As we begin counting down to the fourth UN High-Level Meeting on Noncommunicable Diseases and Mental Health (HLM4) this September, The Lancet has published a powerful new Comment authored by NCDA’s Katie Dain and Marijke Kremin, calling out the urgent need for political courage to transform global NCD commitments into meaningful change.

The article delves into the recently published Zero Draft Political Declaration, highlighting its notable advances—like new “fast-track” targets on tobacco use, hypertension, and mental health access—while also identifying critical gaps that could undermine its potential. The authors underline the need for bolder ambition, most notably in tackling the commercial determinants of health, increasing financial investment in NCD prevention and care, and embedding community engagement throughout the process.

With just three months to go before the HLM, this article is both a call to action and a reality check. It reinforces why the NCDA campaign’s five priority asks—Accelerate implementation, Mobilise investment, Break down siloes, Deliver accountability, and Engage communities—are so vital.

At this decisive moment, the global health community cannot settle for half-measures. As Dain and Kremin write, “the Zero Draft relies on the courage of governments to step up and call for ambitious language and targets, and the determination of civil society to support them from behind the scenes.”

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