Heart disease, stroke, diabetes and cancer are now among the leading causes of death and disability around the world. The causes of these diseases include modifiable lifestyle-related risk factors, such as smoking, poor diet, lack of physical activity, as well as non-modifiable risk factors, including age and genetics. Due to population growth and the relative success of efforts to reduce communicable diseases, the number of people with non-communicable diseases will continue to rise in the future. However, there are exciting possibilities for encouraging healthy ageing by postponing death and illness from these diseases. The World Health Organization (WHO) has set a global goal of reducing deaths from non-communicable diseases by an extra 2% over the period 2005 to 2015 – avoiding 36 million deaths. Roger Magnusson comments on the current global framework for non-communicable diseases and considers how it might be strengthened.