple threat of communicable diseases, non-communicable diseases, and road traffic accidents is primarily driven by economic development, urbanization, and changing lifestyles. These factors influence health outcomes. To combat these issues, low and middle-income countries must implement strong prevention programs to improve health and ensure economic progress.

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