clearly there are many other factors at play notably a range of social barriers and determinants these can be related to gender class ethnicity caste language and religion arising from ingrained social structures norms and processes that accept and even encourage unfair distributions of wealth and social resources for example people living with hiv and some other chronic illnesses face high levels of stigma and discrimination that hinder their access to medical testing treatment care and support governments aiming to improve health standards will therefore want to improve the status of women provide effective reproductive health services implement comprehensive breastfeeding programmes in line with current recommendations and increase communitybased pressures against sexselective abortion poor people lacking education and information or the funds for healthier options are more vulnerable to the impact of ncds than the rich and are likely to die earlier directly and indirectly ncds will have farreaching impacts on progress towards the mdgs