The Third Annual Multistakeholder Gathering on Tackling Inequities in Noncommunicable Diseases
On the sidelines of the 79th UN General Assembly and the third Global NCD Compact Heads of State and Government annual meeting, and just 12 months ahead of the fourth UN High-Level Meeting on NCDs in 2025, NCDA and WHO will convene a multistakeholder event to focus on tackling inequities in NCDs through multistakeholder action.
In 2024, the world is off track to meet the 2025 global targets on noncommunicable diseases (NCDs). Since 2015, progress has stagnated and only six countries out of 191 UN Member States appear able to achieve the NCD mortality target to reduce premature deaths by one third by 2030. Many promises made at the last UN High-Level Meeting in 2018, to ensure more people living with NCDs have access to essential health care and protect those at risk of exposure to key risk factors, will go unmet.
The NCD burden may be universal, but it shines a glaring light on deeply engrained inequities both across and within countries. Globally since 2000, the chances of dying prematurely (between the ages of 30 and 70) from an NCD have gone down by 22%, but premature NCD mortality has increased in more than 20 mostly low- and middle-income countries. An estimated 82% of premature deaths from NCDs occur in low- and lower-middle-income countries, and the poor in all countries are the hardest hit.
NCDs follow a social gradient – the lower a person’s social and economic status, the higher chance they have of morbidity and premature mortality related to NCDs. Poor countries and vulnerable communities (such as children, refugees, indigenous populations) have less access across the whole care continuum, from NCD prevention and early diagnosis, to life saving treatment and palliative care. Globally only one in two people living with diabetes has access to the insulin they need; in sub-Saharan Africa, that figure drops to one in seven people. 80% of the 40 million people needing palliative care live in LMICs, but only 6% of the world’s opioids are consumed there.
Exposure to the NCD risk factors follows a similar gradient, where lower income means higher exposure. Higher smoking prevalence for example is associated with almost every indicator of deprivation or marginalisation – lower incomes, unemployment, homelessness to name a few. The social and economic determinants of health – the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems – shape the individual experience of health and are the drivers of inequity.
As with any complex systemic challenge, tackling inequities in NCD prevention and care demands leadership, action and collaboration across multiple sectors well beyond health and across a range of stakeholders from governments, international organisations, civil society and communities (particularly people living with NCDs), academia, foundations and relevant private sector. Fortunately a number of tools, such as NCDA’s NCD Health Equity Conceptual Framework and Practical Guide for NCD Community Advocates, the WHO’s Framework of Engagement of people living with NCDs and mental health and neurological conditions, the WHO’s new practical tool Supporting Member States in reaching informed decision-making on engaging with private sector entities the forthcoming WHO Global Report on Health Equity for People with Disabilities exist to guide stakeholders. Only with a clear commitment across all stakeholders to tackle NCD inequities and by approaching policies, decision-making, health systems, programmes, research and M&E with a strong equity lens will we leave no one behind in the NCD response.
The event will be followed by a 1-hour reception.