The wind in the NCD sails is coming up. A window is opening that should allow for some great steps forward and get some badly needed, timely, attention. In Sept 2011, the United Nations will have a General Assembly Special Session on NCDs. Leading up to this session there are many other meeting including a WHO sponsored meeting in Jarkata, Indonesia, in March, and, in April, a Ministerial meeting in Moscow, Russia. In South Asia, a video-conferenced strategic discussion of the NCD report included all 8 South Asian countries (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka) and found much energy across the region to be come more engaged and to have a voice in the upcoming global discussions on NCDs. This type of opportunity does not come often - and the momentum is building up. In response to Nachiket Mor comments, good primary care will play a key role in reducing the complications among those who already have disease. However, in addition to treatment, population-level prevention is a vital element. A balance between prevention and treatment is needed. We know this from developed countries experiences with NCDs over the last half century. The dramatic declines heart disease deaths in developed countries over this time period were roughly half due to population level change in risk and half due to primary care types of treatments. The challenge is getting the best strategic balance for a country's context. Some real opportunities are out there.