Health literacy in action: JACARDI partners share lessons from 25 European pilots

The second JACARDI health literacy meeting brought together more than 50 professionals from public bodies, research institutes, and healthcare organisations across 13 European countries to exchange progress and lessons learnt from 25 pilot projects.

Over the two-day event coordinated by Biosistemak and held at the Euskalduna Conference Centre on 3–4 June in Bilbao, participants shared implementation experiences from different health literacy contexts, analysed common challenges, and discussed the evaluation of interventions, the inclusion of equity and diversity, and the sustainability and impact of JACARDI’s work beyond the project.

As a part of its integrated approach, JACARDI addresses the entire patient experience, making health literacy one of the fundamental pillars of health promotion and disease prevention. By focusing on enhancing how populations access, understand, evaluate and apply health information, JACARDI empowers individuals to make more informed decisions about their own health and well-being.

As a result, people are better prepared to adopt healthier lifestyle habits and become active agents in their own well-being and that of their communities, reinforcing health literacy as a cornerstone of a healthier and more equitable Europe.

Health Literacy for a Healthier Europe: 25 JACARDI pilots leading the way

During these two days, representatives from different countries including Croatia, Czech Republic, Finland, France, Iceland, Italy, Lithuania, Malta, Poland, Portugal, Romania, Spain, and Ukraine, they have addressed critical gaps in health literacy by developing and adapting tools, structures, and processes that empower individuals to better manage their health. 

The pilots target a wide range of population groups, from adults and people living with diabetes, to pregnant women, children and adolescents, and people in vulnerable situations such as migrants, ensuring that interventions are tailored to the specific needs and circumstances of each community.

At the heart of JACARDI’s approach is a commitment to equity, inclusion, and co-creation. Rather than applying one-size-fits-all solutions, the project places end-users, patients and the general population at the centre of the design process, co-creating tools and interventions directly with those who will use them. 

A key instrument in this effort is JACARDI’s Equity and Diversity Matrix guiding the pilots to ensure that health programmes reach the most vulnerable groups, including migrants and socio-economically disadvantaged populations, leaving no one behind. 

Within health literacy-related pilots the interventions are also focused on reducing social inequalities by enabling fair access to health information, services, and resources, with particular attention to culturally and ethnically diverse communities who are often the most underserved. During the two-day meeting, pilots shared their progress and experiences, highlighting the importance of meaningful stakeholder engagement through the involvement of local, regional, and national entities as a critical driver of sustainable impact.

A highlight of the meeting was a joint activity including a dedicated synergies session, bringing together complementary EU-funded initiatives to share preliminary results and foster cross-project collaboration. Three projects presented their work: JA PreventNCD, focused on strengthening health literacy to reduce inequalities in cancer and other NCDs; the Preventia Action Grant addressing the prevention of diabetes, obesity, and cardiovascular disease; and the DUSE Action Grant, which focuses on counteracting diabetes through interdisciplinary educative programmes. 

This collaborative exchange reflects JACARDI’s broader strategy of enhanced health promotion through shared learning,  promoting the systematic exchange of health literacy policies, tools, and capacity-building initiatives among member states, encouraging the adoption of WHO-recommended frameworks, and ensuring equity-driven health promotion across Europe.

Basque pilot supports youth to build health literacy for healthier daily habits

In the Basque Country region in Spain, Biosistemak Institute, together with Osakidetza, is leading a JACARDI pilot that aims to strengthen health literacy among adolescents and young people. Implemented under Work Package 6, which focuses on health literacy and awareness of cardiovascular diseases and diabetes, the pilot contributes to JACARDI’s wider goal of reducing the burden of non-communicable diseases through prevention, equity and stronger health systems.

The pilot responds to a central challenge in chronic disease prevention: young people need health information and resources that are understandable, relevant and usable in daily life. By supporting adolescents and young people to better access, understand and apply health information and services, the Basque pilot seeks to help them build healthier habits early, before cardiovascular disease and diabetes risks become established.

Making health information meaningful for young people

Health literacy is not only about providing information. It is about making sure that people can use that information and services in real situations: when making food choices, understanding physical activity recommendations, navigating health systems or recognising how everyday habits can influence long-term health.

