We are surprised the NCD Countdown 2030 collaborators make no mention of the pivotal importance of maternal, neonatal, and child health (MNCH) in reducing NCD. Prematurity, intrauterine growth restriction, and being born to a mother who is overweight or has diabetes now characterise approximately 50% of all births. These children are major contributors to the growing population prevalence of NCD as they have substantially increased odds of developing hypertension, diabetes, chronic renal impairment, heart disease, and other conditions
A woman who was born preterm is more likely to deliver a child preterm, and the daughter of a mother who is obese is more likely to become obese. Hence intergenerational transmission amplifies the problem.
The collaborators primarily consider solutions within a medical construct even though child rearing and education are also powerful determinants of physical and mental health.
Strategies that improve MNCH would uniquely benefit human potential across generations, needed now more than ever as countries grapple with the task of prioritizing investment in post-COVID recovery
These visionary policies include, for example, tax-exempt childcare, 6 months statutory paid leave on a use-it-or-lose-it basis for each parent during a child’s first year, and investment in universal secondary school education. These would reduce NCD through multiple interrelated pathways including improved newborn health, breastfeeding, family cohesion, and gender equity, and they would empower girls, reduce crippling dependencies, and help fulfil human potential.