Chronic non-communicable diseases (NCDs) such as diabetes, cardiovascular disease (CVD) and cancers are a major public health problem. In an effort to increase awareness about the behavioural risk factors for NCDs a community-based project was implemented in Khayelitsha. Informed by the results of this study the School of Public Health at the University of the Western Cape joined the Prospective Urban and Rural Epidemiology (PURE) study in January 2009. The study seeks to scientifically document the root-causes of the traditional risk factors for NCDs by following-up adults aged 30 to 75 years for 12 to 15 years and collecting individual-, household-, community- and national-level information. Responding effectively to the growing burden of NCDs incorporates addressing societal and biological pathways from environmental causes to primordial predispositions and adequately managing the primary risk factors.