As explained by Irati Erreguerena Redondo, Researcher and Project Manager at Biosistemak, the Basque pilot places young people at the centre of this process. Rather than applying a “one-size-fits-all” model, Biosistemak works within the JACARDI implementation methodology to adapt the pilot to the regional context, and integrate the needs of adolescents and young people as well as the realities of the Basque health system. This reflects the broader JACARDI approach, which promotes a co-designed health literacy programme based on local needs and situations, enhancing a participatory process with community stakeholders integrating the equity and sustainability perspective.

“By improving health literacy early in life, we can help adolescents and young people make informed choices that support their health now and in the future,” says Irati Erreguerena Redondo, Researcher and Project Manager at Biosistemak Institute for Health System Research.

From local action to European learning

The pilot also contributes to JACARDI’s wider commitment to equity. Young people do not all access, understand, use and appraise health information in the same way, and their opportunities to act on it can be shaped by social, economic, cultural and family circumstances. By focusing on understandable and relevant communication, the pilot aims to reduce barriers and make prevention more feasible for all. 

The results from the Basque Country pilot will contribute to JACARDI’s shared learning on how health literacy can support prevention from an early age. Insights from the pilot will feed into the project’s assessment and sustainability work, helping identify what can be maintained, scaled up or transferred to other settings after the project ends.

By helping adolescents and young people turn health information, resources and services into practical everyday choices, the Basque pilot shows how health literacy can become a foundation for healthier lives and more resilient health systems.

Research highlights the potential of self-measurement tools in preventing cardiovascular disease and diabetes

Research conducted within JACARDI summarises evidence on non-clinical methods for measuring blood glucose and cholesterol. The findings point to the preventive potential of self-measurement approaches, while emphasising that wider public health use requires further research, standardisation and strong clinical quality assurance.

Cardiovascular diseases and diabetes are among the leading causes of ill health and premature mortality in Europe. Both conditions are largely preventable, but prevention requires timely data on risk factors and approaches that are accessible to different population groups. Traditional screening methods can be resource‑intensive and may not reach everyone equally.

The researchers reviewed existing evidence on non-clinical measurement methods, such as dried blood spot samples, finger‑prick capillary blood collection, and emerging non‑invasive technologies. Some of these approaches showed close agreement with standard venous blood tests for specific measurements, particularly glycated haemoglobin (HbA1c) and triglycerides.

Clinical standards remain essential

However, the review also makes clear that clinical standards remain essential. Accuracy varies between methods, and differences in sample collection, handling and analysis can affect results. For this reason, self-measurement tools cannot currently replace clinical screening and are not recommended for diagnostic or population-level screening purposes.

“Self-measurement technologies have clear potential to support prevention and reduce barriers to participation,” says researcher (PhD candidate) Hanna Elonheimo, lead author of the study. “At the same time, they should be seen as complementary tools, not alternatives to clinically validated methods.”

The authors highlight that accessible and user‑friendly measurement approaches may still play an important role in increasing awareness of cardiovascular and diabetes risk, supporting disease management, and informing future prevention strategies. Further research is needed to improve standardisation, reliability and regulatory validation before wider implementation can be considered.

Publication: Innovative approaches to early detection of cardiovascular disease and diabetes risk: focus on glucose and cholesterol measuring
Authors: Hanna M Elonheimo, Alexandra Cucu, Gabriela Cristisor, Ciprian Ursu, Claudia Dima, Petru Milos, Giulia Franceschini, Katiuscia Dibiagio, Roberta Papa, Massimiliano Petrelli, Jelka Zaletel, Hanna Tolonen
Journal: European Journal of Public Health
Publication date: 9 February 2026
DOI: https://doi.org/10.1093/eurpub/ckag007

Building stronger prevention systems in Ukraine: insights from the Kyiv JACARDI meeting

A strategic meeting on implementing effective models for the prevention of cardiovascular diseases and type 2 diabetes was held in Kyiv, Ukraine, organized by the Public Health Center of the Ministry of Health of Ukraine within the framework of JACARDI. The event brought together representatives from the Ministry of Health of Ukraine, the WHO Country Office in Ukraine, and regional centers for disease control and prevention. The main goal of the meeting was to strengthen collaboration in public health, exchange experiences, and integrate European best practices into the prevention of non-communicable diseases (NCDs).

