We welcome Ackland et al’s timely discussion on the terms “non-communicable” and “chronic” disease.¹ Their argument is that conditions currently labelled “non-communicable” are in fact “communicable” because the risk behaviours that underlie them are highly transmissible. Thus they argue for a change in label, from “non-communicable diseases” to “chronic diseases”.

Their argument, however, confuses one classification system, which is based on cause (namely, communicable diseases compared with non-communicable diseases compared with injuries), with a second classification system, which is based on effect (namely, acute conditions compared with chronic conditions). Their argument also overlooks the growing consensus that chronic conditions include certain communicable diseases, such as HIV/AIDS.^2,3 In fact, certain non-communicable conditions are acute in nature, while certain communicable conditions require chronic, ongoing care. For example, HIV/AIDS clearly has an infectious aetiology but requires long term management by the healthcare system. As …