What are NCDs?
Noncommunicable diseases (NCDs), also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behaviours factors.
The main types of NCDs are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma), diabetes and mental health conditions.
NCDs disproportionately affect people in low- and middle-income countries where more than three quarters of global NCD deaths – 32 million – occur.
FAQs about NCDs
Who is at risk of such diseases?
People of all age groups, regions and countries are affected by NCDs. These conditions are often associated with older age groups, but evidence shows that 15 million of all deaths attributed to NCDs occur between the ages of 30 and 69 years. Of these "premature" deaths, over 85% are estimated to occur in low- and middle-income countries. Children, adults and the elderly are all vulnerable to the risk factors contributing to NCDs, whether from unhealthy diets, physical inactivity, exposure to tobacco smoke and air pollution, or the harmful use of alcohol.
These diseases are driven by forces that include rapid unplanned urbanization, globalization of unhealthy lifestyles and population ageing. Unhealthy diets and a lack of physical activity may show up in people as raised blood pressure, increased blood glucose, elevated blood lipids and obesity. These are called metabolic risk factors that can lead to cardiovascular disease, the leading NCD in terms of premature deaths.
Modifiable behavioural risk factors
Modifiable behaviours, such as tobacco use, physical inactivity, unhealthy diet, exposure to air pollution and the harmful use of alcohol, all increase the risk of NCDs.
Tobacco accounts for over 7.2 million deaths every year (including from the effects of exposure to second-hand smoke), and is projected to increase markedly over the coming years. (1)
4.1 million annual deaths have been attributed to excess salt/sodium intake. (1)
More than half of the 3.3 million annual deaths attributable to alcohol use are from NCDs, including cancer. (2)
1.6 million deaths annually can be attributed to insufficient physical activity. (1)
In 2012, air pollution has caused 6.5 million deaths globally, including ambient and household air
Metabolic risk factors
Metabolic risk factors contribute to four key metabolic changes that increase the risk of NCDs
Raised blood pressure
Hyperglycemia (high blood glucose levels) and
Hyperlipidemia (high levels of fat in the blood).
In terms of attributable deaths, the leading metabolic risk factor globally is elevated blood pressure (to which 19% of global deaths are attributed), (1) followed by overweight and obesity and raised blood glucose.
What are the socioeconomic impacts of NCDs?
NCDs threaten progress towards the 2030 Agenda for Sustainable Development, which includes a target of reducing premature deaths from NCDs by one-third by 2030.
Poverty is closely linked with NCDs. The rapid rise in NCDs is predicted to impede poverty reduction initiatives in low-income countries, particularly by increasing household costs associated with health care. Vulnerable and socially disadvantaged people get sicker and die sooner than people of higher social positions, especially because they are at greater risk of being exposed to harmful products, such as tobacco, or unhealthy dietary practices, and have limited access to health services.
In low-resource settings, health-care costs for NCDs quickly drain household resources. The exorbitant costs of NCDs, including often lengthy and expensive treatment and loss of breadwinners, force millions of people into poverty annually and stifle development.
Prevention and control of NCDs
An important way to control NCDs is to focus on reducing the risk factors associated with these diseases. Low-cost solutions exist for governments and other stakeholders to reduce the common modifiable risk factors. Monitoring progress and trends of NCDs and their risk is important for guiding policy and priorities.
To lessen the impact of NCDs on individuals and society, a comprehensive approach is needed requiring all sectors, including health, finance, transport, education, agriculture, planning and others, to collaborate to reduce the risks associated with NCDs, and promote interventions to prevent and control them.
Investing in better management of NCDs is critical. Management of NCDs includes detecting, screening and treating these diseases, and providing access to palliative care for people in need. High impact essential NCD interventions can be delivered through a primary health care approach to strengthen early detection and timely treatment. Evidence shows such interventions are excellent economic investments because, if provided early to patients, they can reduce the need for more expensive treatment.