Early identification of risk factors, modern community-level screening models, and international experience in prevention programs were at the forefront of discussions, with special attention on the Safe Hearts Plan. Behavioural risk factors and their impact on premature mortality and population health loss were also high on the agenda.

“Non-communicable diseases often remain ‘invisible’ — their consequences do not appear immediately. At the same time, it is important to understand that prevention is far cheaper than treatment, and healthy nutrition and physical activity are not about trends but primarily about preserving health,” said Tetiana Skapa, Director of the Public Health Department of the Ministry of Health of Ukraine.

What JACARDI pilot studies reveal about prevention and care

The meeting also included discussion of the main findings from a study on health literacy regarding self-monitoring of arterial hypertension. The study was conducted using the Ophelia (Optimising Health Literacy and Access) process, a co-design approach for developing health literacy actions that is applied across 24 pilot projects within JACARDI’s work package on health literacy. The findings of the study confirmed that health literacy is a key factor in the effective prevention and self-management of high blood pressure, influencing adherence to treatment and regular monitoring. The study also highlighted practical opportunities for improvement, including clearer patient communication, better access to blood pressure monitoring in community settings, stronger patient education and peer support, and more coordinated healthcare delivery.

Results from another JACARDI pilot project exploring the barriers to prevention and screening for type 2 diabetes were presented. The study found that while primary care is trusted and access to diagnosis and medications is generally good, key barriers persist, including limited access to diagnostics, high administrative burden, short consultation times, and low patient awareness and motivation for prevention, alongside contextual challenges related to war, such as stress and disruption of care. Lifestyle change remains the greatest challenge for patients, and structured education and support programmes are largely absent. Overall, the findings highlight the need to strengthen prevention, improve access to essential diagnostics, and expand patient and professional education.

“Participation in the JACARDI project allows Ukraine to align with European best practices in cardiovascular disease and diabetes prevention and provides a strategic framework that guides our local prevention efforts, supports early detection, and helps us implement evidence-based interventions tailored to the Ukrainian context, particularly in the challenging conditions of war,” said Nataliia Hryb, Specialist in Non-communicable Disease Prevention at the Public Health Center of the Ministry of Health of Ukraine and pilot lead from the Ukrainian team.

Importance of a systemic prevention approach

Participants emphasized the importance of a comprehensive approach to NCD prevention, including improving health literacy and implementing screening programs. The national “Health Screening 40+” program, which provides basic examinations for early detection of cardiovascular diseases, diabetes, and mental health issues, was also discussed.

“Behavioral risk factors remain the key determinants of premature mortality and health loss in Ukraine,” noted Dmytro Shushpanov, Head of the Department of Demographic Modeling and Forecasting at the M. Ptukha Institute for Demography and Social Research, NAS of Ukraine. “At the same time, significant territorial disparities persist, especially in rural areas, which requires strengthening preventive measures and adapting programs to local conditions.”

Next steps and further collaboration

Following the meeting, participants outlined the key directions for future work: strengthening and supporting community-based prevention programs, developing screening initiatives, and increasing public health literacy. The strategic meeting provided an important platform for reinforcing partnerships between state institutions, regional centers for disease control and prevention, and international organizations.

Diabetes education course supports the Bangladeshi community in the Marche region

In November 2024, the Marche region concluded the first edition of a free Type 2 diabetes education course in Ancona, in collaboration with the ANOLF Association (Associazione Nazionale Oltre le Frontiere), and organised within the European joint action JACARDI by the Marche region, the regional health agency of the Marche region and the Marche diabetes network. The initiative aimed to improve access to prevention, information and healthcare services for the Bangladeshi community by overcoming linguistic and cultural barriers through culturally adapted education, developed through the collaboration established with the ANOLF Association.

Participants shared how valuable the course was for their daily lives. Roxina Akther, a course participant, said the training helped her better understand how to manage diabetes through doctors’ advice, healthy diet and daily habits, and encouraged her to share this knowledge with friends and the wider community. Romana Abdur, a Bangladeshi cultural mediator working with ANOLF, highlighted how culturally adapted guidance supports community members who do not speak Italian in accessing information and healthcare services with greater confidence.

