As the developing countries experience a rapid health transition, the mismatch between healthcare needs and resources is widened by an expanded list of health conditions that vie for policy maker’s attention and public health action, while posting competing claims for clinical care. The complexities are compounded when policy has to prioritise on the basis of disease burdens, cost-effectiveness and equity, while the delivery systems have to simultaneously cope with the transformative pressures of economic restructuring and healthcare reforms. The rising burdens of CVD exemplify the high costs that unchecked epidemics of NCDs will impose on healthcare systems, and the adverse effects on development that would result from mid-life death and disability.