Non-communicable diseases (NCDs) are the leading cause of death worldwide. Their emergence as the predominant health problem in wealthy countries accompanied economic development. As a result, NCDs are often referred to as ‘diseases of affluence’. But is this a misleading term? It suggests that these are not major problems for the world’s poor, which is quite simply wrong, as this issue of Insight Health illustrates. Is it time to rethink policy on NCDs?