Watch the video to hear and see the community’s perspective.

Strengthening European Health: JACARDI at the JARED Consortium Day

The Joint Action on REspiratory Diseases (JARED) is a major European initiative dedicated to reducing the burden of chronic respiratory diseases through improved prevention, early detection, and integrated care models across the EU. Since chronic conditions like respiratory diseases, diabetes, and cardiovascular issues often share common risk factors, building strategic synergies between Joint Actions is essential to create a unified, high-impact approach to public health and societal prosperity.

In this context, JACARDI contributes to these goals by strengthening prevention and management strategies for cardiovascular diseases and diabetes across Europe within a single framework. By promoting health promotion, reinforcing screening, integrated care pathways and self-management, together with labour participation and improved data governance, JACARDI reinforces a cross-disease, system-based approach that complements JARED’s goals.

Addressing shared risk factors — such as tobacco use, unhealthy diets, physical inactivity, environmental exposures, and social determinants of health — allows both Joint Actions to amplify their impact beyond single disease areas and move toward a more cohesive NCD strategy at EU level.

Building synergies across European public health initiatives

The event program featured a high-level opening with remarks from the WHO and the European Respiratory Society (ERS), followed by a deep dive into JARED’s first-year achievements in indoor air quality, patient pathways, and reaching vulnerable populations. A dedicated session on Strategic Synergies brought together coordinators from various European projects to discuss how to align our efforts for maximum impact.

During this session, Benedetta Armocida, Coordinator of JACARDI presented on building synergies for impact between JACARDI, JARED, and JA PreventNCD, focusing on how coordinated intervention strategies can drive broader societal prosperity. Together, we are ensuring that European health interventions are not just individual projects, but a cohesive movement toward a healthier future.

A Short Guide to Screening for Individuals at Increased Risk of Developing Cardiovascular Diseases and Type 2 Diabetes

As work progresses on a harmonized EU approach to health checks under the EU Safe Hearts Plan, JACARDI has published its Short Guide for Screening. The document provides practical, evidence-based recommendations to support the organization and implementation of effective screening activities across Europe. It is intended as a quick, accessible reference for public health professionals, policymakers, and other stakeholders involved in planning, designing, or evaluating risk assessment and screening approaches for cardiovascular disease and Type 2 diabetes. The guide was developed by lead authors William Leysen of Diabetes Liga (Belgium) and Hanna Tolonen, Director of Research and Development at the Finnish Institute for Health and Welfare (THL), together with a wider team of JACARDI experts.

Authors: William Leysen, Alessandra Cardinale, Alexandra Cucu, Aurélie Lampaert, Beatrice Formenti, Benedetta Armocida, Benedetta Marcozzi, Carmen Angheluta, Claudia Dima, Claudia Giacomozzi, Eeva Rantala, Fanny Monet, Giovanni Calcagnini, Hanna Elonheimo, Jelka Zaletel, Jill Farrington, Jorik Vergauwen, Krista Kruja, Laura Paalanen, Luigi Palmieri, Massimiliano Petrelli, Mattei Eugenio, Paola Santalucia, Petry Milos, Roberta Papa, Ruth Verdegem, Sue Cohen, Tsvetalina Tankova, Hanna Tolonen

Abstract:

The aim of this short guide, developed within the framework of the Joint Action on Cardiovascular Diseases and Diabetes (JACARDI), a European Joint Action co-funded by the EU4Health Programme, is to provide an overview of approaches for identifying individuals or segments of the population at increased risk of developing cardiovascular disease (CVD) or Type 2 diabetes (T2D). These approaches may include population-level monitoring, individual risk assessment, population segmentation, and also screening. When appropriately designed and implemented, such approaches can support primary prevention efforts by helping to target interventions that tackle harmful risk factors and encourage protective factors.

While not all risk assessment methods constitute formal screening programmes, they may still inform policies and practice. For instance, individual-level risk assessment can support clinical decision-making, whereas population-level stratification can guide broader public health strategies. In some cases, risk identification may also facilitate earlier diagnosis, provided that it is linked to follow-up, diagnosis and treatment pathways. However, any assumptions about improved health outcomes must be supported by evidence, and should consider the full pathway from identification to intervention.

