New report shows progress and missed opportunities in control of NCDs at national level

A new edition of WHO’s NCD Progress Monitor, documenting the actions that WHO Member States are taking to set targets and develop policies and plans to prevent and control major noncommunicable diseases (NCDs) and their risk factors, finds that simple and effective interventions are not being adopted widely enough around the world.

Of 194 countries, the 2022 NCD Progress Monitor indicates that 126 countries have set time-bound national targets for NCDs based on WHO guidance. Encouragingly, 77 countries have fully achieved more indicators in 2022, compared to the previous NCD Progress Monitor published in 2020.

An area of progress was in efforts to reduce tobacco use, with more than half of all countries now fully achieving the implementation of plain/standardized packaging and/or large graphic health warnings on tobacco packaging, one of the best-buy interventions (to effectively reduce tobacco use under the NCD Global Action Plan).

There was also improvement in the development of clinical guidelines for NCD management, with the majority of countries fully achieving this indicator for the first time. Progress is also made in efforts to improve nutrition and food environments.

Well over half of countries – 120 in total – currently have an operational multisectoral national strategy or action plan for NCDs that integrates the major diseases and their shared risk factors. While this is slightly lower than the same figure from the 2020 NCD Progress Monitor (n=129), due to national strategies and action plans expiring during the COVID-19 pandemic, it is still considerably higher than the 87 countries who had an operational, multisectoral integrated NCD strategy or action plan in 2015, when this indicator was first reported in the first NCD Progress Monitor.

In total, fifty-four countries have lost ground, achieving fewer indicators than in 2020. There have also been major declines in physical activity awareness campaigns, and NCD surveillance. This is against a backdrop of premature NCD mortality increasing in more than 20 countries, mostly low- and middle-income countries. Globally, rates of diabetes and obesity are on the rise.

Similarly, variations by geography and income status persist. As two examples, no Member State in the WHO African Region has fully achieved the NCD surveillance indicator to deliver a STEPS survey or a comprehensive health examination survey every five years, while only one no low-income countries (of 27) has achieved a functioning system for generating reliable cause-specific NCD mortality data on a routine basis.

Effectively tackling NCDs and their key risk factors requires a detailed understanding of what progress is being made at the country level. By tracking the implementation of a key set of NCD actions at national level, the NCD Progress Monitor can measure progress over time, provide an indication of how widely several ‘best buy’ NCD policies are being adopted globally.

As well as tracking key actions taken by each WHO Member States, the NCD Progress Monitor 2022 also includes the latest data on a country’s population, the percentage and number of deaths from NCDs, and the risk of premature death from the four main NCDs (cardiovascular diseases, cancer, diabetes and chronic respiratory diseases) – the indicator used to monitor the Sustainable Development Goal target 3.4 on NCDs.

In his foreword to the Monitor, Dr Tedros Adhanom Ghebreyesus, WHO Director-General, highlighted why uncertainties from COVID-19 tell us that action on NCDs is critical for strong health systems:

“In a world filled with uncertainty, a silver lining for NCDs is that we know both how to prevent them and how to manage them. This report presents evidence-based policies that represent the most effective and cost-effective actions for countries to protect their citizens from the death and disability wrought by NCDs”.

Dr Bente Mikkelsen, Director for Noncommunicable Diseases at WHO, described the findings as a startling reminder of the need for accelerated action on NCDs.

“WHO’s work is made more effective when responses to NCDs are contextualized to a country’s population, health system and policy response. By shining a light on what steps Member States are taking to prevent and control NCDs, the NCD Progress Monitor is critical to informing data-driven actions that accelerate new pathways and solutions.

”NCDs are the world’s biggest killers, and these findings reaffirm the urgent need for countries to adopt our simple, effective and cost-effective, best-buy interventions”.

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