Asia Arsenic Network

NCDs on the Global Agenda: A Sustainable Development Priority

The 2030 Agenda for Sustainable Development, adopted by all United Nations Member States in 2015, marks a pivotal moment in the global response to noncommunicable diseases (NCDs). For the first time, these chronic conditions—primarily cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes—were recognized as a major obstacle to sustainable development, a significant shift from the preceding Millennium Development Goals which did not address them.

At the heart of this commitment is Sustainable Development Goal 3 (SDG 3), which aims to "ensure healthy lives and promote well-being for all at all ages." The agenda outlines several key commitments to tackle the NCD epidemic, reflecting a comprehensive approach that extends from prevention to treatment and access to care.

Reducing Premature Mortality: A Central Target

A cornerstone of the global commitment to combat NCDs is SDG target 3.4, which calls for a one-third reduction in premature mortality from NCDs by 2030 through prevention and treatment, and the promotion of mental health and well-being. This ambitious target underscores the urgency of addressing the significant burden of NCDs, which are responsible for 74% of all deaths globally.

However, progress towards this target has been slow and uneven. The World Health Organization's (WHO) 2022 Noncommunicable Diseases Progress Monitor revealed that while many countries are taking action, these efforts are often insufficient to meet the 2030 goal. The probability of dying from one of the four major NCDs between the ages of 30 and 70 declined from 19.9% in 2010 to 17.8% in 2019, a rate of decline considered insufficient to meet the SDG target. The COVID-19 pandemic further exacerbated the situation by disrupting essential health services and heightening the vulnerability of individuals with NCDs.

Strengthening Responses to Risk Factors

The 2030 Agenda also emphasizes the importance of addressing the primary risk factors for NCDs. Specifically, it calls for strengthening responses to reduce the harmful use of alcohol and for the robust implementation of the WHO Framework Convention on Tobacco Control (FCTC).

SDG target 3.5 aims to "strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol." This recognizes the significant contribution of alcohol consumption to the global burden of NCDs, including various cancers, liver disease, and cardiovascular diseases.

Furthermore, SDG target 3.a is dedicated to strengthening the implementation of the WHO FCTC in all countries. Tobacco use is a leading preventable cause of NCDs, and the FCTC provides a blueprint for evidence-based tobacco control measures. Progress in this area has been encouraging, with over half of all countries implementing plain packaging and/or large graphic health warnings on tobacco products.

Universal Health Coverage: The Foundation for NCD Care

Achieving universal health coverage (UHC) is a central tenet of the 2030 Agenda and a critical enabler for effective NCD prevention and control. SDG target 3.8 aims to "achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all."

For individuals living with or at risk of NCDs, UHC means access to a continuum of care, from prevention and early detection to treatment and palliative care, without suffering financial hardship. High-impact essential NCD interventions can be delivered through a primary healthcare approach, which is a cost-effective strategy to strengthen early detection and timely treatment.

Fostering Innovation and Ensuring Access to Medicines

Recognizing the critical role of innovation and equitable access, the 2030 Agenda includes a specific commitment to support the research and development of and ensure access to affordable essential medicines and vaccines for NCDs, particularly those affecting developing countries.

SDG target 3.b explicitly calls for supporting "the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines...". This commitment acknowledges the market failures that often leave diseases prevalent in lower-income countries neglected in research and development pipelines.

Initiatives such as pooled procurement mechanisms and public-private partnerships are being explored to improve the affordability and availability of NCD medicines in low- and middle-income countries. For example, the Novartis Access program focuses on making a portfolio of medicines for key NCDs available and affordable in lower-income countries. However, significant gaps in access to essential NCD medicines persist, with availability often low in the public sector of many of these nations.

In conclusion, the 2030 Agenda for Sustainable Development has firmly placed NCDs on the global health and development agenda. The comprehensive set of commitments within SDG 3 provides a roadmap for a multi-faceted response. However, achieving these ambitious goals will require accelerated action, increased investment, and unwavering political commitment to translate these promises into tangible improvements in the lives of people affected by NCDs worldwide.