This guide is intended as a quick reference, summarizing key concepts related to the use of risk assessment and stratification approaches in the context of CVD and T2D prevention, the focus being on primary prevention within a public health framework. For comprehensive discussions and detailed guidance on specific screening programmes, readers are encouraged to consult additional sources listed in this document.

Read the full guide here:

Short Guide for Screening Individuals at Increased Risk of Developing CVDs and T2D

Call for papers: join the scientific debate on cardiovascular disease and diabetes

The current policy landscape offers unique momentum for strengthening collective action on noncommunicable diseases. To stimulate discussion on the challenges and opportunities related to cardiovascular disease and diabetes, the International Journal of Public Health and Public Health Reviews have opened a joint call for papers.

Authors are invited to submit Original Articles, Theory and Concept papers, Reviews, and Policy Briefs for the special issue “Strengthening the public health response to cardiovascular diseases and diabetes”. The call for papers is open until 15 January 2027. Submissions will be reviewed by an editorial board that includes two experts from JACARDI, Yhasmine Hamu and Edwin Wouters.

Developed in line with the JACARDI mission, the special issue seeks to foster actionable knowledge that advances effective, equitable, and sustainable responses. Its aim is to support healthier lives, more resilient health systems, and stronger commitment to tackling noncommunicable diseases.

Topics of interest, identified in collaboration with JACARDI, include:

• Primary prevention, including health literacy, awareness, and health promotion
• Screening of high-risk populations
• Integrated health pathways, including health care organization, patient self-management, and reintegration into the workforce
• Data infrastructure and digital technologies as drivers of evidence-informed decision-making and innovation
• Health system strengthening, with a focus on governance, financing, and service delivery
• Strategies to reduce health inequities and ensure that populations living in vulnerable situations are not left behind

Accepted papers will be published on a rolling basis in the online special issue.

Be part of the call and support the creation and dissemination of knowledge that strengthens our public health response to cardiovascular disease and diabetes!

For more information on the call visit the website of the International Journal of Public Health.

Navigating adulthood with juvenile-onset type 1 diabetes: a scoping review on education, employment and quality of life

Scientific publications by JACARDI

In this post series we share the scientific publications directly linked to the JACARDI project. All publications featured in this series are authored or co-authored by JACARDI partners and reflect research and findings developed within the project framework.  

We aim to showcase how evidence supports our joint mission to tackle cardiovascular diseases and diabetes across Europe. 

Stay informed on how JACARDI turns evidence into action.

Authors: Eleonora Maurel, Arianna Fornari, Alessandra Knowles, Erika Guastafierro, Martina Lanza, Alessia Marcassoli, Matilde Leonardi, Luca Ronfani and Lorenzo Monasta 

Abstract:

 Background: Juvenile type 1 diabetes can present lifelong challenges that may affect educational, employment, and health-related quality of life (HRQoL) outcomes in adulthood. This scoping review aims at exploring the long-term impact of juvenile-onset type 1 diabetes on education and career achievements and well-being in adulthood. 

Methods: A scoping review conducted using PubMed and PsycInfo (2005– 2025) identified studies comparing adults diagnosed with type 1 diabetes during childhood and adolescence to controls without type 1 diabetes. Three studies focusing on educational attainment, employment, income, and HRQoL, met the inclusion criteria. 

Results: The studies included in the review show that university attendance is significantly lower among individuals with juvenile-onset type 1 diabetes, and this affects both men and women. Access to the labor market and earnings are similarly affected, especially in the case of women who experience both lower employment rates and income, compared to controls without diabetes. Men with type 1 diabetes have equal opportunities for workforce entry, but this does not translate into long-term income parity. Compared to healthy controls, HRQoL is lower among adults with type 1 diabetes, particularly in the school/work and emotional domains. Common challenges include low energy, forgetfulness, and concentration difficulties. 

Conclusion: While it is a matter of debate how juvenile-onset type 1 diabetes affects academic achievements, there is general agreement that it leads to persistent disadvantages in employment and HRQoL in adulthood. Targeted support from diagnosis and during transition to adulthood is essential to mitigate the long-term impact of juvenile-onset type 1 diabetes on educational, employment and psychosocial outcomes for this population. 

