Congratulations on materials on the surveillance of noncommunicable diseases.

I would like to extend my congratulations to the Revista Panamericana de Salud Pública/Pan American Journal of Public Health for the two interesting, timely articles and the accompanying editorial about the surveillance of noncommunicable diseases (1–3). After searching for evidence and dissecting the problem analytically, the authors of these papers concluded that a great majority of the prevalence studies carried out in Latin America and the Caribbean on noncommunicable diseases (NCDs), particularly hypertension, are not very useful for surveillance or for defining interventions to use with these emerging conditions. This was a common hypothesis among those who have dedicated much time to these issues, but it was never clearly proved before (4). As the authors suggested, it is necessary to build common minimum standards for variables used in surveys and surveillance, especially for NCDs. In other words, as with Esperanto, a new language is needed in this field. Otherwise, large amounts of resources will continue to be expended without producing reliable, comparable results. The lessons learned with large carefully designed countrywide studies have demonstrated their power in this sense (5). This has been true, for example, with the multinational MONICA project of the World Health Organization (WHO) to monitor trends and determinants in cardiovascular diseases, the Countrywide Integrated Noncommunicable Disease Intervention (CINDI) program of WHO’s European Regional Office, the WHO’s global INTERHEALTH program for the integrated prevention and control of noncommunicable diseases, and the Pan American Health Organization’s program in Latin America and the Caribbean called the Conjunto de Acciones para la Reducción Multifactorial de las Enfermedades No Transmisibles (CARMEN) (Actions for the Multifactorial Reduction of Noncommunicable Diseases). Finally, I agree that the STEPwise approach of the WHO is also an excellent tool for making progress in this important field of health surveillance (3), particularly in developing countries, where resources are very limited.