Every two seconds, someone under the age of 70 dies from a non-communicable disease (NCD). Yet most of these deaths are preventable. Non-communicable diseases are chronic medical conditions that are not transmitted from person to person. They typically develop over a long period and are often influenced by genetic, physiological, environmental and behavioral factors. Major types of NCDs include mental health, cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. NCDs cannot be spread through pathogens but are instead linked to lifestyle choices such as poor diet, physical inactivity, excessive alcohol consumption and biological risk factors such as age and genetics.
Global trends and statistics
Non-communicable diseases remain the leading cause of mortality worldwide, responsible for over 43 million deaths in 2021, representing approximately 75% of all non-pandemic-related deaths. Among the ten leading causes of death globally, seven are attributable to NCDs, including ischaemic heart disease, stroke, chronic obstructive pulmonary disease, lung cancer, dementia, diabetes, and chronic kidney disease. Although the global probability of premature death from the four major NCDs—cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes—declined from 23% in 2000 to 18% in 2019, the pace of progress has slowed considerably since 2015. In 2021 alone, cardiovascular diseases accounted for 19 million deaths, cancer for ten million, and chronic respiratory diseases and diabetes for millions more. Furthermore, mental health conditions and NCDs together accounted for four out of every five years lived with disability.
How do NCDs develop?
NCDs tend to develop gradually, often beginning with minor physiological changes that may go unnoticed. These conditions arise from a complex interaction of genetic factors, environmental influences, metabolic imbalances, and modifiable lifestyle choices. In the early stages, signs like elevated blood pressure, insulin resistance, or low-grade inflammation may occur without noticeable symptoms, progressively contributing to the onset of disease. Lifestyle-related risk factors such as unhealthy diets, physical inactivity, tobacco use, excessive alcohol intake, and chronic stress are primary contributors. These behaviors can lead to intermediate health problems like obesity, high blood pressure, and elevated cholesterol levels, which significantly increase the likelihood of more severe conditions including cardiovascular disease, type 2 diabetes, and certain forms of cancer. While genetics can predispose some individuals, the majority of NCDs are preventable through healthy lifestyle choices. For example, consuming high-fat, high-sugar foods combined with a sedentary lifestyle can lead to harmful metabolic changes. Similarly, tobacco smoke exposure harms respiratory tissues and diminishes lung function, elevating the risk for diseases like chronic obstructive pulmonary disease (COPD) and cancers. Mental health conditions often develop over time due to a blend of biological and psychosocial influences, including persistent stress and insufficient social support.
Effective prevention strategies
Globally, more than 130 regions have introduced taxes on sugar-sweetened beverages (SSBs), with significant results seen in places like Mexico, the United Kingdom and South Africa, Berkeley, and Philadelphia. In Mexico, for instance, SSB consumption dropped by 37%. The UK responded with product reformulations that led to the annual elimination of 45 million kilograms of sugar. These actions are projected to yield long-term health improvements, including reductions in obesity and diabetes prevalence. Similarly, increased taxes on tobacco and alcohol have proven successful in lowering use. Examples include Ghana’s transition to a hybrid excise tax model, Australia’s 15% tobacco levy, and Estonia’s annual 5% tax hikes. Chile’s 2016 food policy, which featured clear packaging labels, bans on marketing to children, and restrictions on in-school sales, resulted in a 73% decrease in children’s exposure to junk food advertising and a 10.2% drop in household sugar consumption. These examples illustrate the high return on investment of well-designed public health interventions.
Integrated solutions and the way forward
Despite progress in NCD prevention and management, major challenges persist. Strengthening healthcare infrastructure, especially in low- and middle-income countries, is crucial for enhancing prevention, early diagnosis, and treatment. Urban environments should be designed to encourage active lifestyles by including parks, bike paths, and pedestrian-friendly areas. Mental health services need to be embedded into broader NCD strategies, as conditions like depression can exacerbate chronic physical illnesses. Increased funding for research and international collaboration is essential to develop innovative treatments. Digital health solutions like mobile apps and wearable devices can offer individuals greater control over their health. Expanding health education in schools and communities can help promote better lifestyle choices, while governments should regulate marketing of harmful products and support healthier alternatives through subsidies. Ensuring food security and improving access to nutritious foods are also key strategies in addressing poor diets. By adopting a holistic and multi-sectoral approach, the global burden of NCDs can be significantly reduced, paving the way for a healthier future.