NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4

Abstract

People in all but about 20 countries have a higher risk of dying prematurely from a noncommunicable disease (NCD) than from infectious and parasitic diseases, maternal and perinatal conditions, and nutritional deficiencies combined. The risk of dying from an NCD is highest in low-and middle-income countries, especially in sub-Saharan Africa for both sexes and in central Asia and eastern Europe for men. Progress towards Sustainable Development Goal (SDG) target 3.4 is markedly different across countries. At current rates of decline in NCD mortality, SDG target 3.4 is expected to be met for women in 35 countries (19% of all countries) and men in 30 countries (16%). Most of these are high-income countries with already-low NCD mortality and countries in central and eastern Europe. A further 50 countries (for women) and 35 countries (for men) would achieve the target with a modest acceleration of decline. Mortality from the four NCDs included in SDG target 3.4 has stagnated or increased since 2010 among women and men in 15 and 24 countries, respectively. Another 86 countries (for women) and 97 (for men) are progressing too slowly, and need to implement policies that significantly increase the rates of decline, if they are to meet SDG target 3.4. NCD deaths beyond the age range and causes of death included in SDG target 3.4 cause a larger mortality burden in low-and middle-income countries than in high-income countries. Health policies should address NCDs beyond the causes and age groups covered in SDG target 3.4, so as to "leave no one behind". Substantial reduction of NCD mortality requires policies that significantly reduce tobacco and alcohol use and blood pressure levels, and provide access to efficacious and high-quality preventive and curative care for NCDs in the context of UHC. 86 countries (46%) for women and 97 (52%) for men need the implementation of policies that significantly increase the rates of decline. Mortality from the four NCDs included in SDG target 3.4 has stagnated or increased since 2010 among women and men in 15 (8%) and 24 (13%) countries, respectively. NCD causes and age groups other than those included in the SDG target 3.4 are responsible for a higher risk of death in low-and middle-income countries than in high-income countries. For countries to substantially reduce NCD mortality requires policies that significantly reduce tobacco and alcohol use and blood pressure levels, and provide efficacious and high-quality preventive and curative care for NCDs, including timely diagnosis and treatment of hypertension, diabetes, and treatment-amenable cancers, and treatment pathways that improve the survival of those with acute and chronic NCDs.

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