Countries with inadequate health insurance coverage are unlikely to provide universal access to essential NCD interventions. NCD management interventions are essential for achieving the global target of a 25% relative reduction in the risk of premature mortality from NCDs by 2025, and the SDG target of a one-third reduction in premature deaths from NCDs by 2030.
The 2030 Agenda for Sustainable Development recognizes NCDs as a major challenge for sustainable development. As part of the Agenda, Heads of State and Government committed to develop ambitious national responses, by 2030, to reduce by one-third premature mortality from NCDs through prevention and treatment (SDG target 3.4). This target comes from the High-level Meetings of the UN General Assembly on NCDs in 2011 and 2014, which reaffirmed WHO’s leadership and coordination role in promoting and monitoring global action against NCDs. The UN General Assembly will convene a third High-level Meeting on NCDs in 2018 to review progress and forge consensus on the road ahead covering the period 2018-2030.
To support countries in their national efforts, WHO developed a Global action plan for the prevention and control of NCDs 2013-2020, which includes nine global targets that have the greatest impact on global NCD mortality. These targets address prevention and management of NCDs.
Multisectoral and multistakeholder action
Recognizing that NCDs constitutes one of the major challenges for development in the 21st century, one that requires a multisectoral and multi-stakeholder approach, as stressed in the Moscow Declaration adopted during the First Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control (Moscow, 28-29 April 2011), the UN General Assembly has convened three high-level meetings on NCDs.
The 2011 high level meeting resulted in a UN Political Declaration, in which multiple commitments were made for the prevention and management of NCDs by countries, and multilateral and donor agencies. Subsequently, WHO Member States agreed to a 25% reduction in premature NCD mortality by 2025 (25x25) and then adopted a set of risk factor and health system targets which, if met, would ensure achievement of the 25x25 mortality target.
In addition, the 2018 high-level meeting theme was on “Scaling up multi-stakeholder and multisectoral responses for the prevention and control of non-communicable diseases in the context of the 2030 Agenda for Sustainable Development”. Here the meeting adopted the deceleration which included a range of relevant resolutions on the need for multisectoral and multistakeholder action which can be found here.
You can also find reference to the importance of multisectoral and multistakeholder action for the GCM/NCD through recent high level political and governance documents:
- Montevideo Roadmap 2018-2030 on NCDs as a sustainable development priority
- Paragraphs 18 and 25
- WHO's Thirteenth Priority of Work 2019-2023
- Paragraphs 23, 70, 79 and 80
- Report of the WHO Independent High-Level Commission on NCDs - Time to Deliver
- Recommendation 4F
- UN Third High Level Meeting on NCDs Resolution
"Best buys" and other recommended interventions for the prevention and control of noncommunicable diseases
In May 2013 the World Health Assembly endorsed WHO’s Global Action Plan for the Prevention and Control of NCDs 2013–2020. The global action plan has six objectives (see Figure 1) whose implementation at country level will support the attainment of the nine NCD targets by 2025, as well as facilitate the realisation of Sustainable Development Goal 3 – Good Health and Well-being. Part of this plan comprises a menu of policy options and cost-effective and recommended interventions (“Appendix 3”) to assist Member States, as appropriate for their national context, in implementing measures towards achieving the Sustainable Development Goals (SDG) Target 3.4.
Appendix 3 has since been updated to take into consideration the emergence of new evidence of cost-effectiveness and the issuance of new WHO recommendations that show evidence of effective interventions. The updated Appendix 31 (which reflects changes to objectives 3 and 4 only) was endorsed in May 2017 by the Seventieth World Health Assembly.
Renamed ‘Best buys’ and other recommended interventions, this updated Appendix 3 comprises a total of 88 interventions, including overarching/ enabling policy actions, the most cost effective interventions, and other recommended interventions. These 88 interventions are presented in tables, with one table showing the relevant options for each of the four key risk factors and four NCDs addressed.
You can read more about the 'Best buys’ and other recommended interventions for the prevention and control of noncommunicable diseases here.