If you've been reading the newspapers and watching TV, you probably don't know this . . .

but the UN is about to host a major international meeting on the prevention and control of non-communicable diseases. It evidently hasn't caught the attention of any U.S.-based journalists, but this is actually a fairly big deal around the world. The millennium development goals, which I used to write about here quite a bit, don't really include non-communicable diseases unless you want to put malnutrition and death in childbirth in that category. The focus is very much on poverty and infectious disease.

But the assumption that the most pressing health problems in the poor countries are infectious diseases and parasites is becoming obsolete. In fact most premature deaths around the world are due to heart disease, diabetes, cancer, transportation accidents and other causes that are not considered in the millennium development goals. More people have poor quality diets than literally go hungry; tobacco use is declining in the U.S. and finally becoming less chic in Europe, but the tobacco merchants have firmly set their sites on the developing world; people in the poor countries are far more affected by poor air quality and toxic exposures than are people in the wealthy countries; and hardly a day goes by that we don't read about an overcrowded ferry sinking or a train hitting a bus or a pipeline exploding or some other catastrophe in Africa or south Asia.

The UN meeting on HIV 2001 had major impact, leading to a massive international effort. That effort has fallen well short of what was needed, but it nevertheless averted a far worse disaster that one can scarcely bear to imagine. Perhaps this event will have comparable impact, but first Americans need to break out of their pathological self-obsession and take a look at the world around them. I'm hoping some of us will notice.

(BTW, of course, communicable diseases obviously haven't gone away and the prospect of multi-drug resistant staph, TB, and other pathogens is pretty damn scary. I'll stay on that case as well.)