Source: https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1707581/full

Croí’s Healthy Hearts Club: empowering patients in heart disease self-management

Croí, the heart and stroke charity based in the west of Ireland, is leading one of Ireland’s pilot projects as part of JACARDI. This pilot, called the Healthy Hearts Club, focuses on patient self-management for those recovering from heart events, such as heart attacks. It aims to help individuals manage long-term health risks like high blood pressure and low physical activity. This project builds on Croí’s experience in heart disease prevention and rehabilitation and provides a crucial support system to patients after their initial cardiac rehabilitation.

A Sustainable Model for Long-Term Health

Cardiovascular disease remains the leading cause of death worldwide, and many patients face challenges in maintaining the positive changes achieved during rehabilitation. The Healthy Hearts Club offers a community-based model to help patients continue managing their heart health after formal rehabilitation ends.

“Cardiac rehabilitation is life-saving, but sustaining those changes is key to long-term health,” says Dr. Susan Connolly, Consultant Cardiologist at University Hospital Galway, who is a co-investigator on the project. “The Healthy Hearts Club provides ongoing support and helps patients stay on track with their health goals.”

The programme involves up to 160 patients, all of whom have completed cardiac rehabilitation through the through the Irish health service in Galway. Participants engage in six months of support, including regular nurse check-ins and group workshops on exercise, nutrition, emotional wellbeing, and heart disease risk factors. This ongoing support aims to help participants integrate these healthy habits into their daily lives.

Supporting Long-Term Change through Personalised Care

The Healthy Hearts Club emphasizes peer support, personalized care, and group activities tailored to the participants’ needs. By joining the programme soon after rehabilitation, patients are given the tools to continue the progress they’ve made, ensuring sustainable change over the long term.

“We believe that empowering people with the knowledge and tools to manage their health is essential for sustainable, person-centered care,” says Dr. Lisa Hynes, Head of Health Programmes at Croí. “This initiative aligns perfectly with our commitment to delivering innovative prevention and self-management programmes.”

In addition to in-person support, Croí will explore the use of digital health tools to further enhance the programme. Building on the success of Croí’s previous online self-management programme, the Healthy Hearts Club will assess how digital solutions can support long-term heart health.

A European Approach to Heart Disease Prevention

One of JACARDI’s goals is to integrate best practices across the entire patient journey—from screening and self-management to integrated care and workforce reintegration. The Healthy Hearts Club is a key component of this effort, with the programme’s evaluation aiming to develop scalable models for improving heart disease management across Europe.

“We’re excited to see how this project evolves and contributes to the broader European conversation on heart health,” says Dr. Connolly. “The insights we gain will help improve the long-term care and outcomes for patients.”

A Collaborative Effort for a Healthier Future

Croí’s leadership in the Healthy Hearts Club is part of the wider JACARDI programme, which connects Irish experts with a pan-European network of professionals working to reduce the burden of cardiovascular disease and diabetes. Dr. Hynes adds, “This collaboration with the HSE and European partners is a unique opportunity to learn from each other and translate research into real-world improvements in care.”

Five decisive actions to transform Europe’s NCD monitoring systems: “What gets measured gets prioritised”

A new policy paper published in The Lancet Regional Health – Europe calls for decisive action to transform how Europe monitors noncommunicable diseases (NCDs). Developed jointly by Joint Action on Cardiovascular Diseases and Diabetes (JACARDI), Joint Action Prevent Non-Communicable Diseases (JA PreventNCD), and the WHO Regional Office for Europe (WHO/Europe), the paper sets out five priority actions to strengthen health monitoring systems across the region, an essential step to curb the rising burden of NCDs and mental health and ensure more effective, equitable healthcare.

The publication, titled “Strengthening non-communicable diseases monitoring systems in Europe through a multistakeholder collaborative approach: a key priority for advancing data-driven policymaking”, comes at a critical momentum after the Fourth United Nations High-Level Meeting on NCDs and Mental Health. “Europe has a unique opportunity, and responsibility, to recommit to data-driven health governance and sustained investment in resilient NCD monitoring systems”, the authors explain in the publication.

