• At least half of the world’s population does not currently have full coverage of essential health services. Most of these people live in low- and middle‑income countries.
• Half of adults living with diabetes are unable to access the insulin they need; hypertension is only under medical control for one in five people; chronic kidney disease tends to go untreated, with up to 90% of cases undiagnosed until lifesaving dialysis or a transplant is needed, and more than 90% of cancer patients in low-income countries lack access to radiotherapy.
• Millions of people are pushed into extreme poverty each year due to out-of-pocket payments for healthcare. Many more die from treatable diseases because they cannot afford care.
• An estimated 1.4 billion people are facing catastrophic or impoverishing health expenditure, because they have to pay directly for services, medications, and other related expenses like travel to health centres.
• 8.6 million avoidable deaths occur each year due to low quality or underused care in LMICs.
• 47% of the global population (3.8 billion), and 81% in low- and lower-middle income countries, have little to no access to core diagnostic tools, including laboratory diagnostics and diagnostic imaging.

• A quarter of the world´s population - 1.7 billion people - lives with NCDs such as cancer, diabetes, chronic respiratory diseases, and heart disease. 41 million people die every year due to an NCD, accounting for 74% of all deaths worldwide. Annual deaths from NCDs are projected to escalate to 52 million by 2030 if this trend is not reversed.
• What these diseases have in common are root causes, such as smoking, junk food, alcohol, bad air quality, and nowhere to exercise. The good news is that an estimated 80% of NCDs can be prevented by limiting or eliminating exposure to their root causes.
• The economic burden of NCDs falls heaviest on those most at risk of being left behind by UHC: people living in low- and middle-income countries, and poor people and communities in all countries, are being made poorer by NCDs. The very old and very young, as well as people living in rural areas, are also disproportionately burdened.
• NCDs are both a cause and a consequence of poverty. These same groups are also the most exposed to NCD risk factors, putting them at higher risk of developing NCDs.
• At least 1.4 billion people are facing catastrophic or impoverishing health spending. A large portion of global health expenditure is for noncommunicable diseases, which are chronic in nature and often require long-term or lifelong care.

• World leaders have promised to ensure everyone has access to healthcare, regardless of ability to pay, by 2030; this is known as Universal Health Coverage (UHC).
• UHC is our most powerful tool to reduce health inequities and to close the care gap and move towards achieving the Sustainable Development Goals (SDGs). The progressive achievement of UHC requires the integration of NCD prevention and care services in the design and implementation of UHC health benefits packages.
• As of 2023, the world is expected to have increased UHC by just 290 million people, leaving 710 million people still to be reached by 2030 if the targets of the 2019 Political Declaration of the United Nations High-Level Meeting on Universal Health Coverage are to be achieved.
• The 2023 State of UHC Commitment Review reports that although 70% of countries have used UHC as a goal for their national policies and plans, only 11% have adopted a clear action plan or road map.
• To reach UHC, countries should spend at least 5% of their gross domestic product on health.

• The direct and indirect costs of NCDs are depleting national and global economies. Together, the five leading NCDs – cardiovascular disease, chronic respiratory disease, cancer, diabetes, and mental health and neurological conditions – have been estimated to cost more than US$ 2 trillion per year (or US$ 47 trillion between 2011-2030). Annual losses due to NCDs range from 3.5% – 5.9% of total GDP, and the amount they will cost developing countries alone between 2011 and 2025 will be $7 trillion dollars, equivalent to the combined annual GDP of France, Spain, and Germany.
• By introducing a realistic and cost-effective package of 21 NCD prevention and treatment interventions, governments could avert 39 million deaths in low- and middle-income countries. These interventions could generate an average net economic benefit of $2.7 trillion, or $390 per capita, between 2023 and 2030. Implementing this set of interventions would require an additional investment of US$18 billion annually over the same seven-year period—the equivalent of the world's health ministries collectively dedicating 20% of their budgets to NCDs. The economic benefits of implementing this package outweigh the investment.
• Financing NCDs in developing countries will require a mixture of domestic financing and catalytic development aid. Domestic NCD financing efforts should start by enhancing public finance capability through general taxation or social health insurance, coupled with fiscal reforms. Removing subsidies or imposing taxes on health-harming goods, such as fossil fuels and sugar, plays a crucial role in NCD financing and generates resources while preventing NCDs and protecting public health.
• Taxes and regulations on unhealthy products are key interventions to improve population health and generate funds that can be channelled into NCD prevention and treatment, but these policies are usually met with strong opposition from the industries concerned. A priority for collective action is to counter industry efforts to influence policies at the expense of our health. Watch these short videos to see how Mexico and Barbados are taking action against the ultra-processed food industry.

Seven of the top ten causes of death globally are noncommunicable diseases, or NCDs. They include cancers, cardiovascular disease, stroke, chronic respiratory diseases, diabetes, mental health and neurological conditions, and chronic kidney disease, among many others.

A staggering 41 million people die every year due to NCD, accounting for 74% of all deaths worldwide. Annual deaths from NCDs are projected to escalate to 52 million by 2030. Although the burden is universal, low- and middle-income countries (LMICs) are hit the hardest, with over 85% of premature deaths between the ages of 30-70 from NCDs occurring in poorer countries. This makes NCDs  far more than a health issue – they are a major human rights and equity issue, as they disproportionately burden the poorest and most vulnerable populations with disease, disability and death.

