Blood-pressure-related disease is a global health priority.

I n global-health politics, cardiovascular disease is the elephant in the room—a massive problem that few want to acknowledge and even fewer want to tackle. In [a recent issue of] Lancet, Carlene Lawes and colleagues, on behalf of the International Society of Hypertension, estimate that bloodpressure-related diseases cause about half this burden, killing around 8 million people each year.1 Low-income and middleincome countries shoulder about 80% of the cardiovascular-disease burden, half of which is in people of working age. This situation was all predicted a decade ago by the Global Burden of Disease Project,2 but none of the major healthdevelopment funds—including the Bill & Melinda Gates Foundation, the World Bank, the major regional development banks, and major bilateral donors—have made any substantive or sustained effort to address this issue. Similarly, none of the major international drug companies have offered material assistance in this