Five priorities for 2025 and beyond

The publication highlights five critical areas where action is needed to make monitoring systems stronger, fairer, and more effective. It calls for collecting data that is truly inclusive and disaggregated, so that inequalities become visible and can be addressed. It stresses the importance of solid governance, clear legal frameworks, and long-term investment to ensure that progress is sustained.

Monitoring, the authors argue, should also be embedded in real-time policymaking, so that information directly shapes decisions and drives accountability. Civil society, communities, people with lived experience, and marginalized groups should have a meaningful voice in this process, making sure that data reflects people’s lived realities. And finally, the paper points to the need for stronger collaboration across sectors, greater sharing of knowledge, and more capacity building to secure lasting impact.

“Tackling NCDs is one of five priorities of WHO/Europe’s Second European Programme of Work, co-created with 53 Member States and shaped through broad public consultations, including with health professionals, people living with NCDs and civil society. Effective action on NCDs hinges on good data. Europe can lead by example and showcase collaborative and inclusive approaches together with key stakeholders, including EU Joint Actions”, said Dr Gundo Weiler, Director of the Division of Prevention and Health Promotion at WHO Regional Office for Europe.

The challenge: gaps between commitments and reality

An estimated 80% of NCDs are considered preventable through effective public health policies and early detection strategies. These figures underscore the urgent need for a paradigm shift from a model centred on diagnostics and treatment to one rooted in prevention, health promotion, and evidence-based screening.

Despite great efforts in international commitments, progress at the national level has been inconsistent. Monitoring systems remain fragmented, overly reliant on short-term projects, or challenged by limited governance and insufficient investment. This has created a critical gap between ambitious global targets and their translation into actionable national policies.

The policy paper identifies persistent data gaps, structural weaknesses, and opportunities for innovation. It emphasizes that monitoring is not just about collecting data, it is about ensuring that information is used in real time to drive policy reform, accountability, and equity.

Lessons from Europe

The authors underline that too often, NCD monitoring efforts have been ad hoc, reliant on external funding or driven by individual champions. This has led to uneven coverage, lack of comparability between countries, and persistent blind spots when it comes to the health of groups living in vulnerable situations, such as migrants, minorities, and people with disabilities.

Without data that is disaggregated and reflects disparities, inequalities remain invisible and policies risk reinforcing exclusion. The authors argue that equity must be at the center of all future monitoring efforts.

“It is a moral and ethical imperative to advocate for and generate more inclusive data. Data should be systematically disaggregated by age, sex, gender, geography, socioeconomic status, disability, ethnic and migration background to reveal territorial disparities and enable place-based interventions”, unfolds Dr Benedetta Armocida, from the Department of Cardiovascular, Endocrine-metabolic Diseases and Aging at Istituto Superiore di Sanità-ISS, Rome (Italy) and Coordinator of JACARDI.

“We should begin to view data not merely as numbers, but as reflections of human lives and rights: each data point tells a story, and data becomes truly powerful when it shifts narratives, amplifies the voices of those too often overlooked, and holds systems accountable. Data must be observed critically and translated into policies that strengthen health systems. Without inclusive monitoring, structural inequities remain concealed, and the most vulnerable remain invisible—one data point, one life, one missed opportunity at a time”, adds Dr Armocida.

At the same time, the authors highlight successful innovations and good practices emerging from European Joint Actions, such as JACARDI and JA PreventNCD, demonstrating that progress is possible when commitments are matched by clear governance, adequate investment, and cross-sector collaboration.

“Across Europe we already see solutions that work. Joint Actions like JA PreventNCD and JACARDI help countries align methods, share tools and learn faster from each other. That is how we improve comparability between countries and make monitoring more useful for prevention and health promotion, including by showing more clearly where inequalities persist,” says Professor Knut-Inge Klepp, from the Norwegian Institute of Public Health, Oslo and Scientific Coordinator of JA PreventNCD.

“But we have to treat monitoring as core infrastructure, not an extra task. It needs stable funding, clear governance and the ability to produce data that is timely and inclusive. If monitoring depends on short-term projects or individual champions, it will remain uneven. If it is institutionalized, it can guide priorities, strengthen accountability and help sustain progress over time,” adds Klepp.

