Key Takeaways and Recommendations

A wide variety of stakeholders is necessary to any successful effort to mitigate NCDs’ sizable and expanding burden on populations around the world. As the preeminent health challenge of this century, the global response to NCDs warrants cross-sectoral and international cooperation and investment, with an emphasis on the considerable gains accessible in NCD care and health-related innovation. Reflecting this, an expert roundtable, hosted by Foreign Policy with support from Roche and held alongside the 80th convening of the UN General Assembly in September 2025, brought together a cross-section of leaders to discuss challenges and opportunities to tackle the global NCD burden, with a particular focus on LMICs. Insights from the roundtable point to several key recommendations:

• Engage new funding models to get resources where they are needed. Health care has been subject to chronic underinvestment, particularly in emerging markets and LMICs, an issue that is only intensifying as traditional donors reduce their global health assistance. This challenge necessitates diversifying funders and investors in health and how those investments are made, using blended finance tools and other innovative funding mechanisms to de-risk the sector.
• Reframe health spending as an investment, not a cost. All too often, spending on health is considered an outlay rather than a smart investment that results in considerable returns over time. A wide array of strategies and therapeutics for mitigating and preventing NCDs have not only proven effective but are also cost-efficient, more than paying for themselves in returned value to society. Understanding this cost-benefit relationship and building it into the framing and content of health care spending discussions are critical steps to addressing the expanding NCD burden.
• Focus on the implementation gap. Effective tools for counteracting many NCDs already exist, yet remote and under-resourced populations lack access to these baseline health services and therapeutics. A top priority for governments and health care providers needs to be ensuring that these simple, relatively inexpensive services and technologies are available to those who need them, leveraging sustainable models that deliver continuity in care to broad populations.
• Leverage prevention and regulation to access big wins. Preventing or delaying the onset of NCDs is both more cost-efficient and more effective than paying for and delivering remedial care and therapeutics after the onset of disease. Targeting behavioral and environmental factors that contribute to NCDs—such as smoking, sugar consumption, and air pollution—with common sense regulations can pay enormous dividends to society through restored years of healthy life and averted illness, as can implementing early detection strategies such as screenings.
• Improve data collection and analysis. A country’s NCD response is only as good as the data that informs it, and no two countries will experience the same disease burden. Localized, high-quality, high-coverage data is a prerequisite to building a comprehensive NCD response, ensuring maximum impact from limited resources, guiding policy interventions, and attracting future investments into the sector.
• Build strategic partnerships that harness the strengths of public, private, academic, and civil society stakeholders. A whole-of-society response is essential to effectively addressing the scope and scale of the impacts of chronic diseases. Cross-sectoral and cross-border relationships will be critical to effectively sharing the resources and expertise needed to meet the technical, financial, knowledge-based, and human resources aspects of the NCD challenge.

Decades of returns: The economic case for investing in prevention and treatment of NCDs

NCDs levy an enormous, underrecognized burden on societies globally. NCDs are responsible for 46 million deaths and 768 million years lived in poor health annually—a burden that will only continue to rise as the global population continues to grow and economies continue to develop. The current costs imposed by NCDs in most countries are already considerable, generally ranging between 1 and 4 percent of GDP annually, and the global long-term costs are likely to total tens of trillions of dollars over the coming decades. Current models for NCD care, where they exist, focus largely on remedial treatment and generally fail to prioritize prevention and early intervention, posing a significant challenge to global health and health care spending. As one speaker noted during the FP-Roche roundtable: “We are looking after the sick, we are not looking after the healthy.” Changing the narrative on NCDs requires recognizing the scale of these society-wide costs and reconceptualizing NCD-related health care spending as an investment in the future, not a cost to bear in the present.

Proactive investment in prevention and early intervention strategies can generate a multitude of returns that far outstrip their cost—as well as deliver better health outcomes than remedial care. Significant inroads against NCDs are possible through investments in the basics: access to primary health care, simple screening and diagnostics, generic and low-cost medications, and, perhaps most critically of all, behavioral and environmental changes to limit NCD risk factors. These common-sense solutions are laid out clearly within the World Health Organization (WHO)’s Best Buys, seven intervention areas related to chronic illness that promise multifold benefits for relatively limited investment. These interventions include actions such as taxing sugar, alcohol, and tobacco; encouraging healthy diets and exercise; enabling access to well-known therapeutics such as antihypertensives for CVD and inhalers for respiratory illness; and investing in screening and diagnostics for cancer. The return on investment (ROI)—the estimated dollar value of benefits for each dollar invested—for each of these activities is significant, ranging from 4 to 1 for reducing physical inactivity to 14 to 1 for reducing unhealthy diets (see Figure 1).

