Countries Are Falling Behind In Tackling Non-Communicable Diseases, But 2030 Targets Are Still Within Reach

Most countries in the world are not on track to reduce premature deaths from non-communicable diseases (NCD) by a third by 2030, according to a new NCD 2030 Countdown report published by The Lancet.

“An estimated 150 million people will lose their lives too early from a noncommunicable disease over the next decade and right now NCDs are intensifying the impact of COVID-19,” said Bente Mikkelsen, director of NCDs at the World Health Organization in a press release.

But it’s not too late to turn the tide, says Geneva-based NCD Alliance, a partner in the NCD Countdown Consortium that authored the report. Imperial College London and the World Health Organization are also a part of the Consortium.

“The positive message from the study is that all countries still have options to reach SDG3.4 (the NCD target) by 2030 and in doing so save millions of lives,” Nina Renshaw, director of Policy & Advocacy at the NCD Alliance told Health Policy Watch.

“”The target can only be reached by putting in place a package of preventative and treatment measures to reduce premature deaths from multiple NCDs. No country could hit the target by focusing on just one disease, and both prevention and treatment measures are needed,” she added.

Only Six Countries On Track To Meet 2030 Targets – And Rich Countries Aren’t Necessarily Doing Better

Red indicates that the likelihood of dying prematurely from that NCD increased in the country, while green indicates the likelihood of dying prematurely from an NCD decreased. Some high-income countries such as the United States (red box) saw increasing risk in premature mortality across many NCDs, while middle-income countries like Ukraine [green box] saw a decrease in NCD mortality.
Only Norway, Denmark, Luxembourg, New Zealand, Singapore, and South Korea are on track to meet the 2030 goals for reducing mortality by preventable and treatable NCDs such as stroke, heart disease, and cancer.

And high-income countries aren’t necessarily making the most gains in NCDs overall, according to Renshaw.

“There are some LMICs who are doing well at reducing NCDs,” ” she said. ” These include Jamaica, Jordan, Maldives, South Africa, Turkey, Vietnam and many in eastern Europe, including Montenegro and Ukraine.

“On the other hand, some rich countries, most notably the USA, are going backwards, meaning people are dying younger from a number of major NCDs. This shows that success is about more smart policies first and foremost.”

The pandemic has also exposed a ‘syndemic’ – the deadly infectious disease targets those already living with NCDs such as heart disease and diabetes. Those with diabetes are 2 to 4 times more likely to experience severe COVID-19 or death by the virus, according to WHO director-general Dr Tedros Adhanom Ghebreyesus.

“COVID-19 has exposed how a failure to invest in effective public health to prevent NCDs and provide health care for people living with NCDs can come back to bite us,” said Katie Dain, CEO of the NCD Alliance. “NCD prevention and treatment can no longer be seen a ‘nice to have’, it must be considered as part of pandemic preparedness.”

With many essential health services disrupted during the COVID-19 pandemic, the risk of walking back gains on NCDs increases.

Smart Policies Can Turn The Tide On NCDs

The top NCD killers – diabetes, cardiovascular disease (CVD), chronic respiratory disorders, and cancers – can be combatted with a basic package of interventions, tailored to fit countries’ budgets and needs, according to the study.

All countries should implement tobacco and alcohol control policies, added Renshaw. Tobacco and the harmful use of alcohol are major risk factors for cardiovascular and respiratory diseases, and a number of different cancers.

The necessary policy packages vary for different countries, depending on local disease burden and risk factors, but all countries need to implement tobacco and alcohol control policies, as well as a package of treatment interventions,” she said. “We recognize cost constraints in different countries.

“But the study shows that a basic essential package should include at least hypertension and diabetes treatment, primary and secondary prevention of cardiovascular disease (CVD), and treatment for CVD, diabetes complications, asthma and COPD, cancer screening and treatment.”

While the current report highlights the NCDs that should be prioritized by country, the NCD Countdown 2030 Consortium will be releasing a follow-up paper to look at the costs of implementing recommended interventions and policies by country and by region.

Bente Mikkelsen

And as governments build back from COVID-19, NCD’s must be addressed in recovery plans, said Mikkelsen.

“We must ensure that all NCDs are addressed in COVID-19 recovery plans so that we can turn this deadly tide,” said Mikkelsen. “Young people must lead the fight against NCDs. We cannot allow NCDs to become a generational catastrophe, where human potential is wasted, and inequality is exacerbated.”

Image Credits: WHO/A. Loke, NCD Countdown 2030: pathways to achieving Sustainable Development Goal target 3.4, WHO.

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