In this blog, NCD Alliance's Policy and Advocacy Director Alison Cox summarises her major highlights related to NCDs from the 75th World Health Assembly.

I spent the third week in my new role as NCD Alliance’s Policy & Advocacy Director in Geneva, participating in the 75th session of the World Health Assembly (WHA75). Coming back to the NCD Alliance, after ten years working with other organisations, I am inspired to see the progress made in getting noncommunicable diseases onto the global health and sustainable development agenda. From continuous engagement through a wide range of side-events and meetings, to expertly crafted and thought-provoking briefings and statements, the NCD community once again presented a united front, a fact that is reinforced by the prominence of NCDs at WHA75.

As I boarded the train to leave Geneva at the end of the week it was satisfying to hear that the ‘omnibus decision’ on the NCD items was endorsed by the committee – and its adoption at the final plenary assured. These new commitments provide WHO, governments and other stakeholders with indicators to track progress on the NCD response. However, to make any difference to the health of people and communities around the world, all these targets, the road map and the action plans must be put into effect in all countries.

During discussions on the follow-up to the political declaration of the third High-Level Meeting of the General Assembly on the prevention and control of noncommunicable diseases (item 14.1), over 70 Member States addressed the WHA. They provided comments on four progress reports and guidance on the nine NCD-related proposals and associated targets, whilst highlighting cross-cutting and country-specific issues.

A call to integrate NCDs in emergency responses

Preventing and treating NCDs during infectious disease outbreaks and in humanitarian settings was a major theme in Member States' debates. This shows the urgent need to integrate essential services for NCDs and mental health in emergency preparedness and response plans, which was highlighted by France and Egypt in their statements.

Belize also reminded the Assembly of the impact of the pandemic on essential services for NCDs, while Mozambique urged governments to adopt an integrated and holistic approach to managing communicable and noncommunicable diseases. This will safeguard the progress made in tackling infectious diseases and enhance the delivery of essential NCD services whilst the world works towards ensuring Universal Health Coverage (UHC).

The complexities of tackling NCDs in countries most affected by climate change, such as the Small Island Developing States, were also emphasised to highlight the importance of the proposed First WHO Ministerial Conference for Small Island Developing States on the Prevention and Control of NCDs (2023).

New action plan on alcohol

The urgent need to protect health policies, especially those on NCDs, from the influence of the unhealthy commodity industries was a recurring theme in Member State statements when they discussed WHO's new action plan on alcohol. Several Member States used these statements to highlight that there is no safe level of alcohol use, despite industry efforts to keep using the flawed term of "harmful use of alcohol".

Poor regulation of activity by the health-harming industries continues to drive the prevalence of the major risk factors for NCDs: tobacco and alcohol use, unhealthy diets, physical inactivity, and air pollution. Member States must recognise strengthened political leadership for NCDs, such as through the recently established Heads of State and Government Group, as an opportunity to holistically address NCD risk factors.

Driving progress on NCDs in policy, programming and decision-making

There was strong support from Member States for the implementation roadmap 2023-2030 for the global action plan for the prevention and control of NCDs, which placed an emphasis on the meaningful involvement of people living with NCDs at all levels and the need for Member States to take tailored approaches. Norway and Austria reiterated a request that the road map be implemented in full alignment with NCD commitments beyond the "4x4" approach – including those related to air pollution and mental health.

Member States adopted proposals on integrating oral health, epilepsy and neurological conditions in UHC benefit packages, and new targets for diagnosing and treating diabetes, epilepsy and neurological conditions, and obesity. While they welcomed all actions aimed at NCD prevention and early detection, they also called attention to the need for urgent investment in equitable NCD care, with a focus on primary care as "the first responder and gatekeeper for NCDs".

Sustainable financing: The Achilles heel of the NCD response

Lack of financing for action on NCDs is the same problem that we faced over a decade ago, the first time I worked with NCDA, and this has been my greatest disappointment upon returning to the NCD policy world now. Far too little progress has been made in mobilising the resources necessary to deliver on global NCD commitments. More than 7 out of 10 deaths globally are from NCDs, yet NCD prevention and control remains the weakest link in primary health care and universal health coverage.

However, a 2022 Lancet health policy paper makes a strong case to change this. It shows that all countries – including low-and-middle-income countries (LMICs) – can achieve or nearly achieve the SDG target 3.4, to reduce premature mortality from NCDs by one third by 2030, by implementing a package of interventions aligned with the WHO 'Best Buys' on NCD prevention and control.

Now, I look forward to getting involved in our Global Week for Action on NCDs (5-11 September) when we’ll be mobilising civil society to call on governments, development agencies, philanthropies, and the private sector to “Invest to Protect” our health and make NCD commitments a reality. As we approach the UN High-Level Meetings on UHC (2023) and NCDs (2025), the theme reminds policymakers that investing in NCD prevention and control will save money and lives, and is essential if we are to create the fairer, more equitable, sustainable world we all envision.

As I told people throughout the week, I was here when the targets were set. I want to be here when the targets are met.

About the author:

Alison Cox (@AlisonDDCox) is NCDA's Policy and Advocacy Director. She has nearly 30 years of experience working in the areas of environment and global health, delivering significant results for both national and global civil society organisations.