Non-specific low back pain.

1874 www.thelancet.com Vol 379 May 19, 2012 goals of individuals and communities to achieve optimum quality and quantity of life. There is increasing evidence that such a health system should be based on strong primary health care, that uses an eff ective community-oriented primary care model, addressing ways to reduce the causes of NCDs and tackling social and political issues at the local, national, and international level because of its emphasis on community input. Earlier this year, Richard Horton commented that “There has been an argument for several decades now to drop vertical disease programmes...and replace them with schemes that emphasise health systems strengthening... Health systems approaches to aid may be intellectually correct, but they are politically problematic.” A comprehensive integrated strategy based on primary health care to tackle NCDs creates a unique opportunity to make the switch.