World leaders are expected to commit to 150 million fewer tobacco users, 150 million more people under hypertension management, and 150 million more people with access to mental care by 2030 at the United Nations on Thursday.

These targets are in the final draft of the political declaration set for adoption at the UN High-Level Meeting on Non-communicable Diseases (NCDs) and Mental Health in New York.

Earlier in the week, the World Health Organization (WHO) released its global hypertension report, which showed that 1.4 billion people lived with hypertension in 2024 – yet only around 20% (320 million) had their high blood pressure under control.

“Hypertension is a leading cause of heart attack, stroke, chronic kidney disease, and dementia. It is both preventable and treatable – but without urgent action, millions of people will continue to die prematurely, and countries will face mounting economic losses,” according to the report, released on the sidelines of the UN General Assembly.

WHO Director General Dr Tedros Adhanom Ghebreyesus told the launch that he lived with hypertension, which is controlled by medication: “And that is the great paradox of hypertension. It can be controlled by relatively inexpensive medication.”

However, access to affordable medicine and blood pressure devices were the biggest barrier to controlling high blood pressure, added Tedros.

The report, which draws on data from 194 countries, also shows that only 28% of low-income countries had all five WHO-recommended hypertension medicines readily available in their clinics.

“Barriers span the pharmaceutical value chain, from regulatory systems and medicine selection, to pricing, procurement, prescribing, and dispensing,” according to the report.

Major gaps

Other major gaps in addressing hypertension include weak communication about risks – such as the consumption of alcohol, tobacco, salt and transfat, and physical inactivity.

Some countries had limited access to blood pressure devices, a lack of trained primary care teams, unreliable supply chains and costly medicines.

“Every hour, over 1,000 lives are lost to strokes and heart attacks from high blood pressure, and most of these deaths are preventable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. 

“Countries have the tools to change this narrative. With political will, ongoing investment, and reforms to embed hypertension control in health services, we can save millions and ensure universal health coverage for all.”

Dr Kelly Henning, who leads the Bloomberg Philanthropies Public Health Program, told the report’s launch that countries that “integrate hypertension care into universal health coverage (UHC) and primary care are making real progress, but too many low- and middle-income countries are still left behind.” 

Dr Tom Frieden, CEO of Resolve to Save Lives, said that the lives of 50 million people can be saved if the global control of high blood pressure was increased from the current 20% to 50%. He also highlighted that uncontrolled high blood pressure is the cause of one-in-six patients’ dementia.

“It only costs $5 a year to treat a patient with the best medications in the world,” said Frieden. “Twenty-five years ago, South Korea’s hypertension control was 15%. They have increased this to 62% this year … and seen a decline of over 80% in cardiovascular deaths.”

The report also gives credit to Bangladesh and the Philippines for making significant progress – largely by “integrating hypertension care into UHC, investing in primary care, and engaging communities”.

Low-cost anti-hypertensive medication and limited patient fees in South Korea have enabled the country to improve blood pressure control nationally.

Between 2019 and 2025, Bangladesh increased hypertension control from 15% to 56% in some regions by embedding hypertension treatment services in its essential health service package and strengthening screening and follow-up care.

The Philippines has effectively incorporated the WHO’s HEARTS technical package into community-level services nationwide.

The draft declaration commits countries to scaling up “early screening, monitoring and diagnosis, affordable and effective treatment, and regular follow-up for people at risk of cardiovascular disease or living with high blood pressure”.

Impact of mental health

Meanwhile, over one billion people across the world are living with mental health disorders, according to two WHO reports, ‘World Mental Health Today’ and ‘Mental Health Atlas 2024’, released earlier this month.

In low-income countries, fewer than 10% of affected individuals receive care, compared to over 50% in higher-income nations.

“Transforming mental health services is one of the most pressing public health challenges,” said Dr Tedros. “Investing in mental health means investing in people, communities, and economies — an investment no country can afford to neglect. Every government and every leader has a responsibility to act with urgency and to ensure that mental health care is treated not as a privilege, but as a basic right for all.”

The draft declaration commits to several measures to address mental health, including scaling up “psychosocial and psychological support, and pharmacological treatment for depression, anxiety and psychosis”, particularly at the primary health care level and within general health care services.

It also commits to addressing the stigma associated with mental illness, and the “health risks related to digital technology, including social media, such as excessive screen time, exposure to harmful content, social disconnection, social isolation, and loneliness.”

Weakened declaration

While NCD advocates have welcomed the three “150 million” targets, they have lamented the weakening of language on taxing unhealthy products since the zero draft in May.

As previously reported by Health Policy Watch, the text no longer refers to taxing sugar-sweetened beverages, and describes higher taxes on tobacco and alcohol as “considerations… in line with national circumstances” rather than concrete proposals.

The zero draft target of “at least 80% of countries” implementing excise taxes on tobacco, alcohol, and sugar-sweetened beverages to levels recommended by the WHO by 2030 is completely absent from the final draft.

The declaration has also removed virtually all references to WHO recommendations. This is apparently at the insistence of the United States, which withdrew from the WHO when Donald Trump became president in January, sources close to the talks told Health Policy Watch.

Image Credits: Bruno Martins/ Unsplash.