Summary box

• Hypertension is the leading risk factor for death worldwide and is now more common in low-income and middle-income countries (LMICs) than high-income ones. However, hypertension control programmes are massively underfunded relative to their contribution to global disease burden, in contrast to efforts to control HIV/AIDS and other infectious diseases.

• New data reveal the size of the burden of hypertension in LMICs, the cost of its treatment and the number of lives saved per patient treated. These data suggest that treatment of all persons in LMICs with uncomplicated hypertension would cost $7.6 billion annually and save 4.7 million lives over a decade, at a total cost of roughly $16 000 per life saved.

• These numbers now compare favourably with the impact and cost-effectiveness estimates that kickstarted global health programmes such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, and rebut prior claims that universal hypertension treatment is not yet cost-effective.

• Advocates and policymakers should use these data to argue for increased funding for hypertension care in developing countries. Even in a political climate marked by antiglobalism, populism and scepticism of international aid and development, investment in hypertension control is sufficiently cost-effective—from both humanitarian and strategic perspectives—for bilateral and non-governmental donors to rally behind.