FIGURE 1

Return on Investment for Every $1 Spent in Key NCD Care and Prevention Action Areas

The WHO Best Buys demonstrate the investment rationale for global NCD care and prevention. Investments to address behavioral choices and expand access to essential therapeutics show significant potential to prevent and mitigate NCDs and return signficant value to society per dollar invested.

Reduce physical inactivity

4x ROI

Efforts to reduce physical inactivity generally focus on outreach campaigns that seek to facilitate a population-wide behavioral response. This can be complemented by environmental and community-focused policies, including those related to transportation, infrastructure, housing, and counseling.

Managing chronic respiratory illness

5x ROI

Chronic respiratory illness, such as asthma and chronic obstructive pulmonary disease (COPD), can be effectively addressed by treating exacerbations and offering long-term management. Relevant therapeutics include inhaled bronchodilators, oral steroids, and low-dose beclomethasone.

Screening, early detection, and treatment of cancer

6x ROI

Effective methods to prevent and treat cancer center on identifying cases early, when cancer is typically easier to treat. HPV vaccination presents a clear opportunity to prevent cancer cases altogether, but early diagnosis and treatment show considerable effectiveness for common cancers such as cervical, breast, and colorectal.

Reduce tobacco use

7x ROI

Policies to reduce tobacco use focus on taxation, communication campaigns, packaging alteration, advertising bans, smoke-free policies, and providing cessation services. Excise taxes, for example, can create a cost deterrent for consumers, while public campaigns can alert consumers to negative consequences or reinforce a negative stigma for smoking.

Manage cardiovascular disease

8x ROI

Effective strategies to prevent and mitigate cardiovascular disease (CVD) include efforts to manage hypertension and secondary prevention of rheumatic fever and rheumatic heart disease. Methods to manage CVD include the use anti-hypertensives as well as comprehensive care for stroke and heart attack patients.

Reduce the harmful use of alcohol

9x ROI

Harmful alcohol use can be deterred through taxation, restrictions on availability, and advertising bans. Similar to efforts to deter smoking, these measures focus on raising costs, reducing availability, and deterring consumption.

Reduce unhealthy diet

14x ROI

Improving diets offers the biggest potential returns on investment for any of the WHO Best Buys. These interventions focus on reducing consumption of trans fats, saturated fats, sugar, and sodium, including through product labeling, media campaigns, and addressing problematic marketing, particularly for children.

These favorable returns are largely driven by two key calculations. First, preventing an illness is less costly to society writ large than treating an illness after it develops. For example, access to routine primary health care can help members of a population manage their weight and diet and thereby limit the prevalence of costly illnesses such as CVD or diabetes. Second, early detection of disease often allows for more effective treatment and lower costs. In the case of breast cancer in the United Kingdom, for example, a patient has a near 100 percent chance of survival if the cancer is identified in Stage I, compared to a 25 percent survival rate if found in Stage IV. Similar trends hold across many other types of cancer, though some currently remain relatively untreatable, representing an area for continued research and development efforts. Taken together, expenditure of just USD 3 per person per year in these prevention and early detection strategies could generate as much as USD 1 trillion in benefits globally by 2030 and drastically reduce mortality and disability, particularly among the world’s poorest countries.

Deploying known interventions, including those contained within the WHO Best Buys, could reduce the global NCD disease burden by an estimated 35 percent by 2050. Governments and health care providers therefore have a clear imperative—motivated by improved health outcomes and cost-efficiency—to prevent the onset of NCDs to the best of their ability and to enable early detection and access to the appropriate care strategies and diagnostics, including through innovation, research, and development. However, accessing these benefits requires recognizing the differentiated needs and capabilities of countries around the world, improving data collection about disease burden, and strategizing to deploy targeted programming where it can make the biggest difference.