Europe has both a responsibility and an opportunity to lead the way in building stronger, more inclusive health information systems that can serve as a global benchmark. Doing so will be critical not only to reducing premature mortality from NCDs by one-third by 2030, but also to ensuring health equity and resilience in the face of future challenges. “Because what gets measured gets prioritised. What gets disaggregated gets addressed. And what gets institutionalised can be sustained”, conclude the authors.

Disclaimers

JACARDI (Grant Agreement 101126953) and JA PreventNCD (Grant Agreement 101128023) projects have received funding from the EU4Health Programme 2021-2027. Views and opinions expressed are however those of the authors only and do not necessarily reflect those of the European Union or the European Health and Digital Executive Agency (HaDEA). Neither the European Union nor the granting authority can be held responsible for them.

WHO disclaimer: The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated.

Benedetta Armocida, Hanna Tolonen, Ivo Rakovac, Beatrice Formenti, Jill Farrington, Allison Ekberg, Hector Bueno, Giovanni Capelli, Silvia Francisci, Morten S. Frydensberg, Ane Fullaondo, Linda Granlund, Yhasmine Hamu Azcarate, Torben F. Hansen, Emil Høstrup, Tomi Mäki-Opas, Luigi Palmieri, Markku Peltonen, Valentina Possenti, Marco Silano, Gundo Weiler, Kremlin Wickramasinghe, Edwin Wouters, Knut-Inge Klepp, Graziano Onder, Gauden Galea, Strengthening non-communicable diseases monitoring systems in Europe through a multistakeholder collaborative approach: a key priority for advancing data-driven policymaking, The Lancet Regional Health – Europe, Volume 61, 2026, 101553, ISSN 2666-7762, https://doi.org/10.1016/j.lanepe.2025.101553

A major step forward: Basque country rolls out integrated heart failure care model

A new pilot project has recently been launched in the Basque country as part of JACARDI, featuring an integrated, value-based care pathway for people with heart failure. This pilot is aligned with JACARDI’s broader mission to reduce the burden of cardiovascular disease and diabetes across Europe by strengthening coordinated care, enhancing health literacy, and scaling best practices. 

Within JACARDI, Biosistemak represents the Basque country as an affiliated entity, co-leading communication and dissemination activities, supporting methodological frameworks for European pilots, contributing to health literacy initiatives, and leading the deployment of the heart failure pathway. This includes conducting a comprehensive needs assessment on the European level.

On 27 November, at the launch event organized at Cruces University Hospital in Barakaldo, Osakidetza – the public health care service of the Basque country – presented the new value-based integrated care pathway for heart failure, after two years of joint development with Biosistemak and Osakidetza’s Care Integration and Chronicity Service (SIAC). Throughout the entire development process, Biosistemak provided methodological support on pathway design, including the adaptation of care pathways and resources, the development of evaluation frameworks, the integration of technological requirements, and the preparation of awareness raising actions and training plans for professionals. The result is a comprehensive and coordinated care model that improves outcomes and quality of life for people living with heart failure while ensuring long-term sustainability.

During the event, Biosistemak researcher Yhasmine Hamu highlighted the importance of the extensive multidisciplinary collaboration behind the initiative. Over two years, professionals from family and community medicine, hospital care, nursing, pharmacy, and management collaborated to create a model that responds to real patient needs and incorporates sex- and gender-based perspectives. Presentations also highlighted innovative solutions, new corporate tools, and lessons learned on improving communication, standardising care, and defining indicators for continuous improvement.

The jointly developed pathway covers the entire care cycle for people with heart failure, from initial suspicion of the condition to hospitalisation, discharge, and ongoing follow-up in both primary and specialised settings. It is designed to align the perspectives of patients, professionals, and the general population. For patients, the model organises interventions and responsibilities in one integrated system to reduce morbidity and mortality and strengthen self-care. For professionals, it offers a clear overview of actions to be taken, decision-support tools, and a framework that promotes coordination and reduces variability. On a societal level, the model improves population health by enhancing scientific knowledge and reinforcing the sustainability of health systems.

The success of this pilot is a perfect example of how JACARDI supports Member States in adopting evidence-based and scalable care models for chronic disease management. Through its leadership in this initiative, Biosistemak contributes to strengthening integrated care and advancing cardiovascular health both within the Basque country and across Europe.