Advancing Europe's non-communicable diseases agenda through cross-national collaboration: translating WHO-Europe findings into actionable strategies

Noncommunicable diseases (NCDs) are the leading cause of morbidity and mortality across Europe, posing a substantial burden on people, health systems and societies. The latest WHO Regional Office for Europe report on NCDs provides a comprehensive assessment of current trends, trajectories of key NCD indicators, and progress towards achieving regional targets.¹ The report systematically evaluates inequalities, quantifies economic impacts, and, for the first time, examines the effects of the COVID-19 pandemic on preventable and treatable NCD-related mortality.

Despite decades of progress in reducing premature mortality from the four major NCDs prioritised by global agendas—cardiovascular diseases, cancer, diabetes and chronic respiratory diseases—the report highlights a slowdown since 2014, leaving the region off track to meet its 2025 targets.¹ The COVID-19 pandemic has further disrupted progress, leading to an increase in premature mortality in some countries, particularly in the central-eastern region, with this increase more pronounced among males.¹ Encouragingly, in all countries that experienced temporary increases, premature mortality from the four major NCDs has since returned to pre-pandemic levels.

Trends in risk factors reflect both progress and remaining challenges.¹ In 2022, the prevalence of tobacco use, and hypertension, as well as average per capita alcohol consumption, were lower than in 2010. However, the prevalence of obesity and diabetes continued to rise, while physical inactivity remained unchanged. The implementation of population level policy interventions has stalled since the pandemic. For example, the proportion of countries fully achieving NCD survey implementation—including objective measurement of key risk factors—declined from 28% in 2021 to 19% in 2023, and the proportion of countries with operational multisectoral national NCD strategies decreased from 60% in 2021 to 55% in 2023. These declines have occurred despite 85% of countries having fully adopted NCD management guidelines encompassing all four major NCDs.¹

Recognising NCDs as a health challenge, the European Union (EU) has reinforced its commitment to reducing their burden through a comprehensive policy framework that integrates prevention, treatment, and health system strengthening. Flagship initiatives such as Healthier Together,² Europe's Beating Cancer Plan,³ and the EU's enhanced focus on cardiovascular health and prevention,⁴ exemplify this commitment. Beyond policy frameworks, under the EU4Health Programme,⁵ the EU has co-founded Joint Actions JACARDI⁶ and JA PreventNCD to strengthen cross-national collaboration, and to test evidence-based interventions and policy implementation in NCD prevention and management. While both initiatives aim to reduce the burden of NCDs, JA PreventNCD targets the primary prevention of NCDs, whereas JACARDI focuses on secondary and tertiary prevention, particularly for CVDs and diabetes. With a combined budget of €160 million and participation from 27 European countries, JACARDI and JA PreventNCD are facilitating implementation of an integrated NCD-pathway framework.

NCD-related challenges in Europe require sustained and innovative action from the EU, European countries, international organisations, policy makers, and health institutions. Measurable reductions in mortality within 5 years could be achieved by accelerating the implementation of high-impact, cost-effective interventions, such as the so-called Quick Buys⁷—a selection of WHO Best Buys and other recommended interventions that can quickly have an impact—and best and promising practices available at the EU Best Practice Portal on Public Health.⁸ Policy frameworks must adapt to emerging determinants of NCDs, including novel tobacco and nicotine products, digital marketing of unhealthy commodities, and the broader commercial, environmental, and digital determinants of health. Integrating gender-responsive and equity-driven approaches is crucial to address diverse risk profiles and barriers to health-care access, ensuring inclusive and sustained progress. Overcoming these challenges requires enhanced regulatory oversight, strengthened policy coherence, and improved data collection and reporting systems to track progress and drive accountability.

High-quality data are pivotal in shaping future policy directions, particularly in the lead-up to the UN General Assembly's High-Level Meeting on NCDs in September 2025. Strengthening primary data collection and monitoring systems remains essential to generating high-quality science and evidence for successful policy making. Standardised indicators are needed for better evaluation of prevention and treatment strategies. Recognising the crucial role of data-driven policies, the EU has prioritised robust data infrastructures through the European Health Data Space.⁹ JACARDI and JA PreventNCD advance these efforts by fostering high-quality data collection and monitoring systems.

With the WHO NCD Global Monitoring Framework and the Action plan for the prevention and control of NCDs in the WHO European Region set to expire in 2025, and the launch of the Second European Programme of Work,¹⁰ the European NCD response must be reimagined and accelerated. Future strategies should fully integrate NCD prevention and management across the entire care continuum, while embedding equity at their core. Ensuring systematic policy implementation and strengthening data infrastructures will be crucial to translating commitments into measurable health outcomes. 2025 presents a decisive opportunity to realign and accelerate the European response to NCDs. By ensuring a synergistic alignment among the EU, Organisation for Economic Co-operation and Development, and WHO, alongside robust enforcement, equity-driven reforms, and data-informed policy implementation, political commitments can be translated into lasting health improvements.

Contributors

BA, KIK, GO, and IR conceptualised the Commentary. BA drafted the initial version, while all authors contributed to its review and finalisation. The final manuscript was approved by all authors.

Declaration of interests

The Authors declare that there are no conflicts of interest.