A new WHO report highlights the need to intensify national action to meet the global targets governments have agreed to protect people from heart disease, cancers, diabetes, and lung diseases. Globally, these 4 noncommunicable diseases (NCDs) represent the largest cause of death in people aged under 70 years, posing a major threat to sustainable development.
The global survey, “Assessing national capacity for the prevention and control of noncommunicable diseases”, shows that some countries are making remarkable progress. A number of countries have put in place measures to protect people from exposure to tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity. Some have created new financing opportunities to build strong public health systems by taxing tobacco products.
“Countries, including some of the poorest, are showing it is feasible to make progress and reduce premature deaths from NCDs. But that progress, particularly in low and middle-income countries, is insufficient and uneven,” says Dr Oleg Chestnov, Assistant Director-General at WHO.
“If countries continue on this trajectory, there is no way they will all meet the 2030 Sustainable Development Goals (SDG) target of reducing, by one-third, premature mortality from NCDs.”
The report tracks progress on 4 time-bound commitments agreed in 2014 to strengthen countries’ abilities to tackle NCDs. These are to set national NCD reduction targets, develop national multisectoral policies and plans to achieve these national targets, reduce exposure to factors that put people at risk of NCDs, and strengthen health systems to address NCDs.
To date, 60% countries have set national time-bound targets for NCDs indicators and 92% have integrated NCDs in national health plans. Tobacco taxation is the most widespread fiscal intervention with 87% of countries reporting that they have implemented excise and non-excise taxes on tobacco. Alcohol taxation is the second most widespread fiscal intervention with 80% of countries reporting this type of intervention. Sugar-sweetened beverages (18% of countries) and foods high in fat, sugar or salt (8% of countries) were the third and fourth most widespread fiscal intervention.
Key actions required include:
Catalytic funding through domestic, bilateral and multilateral channels to develop essential NCD prevention and control programmes in many low- and middle-income countries to strengthen capacities for primary prevention, screening, and surveillance.
Greater attention to policymaking in sectors beyond health that have a bearing on NCDs, such as trade and marketing of unhealthy or harmful products.
Stronger multisectoral governance mechanisms are needed to implement SDG target 3.4 on NCDs through whole-of-government and whole-of-society approaches.
More widespread operationalizing of national NCD plans – in particular plans to address unhealthy diets.
More widespread establishment of surveillance systems to run national risk factor surveys at least every 5 years to track targets, indicators, and progress.
Ensuring health systems can respond to the health-care needs of people with NCDs by providing basic services such as detection, treatment and care for those with cancer. Cancer screening programmes should become more systematic and reach more people in need.
Better access for people suffering end-stage NCDs to palliative care in the public health system, specifically in primary health care and in community or home-based care.