Levers for closing the NCD implementation gap

Globally, a range of impediments prevent effective NCD care models and treatments from reaching those who need them. The biggest challenge is simply a lack of funding for comprehensive, low-cost health care, which translates into a reduced access for communities, reduced availability of doctors and medicines, fewer facilities, longer wait times, and other negative ramifications. While health services may exist in major cities, rural populations often face difficulty in reaching these services, traveling great distances and bearing significant costs just to get routine care. Primary health care remains a secondary priority in many country contexts, either because it is less attractive to politicians than other types of spending or because there simply are insufficient resources to devote to the task. As a result, lower-middle- and low-income countries account for more than half of the global population but just 3.2 percent of global health spending in the last 20 years. While the challenge of unmet health care capacity is concentrated in LMICs, populations across high-income countries likewise have unmet care needs and indeed bear the majority of the NCD burden today.

Participants in the Foreign Policy-Roche roundtable spoke to the centrality of taxation and regulation as key levers to unlock the immense benefits of preventative and early action against NCDs. In the cases of tobacco, alcohol, and sugar consumption, taxes can serve a dual purpose, disincentivizing key contributing factors to NCD prevalence while raising fiscal revenues, which can then be used to support the primary health care system. In the case of the Philippines, excise taxes on sugar, alcohol, and tobacco are earmarked to support the national universal health care scheme, PhilHealth. Other efforts to change behavior include restrictions on ads, front-of-package labeling, and public media campaigns.

Roundtable participants also highlighted encouraging prevention efforts around the world, including Indonesia’s USD 300 million Free Health Check (CKG) program, launched in 2025, which had conducted basic health screenings for 30 million people as of September 2025. Other countries are taking these prevention efforts even further, outlawing risky behaviors altogether. For example, the Maldives is seeking to become the first country to fully ban smoking among a target population, in this case people born on or after January 1, 2007, though other countries such as the United Kingdom and New Zealand have also considered such a move in recent years.

Globally, better data collection and analysis capabilities are needed to understand the scope and scale of the NCD burden. As one roundtable speaker noted, health ministries and their partners have a pivotal role to play in collecting data and using it to mobilize resources. Such data offers a critical foundation from which to build policy action plans and compelling investment cases to help attract national, regional, and international resources. Achieving wider political and fiscal buy-in can support follow-through on NCD programming across shifts in political administrations and priorities, creating the opportunity for long-lasting change.

The ongoing digitalization of health care and deployment of new technologies—including wearable devices for health monitoring, telehealth and mobile screening programs for rural and remote populations, or the use of AI for data analysis—can contribute to this mission, illustrating success stories, capturing best practices, and documenting lessons learned. Across these contexts, improved data can likewise help improve the targeting of NCD programming to where it is needed most, such as addressing the unique needs of marginalized populations. These groups—particularly low-income and rural communities, women, and Indigenous peoples—are commonly most at risk from NCDs, and targeted investments can therefore often yield the largest health and financial impacts when focused on these populations.

In enacting these visions for NCD care, governments and health care providers will face considerable headwinds amid competing budget priorities, shrinking overseas development assistance, and pushback from certain industries. Particularly amid uncertainty in trade relationships and rising geopolitical tensions, many governments may relegate health care to a secondary priority despite its very real and present costs. At the same time, the immense political influence of the sugar, tobacco, and alcohol industries were flagged by roundtable participants as continuing obstacles to reform. Ultimately, long-term success against NCDs will depend on forming the cross-sectoral, cross-border coalitions needed to overcome these challenges.

A whole-of-society response is necessary to deliver sustained action on NCDs

Mitigating the threat posed by COVID-19 required the combined force of many parts of society: government funding and support for vaccine development, private-sector innovation and diverse supply chains, academic expertise in disease monitoring and epidemiology, and civil society action and advocacy to help communities through hardship. If the world is to shift the trajectory of the global NCD burden, the same cooperation will be necessary on a wide and sustained scale, including through extensive cooperation across borders, a variety of multisectoral partnerships, and the development of new financing models. As several speakers at the FP-Roche roundtable noted, the current shortfall in NCD care capacity globally requires enhanced partnerships that will call upon the strengths of governments, businesses, non-governmental organizations, and communities, particularly to close the funding gap.

