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Health Surveillance and Disease Prevention and Control / Chronic Diseases / CARMEN

CARMEN Network


CARMEN Regional Initiatives | Activities in the Countries |
CARMEN Meetings | Areas of Action | Newsletter |
CARMEN Documents | PAHO/WHO Resolutions on CNCDs |
What is the CARMEN network? |
What are the CARMEN strategies? |
Regional Strategy & Plan of Action | Useful Links

Regional Strategy & Plan of Action


Exploding the Myths

Myth: Chronic diseases are a problem of the rich countries.
Fact: Chronic noncommunicable diseases (CNCDs) account for more than half the burden of disease and 80% of deaths in poorer countries, which carry a double disease burden.

Myth: CNCDs are a problem only of the elderly.
Fact: Half of these diseases occur in adults under 70 years of age, and the problems often begin in the young, e.g. obesity.

Myth: CNCDs affect men more than women.
Fact: CNCDs affect women and men almost equally and globally. Heart disease is the leading cause of death in women.

Myth: CNCDs cannot be prevented.
Fact: If the known risk factors are controlled, at least 80% of heart disease, stroke and diabetes and 40% of cancers are preventable; in addition, there are cost-effective interventions available for control

Myth: People with CNCDs are at fault and to be blamed because of their unhealthy lifestyles.
Fact: Individual responsibility, while important, only has full effect where people have equal access to healthy choices. Governments have a crucial role to play in altering the social environment to help make the healthy choice the easy choice.

Myth: "My grandfather smoked and lived to 90 years." "Everyone has to die of something."
Fact: While some people who smoke will live a normal lifespan, the majority will have shorter, poorer-quality lives. And yes, everyone has to die, but death does not need to be slow, painful or premature, as is so often the case with CNCDs.

new campaign logo   diet and physical activity


Action for
Risk Factor Prevention & Effective
Management of



A Network for Integrated Prevention & Control of
Chronic Noncommunicable Diseases (CNCDs)
in the Americas

healthy people

Areas of Action

CNCD Newsletter


  • Chronic Disease Prevention & Control in the Americas:
    English   |  español
  • Brazilian flag
  • Informativos, Prevenção e controle doenças:


Stop the global epidemic of chronic disease

Promote - Prevent - Treat - Care

CARMEN Overview:
   English | español

CARMEN Regional Initiatives

CARMEN Policy Observatory


English-speaking Caribbean

Pan American Cardiovascular Initiative (PACI)

  • 1st Round of Guatemalan Community Cardiovascular Health Promoters Receives Diplomas, 6/08: English | español
  • Visit to Guatemala project 11/07: English | español
  • Awardees' Workshop 5/07: English | español
  • Symposium Report—Lay Health Workers (Health Promoters) Project: Community Mobilization to Improve Cardiovascular Health in the Americas, 10/2005, Chile:   English | español
  • Meeting at NIH/NHLBI, 10/04: English

Central American Diabetes Initiative (CAMDI): English | español

Regional Campaign: Let's eat healthy, live well, & get moving Americas!

CNCD Surveillance

  • new! Improving Cancer Information in the Americas (Quito, 4/09)
       English | español
  • new! CNCD Surveillance, Andean Countries (Quito, 4/09)
       English | español
  • STEPS Stroke, the STEPwise Approach to Stroke Surveillance: English | español | português
  • PanAmerican STEPS, the PAHO/WHO Stepwise Approach to Chronic Noncommunicable Disease Risk-Factor Surveillance: English   |   español
  • CNCD Surveillance, MERCOSUR Countries, Brazil, 2008:
      English   |  español
  • Vancouver Meeting 2008 (MERCOSUR countries): English | español

CARMEN Meetings & Events Directory

CARMEN Documents

PAHO & WHO Resolutions on Chronic Disease

Activities in the Countries: Introduction

Map of the Americas

What is the CARMEN Network?

CARMEN is an initiative of the Pan American Health Organization and aims to improve the health status of the populations in the Americas by reducing risk factors associated with noncommunicable diseases (NCDs).

This is attained through the development, implementation, and evaluation of policies, social mobilization and community-based interventions, epidemiological surveillance of NCD risk conditions, and preventive health-care services.

What are the CARMEN strategies?

physical activity

The interventions developed within the framework of CARMEN imply the definition of a population space (site, be it provincial or national) and the implementation of actions aimed at preventing risk factors for noncommunicable diseases. This involves implementing strategies such as integrated prevention, promotion of health equity, and demonstrative effect.

  • Integrated Prevention

    CARMEN advocates for integrated prevention as a central strategic component that simultaneously reduces multiple NCD risk factors at different levels. For practical purposes, an integrated intervention is one that includes the following:

    • Simultaneous prevention and reduction of a set of risk factors common to major NCDs.
    • Simultaneous use of community resources and health services.
    • Combined and balanced efforts for preventive health care and general health promotion, to enable communities to become active participants in decisions concerning their health.
    • Strategic consensus-building among different stakeholders—such as governmental, non-governmental, and private sector organizations—in an effort to increase cooperation and responsiveness to population needs.

  • Promotion of Health Equity exercise

    Traditionally, chronic diseases have been related to high socioeconomic levels; but currently, there exists sufficient evidence to indicate that this relation has been inverted. Evidence clearly shows that the risk for some NCDs, such as cardiovascular diseases and certain forms of cancers, are higher at low socioeconomic levels, with an apparent increase of this trend in recent years.

    Prevention strategies should consider such underlying influences on health inequalities as education, income distribution, public safety, housing, work environment, employment, social networks, and transportation, among others. It is important that strategies be aimed at reducing overall population risk while simultaneously reducing the gap among different population groups. In many instances, this requires redesigning and evaluating interventions of well-documented efficacy. It also entails identifying and paying special attention to key population groups, such as indigenous peoples, new urban migrants, and women.

  • Demonstrative Effect

    Interventions are first introduced in a demonstration area, so that acceptability and effectiveness can be measured in a given context. It is feasible to conduct evaluations by monitoring the impact of NCD risk factors, morbidity, and mortality.

    In this context, the demonstrative effect measures whether the risk factors and mortality from corresponding noncommunicable diseases have been modified, and whether the observed changes have occurred within a logical time sequence with regard to the interventions. For practical purposes, it is necessary to

    • have a basal measurement that allows for later comparisons;
    • have a surveillance system of mortality and risk factors; and
    • make systematic collections of information related to the intervention, in order to evaluate its development.

    Partnerships with academic centers are highly encouraged in order to strengthen evaluation and participation in international research training activities.

Useful Links

Move for Health

WHO Links

Alliances and Networks

Partners & Collaborating Centers