Figure 1
Changes in age-standardized mortality rate and deaths for cardiovascular diseases, by World Bank income group, 2000–2019 [2].
Source: WHO World Health Statistics 2021 [2].
Table 1
WHO best buys – very cost effective and scalable NCD interventions [5].
| RISK FACTOR/DISEASE TO BE ADDRESSED | INTERVENTIONS | DETAILED DESCRIPTION |
|---|---|---|
| Reduce tobacco use | 1. Taxation 2. Packaging 3. Advertising, promotion and sponsorship 4. Smoke free public policies 5. Health education | Increase excise taxes and prices on tobacco products. Implement plain/standardized packaging and/or large graphic health warnings on all tobacco packages. Enact and enforce comprehensive bans on tobacco advertising, promotion and sponsorship. Eliminate exposure to second-hand tobacco smoke in all indoor workplaces, public places, and public transport. Implement effective mass media campaigns that educate the public about the harms of smoking/tobacco use and second-hand smoke. |
| Reduce harmful use of alcohol | 6. Taxation 7. Advertising 8. Availability | Increase excise taxes on alcoholic beverages. Enact and enforce bans or comprehensive restrictions on exposure to alcohol advertising (across multiple types of media). Enact and enforce restrictions on the physical availability of retailed alcohol (via reduced hours of sale). |
| Reduce unhealthy diet | 9. Reformulate food 10. Supportive environment 11. Health education 12. Packaging | Reduce salt intake through the reformulation of food products to contain less salt and the setting of target levels for the amount of salt in foods and meals. -Reduce salt intake through the establishment of a supportive environment in public institutions such as hospitals, schools, workplaces and nursing homes, to enable lower sodium options to be provided. Reduce salt intake through a behaviour change communication and mass media campaign. Reduce salt intake through the implementation of front-of-pack labelling. |
| Reduce physical inactivity | 13. Health education | Implement community-wide public education and awareness campaigns for physical activity which includes a mass media campaign combined with other community- based education, motivational and environmental programmes aimed at supporting behavioural change of physical activity levels. |
| Manage diabetes and cardiovascular disease including hypertension | 14. Drug therapy and counselling | Drug therapy (including glycaemic control for diabetes mellitus and control of hypertension using a total risk approach) and counselling to individuals who have had a heart attack or stroke and to persons with high risk of a fatal and non-fatal cardiovascular event in the next 10 years. |
| Cervical cancer | 15. Vaccination 16. Screening | Vaccination against human papillomavirus (2 doses) of 9–13 year old girls. Prevention of cervical cancer by screening women aged 30–49. |
Table 2
Updated nine voluntary global NCD targets to be attained by 2030 [5].
| 1. |  | One third relative reduction in the overall mortality from CVD, cancer, diabetes or CRD. |
| 2. |  | At least 20% relative reduction in the harmful use of alcohol. |
| 3. |  | A 15% relative reduction in prevalence of insufficient physical activity. |
| 4. |  | A 30% relative reduction in mean population intake of salt/sodium. |
| 5. |  | A 30% relative reduction in prevalence of current tobacco use. |
| 6. |  | A 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure. |
| 7. |  | Halt the rise in diabetes and obesity. |
| 8. |  | At least 50% of eligible people (age 40 years and older with a 10-year cardiovascular risk ≥20%) including those with CVD to receive drug therapy and counselling (including glycaemic control) to prevent heart attacks and strokes. |
| 9. |  | An 80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major noncommunicable diseases in both public and private facilities. |
Table 3
Percentage of countries implementing NCD-Global Action Plan, 2013 compared with 2021 based on Action Plan (AP) indicators (disaggregated data for 194 countries) [29, 30, 31, 32, 33].
| INDICATOR | 2013 | 2021 |
|---|---|---|
| AP1: National action plan | 24% | 55% |
| AP2: NCD unit | 51% | 74% |
| AP3a: Policy on harmful use of alcohol | 48% | 69% |
| AP3b: Policy on physical activity | 52% | 72% |
| AP3c: Tobacco policy | 63% | 80% |
| AP3d: Policy on healthy diet | 55% | 84%% |
| AP4: Clinical guidelines | 49% | 58% |
| AP5: NCD research policy | n/a | 28% |
| AP6: NCD surveillance system | 23% | 28% |
| APx: National coordination mechanism | n/a | 46% |
Table 4
Percentage of countries in which commitment fulfilment progress (COM) indicators are fully achieved; 2015 compared with 2021 [29, 30, 31, 32, 33].
| INDICATOR | 2015 | 2021 |
|---|---|---|
| COM1: National NCD targets | 30% | 56% |
| COM2: Mortality data | 36% | 42% |
| COM3: Risk factor surveys | 28% | 19% |
| COM4: National action plan | 33% | 55% |
| COM5a: Tobacco tax | 2% | 20% |
| COM5b: Smoke-free places | 25% | 34% |
| COM5c: Graphic warnings | 22% | 53% |
| COM5d: Tobacco advertising bans | 15% | 29% |
| COM5e: Tobacco mass media | n/a | 23% |
| COM6a: Alcohol sales restrictions | 15% | 16% |
| COM6b: Alcohol advertising ban | 20% | 27% |
| COM6c: Alcohol tax | 22% | 24% |
| COM7a: Salt policies | 32% | 17% |
| COM7b: Fat policies | 21% | 28% |
| COM7c: Child food marketing | 22% | 38% |
| COM7d: Breast milk code | 37% | 13% |
| COM8: Physical activity mass media | 61% | 42% |
| COM9: Clinical guidelines | 26% | 58% |
| COM10: Drug therapy and counselling | 14% | 36% |