Tackling the rising disease burden through health system resilience
Acting early on non-communicable diseases benefits us all. We must advocate for targeted investment and policies to meet the challenges these diseases pose, and partner on efficient, long-term solutions to improve global health
Every two seconds, someone dies prematurely from an NCD. By my estimation, that’s around 90 lives lost by the time you finish reading this article. Driven by varied, complex factors, NCDs cause 74% of deaths globally – 41 million people every year – and this number is rising. Together, cardiovascular and chronic respiratory diseases, cancer, diabetes and mental health conditions could cost the global economy $47 trillion between 2010 and 2030 – almost twice the current GDP of the United States. We’re in an unprecedented health crisis, which is set to increase in severity as the global population ages and more people live with multiple health conditions.
Approximately 80% of NCDs are preventable, and evidence suggests this disease burden could be significantly reduced. But progress has been inconsistent, and few countries are set to achieve Sustainable Development Goal target 3.4, which aims to reduce premature mortality from NCDs by one-third by 2030.
There is a significant United Nations High-Level Meeting on NCDs in 2025, which is a critical opportunity for concerted action on this agenda. Stakeholders must address the issue head on, and as health sector leaders we must advocate for early action, evidence-based policies and investment in long-term solutions to safeguard population health.
We must act now to reap the benefits
Time is of the essence. Acting early on NCDs through prevention and early detection will improve health outcomes for patients, reduce pressures on health systems, and benefit societies by boosting economic activity and workforce participation. Everyone, no matter who they are or where they live, must have access to timely, quality care, including regular health checks and screenings for conditions such as cancer and chronic kidney disease. For instance, lung cancer screening through advanced techniques such as low-dose CT scans, X-rays enhanced by artificial intelligence and other early detection methods can significantly reduce the disease burden.
In addition to acting with urgency, we must prioritise equity. NCDs primarily affect people of lower socio-economic status – including those with barriers to accessing education, living in poverty, who are unemployed, or are marginalised due to their ethnicity or sex.
Addressing the social determinants of disease could improve health equity, alleviate poverty and enhance social cohesion. We must ensure health systems serve all and make a concerted effort to close care gaps.
Another critical component is delivering concerted action on the nexus between climate and health. Ironically, the health sector is contributing to the climate crisis, which is, in turn, exacerbating the rise in chronic diseases. That’s because making, moving and delivering medicines and care is energy intensive; currently, around 5% of global emissions stem from health care. Keeping people well and out of the hospital through early detection and optimal treatment is key to reducing this environmental footprint. Equally important is the decarbonisation of health care. This is a huge undertaking, and sector-wide partnerships focused on collective action, such as the Sustainable Markets Initiative Health Systems Task Force, chaired by AstraZeneca’s CEO, Pascal Soriot, are crucial to transitioning to net-zero health systems.
Innovative, long-term solutions
Health leaders must urgently advocate for a shift from ‘sick care’ to ‘health care’, and multisector collaboration is critical. The Partnership for Health System Sustainability and Resilience is a non-profit, global collaboration founded by AstraZeneca, the London School of Economics and the World Economic Forum, which now includes the WHO Foundation, KPMG, Philips and the Center for Asia-Pacific Resilience and Innovation. PHSSR has a unified goal of strengthening health systems, and tackling the NCD crisis is a key focus. It is active in over 30 countries, and several, including Italy, Greece and Vietnam, are already making strides to improve care and screening programmes by adopting PHSSR recommendations.
Embracing innovation is key to ensuring population-wide, timely access to new medicines and technologies, which has been highlighted through PHSSR research. Digital technologies can support improved prevention, diagnosis and treatment of disease, and in turn can alleviate workforce shortages, streamline service delivery and enable swift, personalised care for patients. To maximise the benefits, these solutions must be seamlessly integrated into care pathways.
To foster innovation, we must not underestimate the power of country-specific evidence. Resulting from PHSSR recommendations on electronic health record infrastructure, Japan has prioritised developing a digital platform for collecting and sharing medical information in its latest honebuto, a paper that sets out economic and fiscal policy guidelines for the government. Long term, this will support clinical decision-making and facilitate earlier diagnoses.
Working together to enhance health for all
Health services must coordinate early detection and treatment pathways, integrate primary and specialist care, harness innovation and incentivise guideline-based care. The latter benefits patients and health systems alike, enhancing health outcomes and ensuring efficiency, consistency and standardisation. Guidelines must be underpinned by clinical and real-world research reflecting our diverse society, including people of lower socio-economic status, addressing gaps in screening, diagnosis, referral or access to care.
Chronic diseases do not affect everyone equally, so it is imperative that policymakers use data to identify at-risk groups in their countries and allocate resources efficiently. They must work in partnership with communities to build trust with these groups, influence policy and deploy end-to-end interventions. AstraZeneca’s Healthy Heart Africa programme is an example, helping nine countries address the growing burden of heart and kidney diseases. Partnering with governments, healthcare providers and local communities, HHA is tackling NCDs holistically through awareness, education, screening and evidence-based care, prioritising those at greatest risk and ensuring access to affordable, sustainable and innovative solutions. To date, HHA has identified 10 million people with elevated blood pressure and trained over 11,300 healthcare workers across sub-Saharan Africa.
Meeting SDG target 3.4 on NCDs will not be easy, but we have the resources and know-how to achieve it. PHSSR is already making a difference through its collaborative efforts, and NCDs are the subject of its next research chapter – the Policy Roadmaps – which will be published early next year and provide policymakers with clear, country-specific, evidence-informed action to enhance health system capabilities. Focused action like this demonstrates that by acting now, we can tackle the NCD burden and enhance health system resilience – for the health of people, societies and the planet.