Scaling up and accelerating action on NCDs should be seen as the fulfilment of a promise by governments. Every UN Member State committed to the Sustainable Development Goals (SDGs) in 2015, pledging to deliver health and wellbeing for all, achieve universal health coverage, and build a more prosperous, equitable and sustainable world.  

NCDs are integrated throughout the SDGs, and have their own target, 3.4, to reduce premature mortality from NCDs by one third by 2030. We now need to see these commitments transformed into action through true leadership.  

Leadership on NCDs means taking bold action to put the health and wellbeing of people and planet first, ahead of the interests of powerful multi-national corporations from health-harming industries like fossil fuels, ultra-processed foods, tobacco and alcohol. It means following through on commitments made with the policies and investments that are required to achieve them – and doing it now.  

We know what works to make progress on NCDs, and all countries – even those which have few resources – can save lives and money by putting the right policies in place. There is no excuse for continued inaction.

We need leaders to step up and be among the trailblazers who are walking the talk, who can be part of the critical mass that is needed to turn the tide on avoidable suffering and death caused by NCDs. 

The ability to enjoy the best health possible is a human right, but not everyone is able to see this right fulfilled. In fact, most cannot. At least half of the world’s population does not currently have full coverage of basic health services.  Most of these people live in low- and middle-income countries. And if it is difficult to see a doctor and be treated for a relatively simple illness, imagine trying to get quality care for a noncommunicable disease, which often requires expensive long-term or lifelong treatment. These are just a few statistics that highlight the urgent need for leadership on NCDs:

• Half of adults living with diabetes are unable to access the insulin they need – in sub-Saharan Africa this number is one in seven;  
• Hypertension is only under medical control for one in five people globally;  
• Chronic kidney disease tends to go untreated, with up to 90% of cases undiagnosed until lifesaving dialysis or a transplant is needed, which is unavailable or inaccessible for many people especially in LMICs;
• More than 90% of cancer patients in low-income countries lack access to radiotherapy.

The most common reason that people cannot access quality care is cost. Many people in LMICs do not have health coverage, or their coverage is too limited, so they are forced to pay for care out-of-pocket. Millions of people are pushed into extreme poverty each year due to out-of-pocket payments for healthcare. Many more die from treatable diseases because they cannot afford to pay for care.  

However, there are other barriers to care as well. Many times, people live too far from health centres to realistically visit them when needed, especially if regular care is required. Other times, services are simply not available, or are too low-quality to be effective. For instance, 47% of the global population (3.8 billion), and 81% in low- and lower-middle income countries, have little to no access to core diagnostic tools, including laboratory diagnostics and diagnostic imaging. 8.6 million avoidable deaths occur each year due to low quality or underused care in LMICs.  

Leaders need to prioritize health equity through people-centred care that includes all NCDs. Beyond health, NCDs are a matter of human rights and justice.  

NCDs cause death and disability, and they are both a cause and a consequence of poverty, destroying the economies of millions of families each year and costing trillions to national governments.

Catastrophic expenses due to out-of-pocket payments for health push an estimated 100 million people worldwide into extreme poverty every year. COVID-19 and its containment measures have exacerbated these inequities and created new vulnerabilities. National and global economies are being depleted by the direct and indirect costs of NCDs too. Annual GDP losses range from 3.5% – 5.9%, and the amount it will have cost developing countries alone between 2011 and 2025 will be $7 trillion dollars, equivalent to the combined GDP of France, Spain and Germany last year.

In total the five leading NCDs – cardiovascular disease (CVD), chronic respiratory disease, cancer, diabetes and mental health conditions – have been estimated to cost US$47 trillion between 2011-2030, an average of more than US$2 trillion per year. The unequitable human toll of NCDs is reason enough for urgent action, but the economic impacts underscore that the world cannot afford to neglect NCDs any longer.  

The cost of inaction on NCDs is far greater than the investment required. We know how to invest wisely and effectively in NCD prevention and management – it’s time for governments to put their money where their mouths are to save and improve the lives of millions. 

All countries – and especially LMICs – can achieve or nearly achieve SDG 3.4, saving 39 million lives by 2030, by introducing a cost-effective package of NCD prevention and treatment interventions.

The WHO Best Buys are among the most effective NCD interventions – that is, they are affordable for all countries and guarantee a big return on investment in lives and money saved.

More specifically, the Best Buys are set of 16 NCD interventions which focus on preventing NCDs by addressing the major NCD risk factors – tobacco use, alcohol use, unhealthy diets and inadequate physical activity – and management of cardiovascular disease, diabetes and cervical cancer. These interventions require on average an additional US$0.84 per year, per person in LMICs, with a return of US$7 for every dollar invested.

A 2022 analysis fully aligned with and building on the WHO Best Buys looked at a broader package of 21 NCD prevention and treatment interventions that can form the backbone of effective national NCD strategies. The analysis revealed that nearly all countries can still achieve SDG

3.4 by 2030 by implementing locally tailored packages of cost-effective NCD interventions. Implementing this set of interventions will require, on average, an additional US$18 billion annually over 2023–30; and is projected to avert 39 million deaths in LMICs and generate an average net economic benefit of $2·7 trillion, or $390 per capita. The economic benefits of this package outweigh costs by 19:1.

It’s time for a bold new perspective that values and measures human and planetary health and wellbeing, rather than short term economic gains. We can create a fairer and healthier world by implementing evidence-based solutions for tackling NCDs.