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Addressing non-communicable diseases (NCDs) in a developing country such as Pakistan is a multidimensional challenge with implications at different levels. Lobbying for appropriate investments and policies to facilitate the inclusion of the prevention of NCDs as part of the global development and health agenda is a critical aspect of the issue. However, on the other hand, the implementation of policies for the prevention of NCDs is a challenge in its own right because of the diverse nature of strategies that need to be instituted in tandem. These include institutional, community and public policy level changes set within a long-term and life-course perspective.These considerations lent impetus to the formulation of a tripartite alliance between the Ministry of Health, Government of Pakistan, the World Health Organization, Pakistan office, and the non-government organisation Heartfile. This public–private partnership aims at the development and implementation of a long-term national strategy for prevention and risk factor control of NCDs and health promotion in Pakistan.Though the ingredients of this strategy are sound, it needs to be supported by a clear, strong and sustained political and policy commitment backed by a legislative framework that is supportive of multi-stakeholder models. Copyright © 2006 John Wiley & Sons.