At the multilateral level, states and institutions need to intensify and expand cooperation on NCDs to mobilize crucial expertise and resources. Some of these efforts will need to focus on developing NCD-related policy, such as the Lusaka Agenda, which seeks to promote universal health care, cohesive national planning, and inclusivity. Others may focus on getting scarce resources to where they can make the greatest difference. The United Nations’ Health4Life Fund, for example, seeks to raise USD 250 million in catalytic funding by 2026 to support domestic resource mobilization for health systems in low-income countries. Other avenues for multilateral collaboration include research and development: efforts such as the Global Alliance on Chronic Disease, for example, enable the exchange of best practices and the synchronization of research agendas to ensure alignment on disease priorities. Since 2011, the grouping has awarded USD 375 million in research grants specifically geared toward implementation challenges related to NCDs.

In addition to these efforts, effective partnerships will draw upon subnational and municipal governments, academic and civil society organizations, philanthropy, and the private sector to mobilize the expertise and resources needed to drive change. Initiatives such as Access Accelerated bring together a variety of stakeholders—the World Bank, in-country partners and health care providers, global pharmaceutical companies, and technical experts—to generate catalytic funding to build health system capacity in emerging markets and LMICs and counter chronic illness. Between 2017 and 2023, the initiative contributed USD 25 million in funding to 44 World Bank Projects, reaching some 700 million people in 37 countries. Another grouping, Partnerships for Healthy Cities, represents a growing network of 74 global municipal governments, supported by philanthropic funding, seeking to reduce NCD risk factors in major cities. As such efforts proliferate, opportunities for further collaboration and to crowd in additional funding are likely to follow.

Blended finance mechanisms, which use public-sector incentives and funding to de-risk health investments and make them more attractive to the private sector, were also highlighted by roundtable participants as a key model for meeting health system needs. Such mechanisms may include first-loss and junior tranches, wherein risk is first or largely borne by a government partner, or capped returns, wherein an investor may only emerge with a certain rate of profit. Blended finance is already being deployed today, such as through the Transform Health Fund, which has raised USD 111 million to support enhanced models for care delivery and supply chain access across sub-Saharan Africa. However, driving the fundamental changes needed to mobilize health systems and prepare populations to better cope with NCDs everywhere will require a shift in mindset and an exponential increase in such funding.

The scope of the NCD challenge requires nothing less than an all-hands-on-deck response. As communities, industries, and entire economies stand to suffer from the unchecked costs of chronic illness, so too can they benefit from coordinated efforts to lessen its prevalence and minimize its impact across societies. Particularly amid new funding realities for global health, a diverse array of existing and novel partnerships, including a variety of financial models and incentives, will be needed to ensure comprehensive, inclusive models for care, effective last-mile delivery of services, and access to life-saving therapeutics.

Looking ahead in the fight against NCDs

Health care innovation has enabled as much as one-third of economic growth in advanced economies over the last century. Gains on a similar scale appear to be within reach for low- and middle-income countries through collective, organized innovation and investment to address chronic illness, enhance primary health care, and improve accessibility of therapeutics around the world. Continued innovation in NCD care—particularly to close the implementation gap for proven strategies that exists today—is paramount to reduce the tens of millions of lives and hundreds of millions of healthy years lost to chronic illness annually. Public sector investment and policy planning, private-sector innovation and support, and partnerships of all kinds will be key to closing care gaps, strengthening prevention, and improving health outcomes over the long term.

Although UNGA80 did not result in a declaration on NCDs, there is growing international support for concerted NCD action and an opportunity to build on this momentum. South Africa is using its 2025 G20 presidency to draw attention to the imperative of providing primary health care, highlighting that 4.5 million people lack access to basic health care today, and some two billion face severe economic pressures from health-related out-of-pocket costs. As such, the G20 is well-positioned to continue the vital work of expanding access to primary health care and mobilizing proven solutions to address the growing NCD burden, particularly through the G20 Joint Health and Finance Taskforce and the Sustainable Finance Working Group. Looking ahead to the 2026 World Health Summit and 81st UNGA, the focus areas, success stories, and recommendations contained within this brief can be used to inform concerted and impactful action on NCDs.

By Phillip Meylan (Affiliate Researcher) and Isabel Schmidt (Senior Policy Analyst and Research Manager).

This issue brief was produced by FP Analytics, the independent research division of The FP Group, with support from Roche. FP Analytics retained control of the research direction and findings of this issue brief. Foreign Policy’s editorial team was not involved in the creation of this content.