Higher taxes and warning labels on unhealthy food, cigarettes and alcohol, and better screening for cancers, are on the World Health Organization’s (WHO) updated list of “best buys” to address non-communicable diseases (NCD) discussed by member states at the body’s Executive Board meeting on Thursday.

The list was updated in response to the lack of progress to reduce NCDs, with not a single country on track to achieve the 2025 global targets set by the World Health Assembly back in 2013, and the declaration by the UN General Assembly High-Level Meeting on NCDs in 2018.

The new list now recommends 112 interventions and enabling actions – up from 88 when it was last updated in 2017, and the global body has also worked out which are the most cost-effective.

There was wide support for the new list from member states. However, civil society representatives criticised its silence on kidney disease, dementia, obesity co-morbidities, as well as a lack of attention to older people more likely to have NCDs.

Lack of progress

In his report on progress made to address NCDs, WHO Director-General Dr Tedros Adhanom Ghebreyesus noted that health systems were failing to prevent and control these diseases.

“The [COVID-19 pandemic] has highlighted the urgent need to strengthen health systems through a radical reorientation towards primary health care as the foundation for progress towards universal health coverage, as well as to ensure health security and achieve health and well-being for all,” said Tedros. 

“The prevention and control of NCDs and the promotion, protection and care of mental health are integral to this reorientation.”

The cost of implementing the interventions in 76 low and lower-middle-income countries is less than US$ 1 per person per year, and together these actions could save seven million lives per country, according to the WHO.

However, Botswana, on behalf of the Africa region, requested that more affordable treatments are developed to assist lower-income countries.

Mental health remains neglected

“Between now and 2030, the economic gains from implementing the cost-effective NCD interventions could amount to more than $230 billion in lower-middle income countries when individual, economic and social benefits are factored in,” according to Tedros, who noted that almost three-quarters of deaths were caused by NCDs.

Almost a billion people globally lived with a mental disorder. A massive 283 million people had alcohol use disorders in 2016 and 36 million with drug use disorders in 2019, yet less than a third of member states had mental health policies and plans and only 2% of health budgets go to mental health. 

Denmark, on behalf of the European Union, called on the WHO to “strengthen the efforts for mental health and have a greater focus on information sharing and de-stigmatization efforts”.

Deputy Director-General Dr Zsuzsanna Jakab told the EB at a session on Thursday night that the best buys would “invigorate implementation of both the global action plan and relevant regional frameworks”.

‘We know these approaches work. In Southeast Asia for example, we have seen a rapid decline in tobacco use. Smoking prevalence among men in the region declined from 50% in 2000 to 25% in 2020,” said Jakab.

Assistant Director-General Dr Tereza Kasaeva, WHO’s interim head of NCDs, recommended that member states “define the list of priorities that are considered good value for money according to their national context”, and WHO would support them to implement these.

The list will continue to be updated as more evidence became available, added Kasaeva.