Creating working environments that promote health, inclusion and long-term well-being is a key priority for JACARDI. The Workbox for Inclusion contributes to this goal by offering practical support to organisations, with a particular focus on people living with non-communicable diseases (NCDs).

The programme bridges the gap between policy recommendations and everyday practice, especially in small and medium-sized enterprises, by translating public health principles into clear, actionable steps. The Workbox provides tools to assess workplace inclusiveness and to design tailored action plans. These aim to improve employee well-being, support work ability and foster sustainable inclusion.

By combining evidence-based knowledge with practical guidance, the Workbox strengthens organisational capacity and contributes to healthier and more productive workplaces. With initiatives like this, JACARDI continues to take meaningful steps towards a more equitable society, one that enables, supports and empowers all.

The Workbox was developed by the leadership and co-leadership teams responsible for the Work Package on Labour participation of people living with cardiovascular diseases and diabetes within JACARDI. Its design was led by experts from the Istituto Neurologico Carlo Besta (Italy), Poznan University of Medical Sciences, and the Department of Health Prevention (Katedra i Zakład Profilaktyki Zdrowotnej), Poland.

Access the Workbox for Inclusion here.

Download the leaflet here.

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On 6 May 2026, the Interregional Group on Health and Well-being of the European Committee of the Regions, with the support of EUREGHA, hosted the high-level discussion “Shaping the EU Safe Hearts Plan: regional perspectives for cardiovascular health” in Brussels.

The meeting brought together representatives from EU institutions, regional and local authorities, healthcare professionals, researchers, and public health stakeholders to discuss how to advance the implementation of the Safe Hearts Plan (SHP) through stronger multilevel governance and regional action. JACARDI contributed to the discussion as a key European initiative in this field to support the objectives of the SHP. 

Cardiovascular diseases remain the leading cause of death and disability in Europe, placing a major burden on individuals, health systems, and economies. Against this backdrop, the discussion highlighted the importance of translating European policy ambitions into concrete and equitable actions adapted to regional and local realities.

Speakers included: 

• Carmine Pacente, European Committee of the Regions
• Romana Jerković, European Parliament
• Marianne Takki, European Commission
• Benedetta Armocida, Istituto Superiore di Sanità and Coordinator of JACARDI
• Cristina Gavina, Portuguese Society of Cardiology and European Society of Cardiology
• Antonio Aurigemma, Regione Lazio

The discussion underscored several priorities for the future implementation of the SHP, including strengthening prevention and health promotion, improving early detection and screening, ensuring continuity and integration of care pathways, and addressing persistent inequalities in cardiovascular outcomes, including the cardiovascular gender gap, across and within European regions. 

Evidence-informed policies and prevention beyond healthcare settings

Participants also highlighted the growing importance of data systems and digital innovation in supporting evidence-informed and more equitable cardiovascular health policies. At the same time, speakers stressed that effective prevention strategies must extend beyond healthcare settings and reach people directly within schools, workplaces, and local communities, especially underserved populations and people living in vulnerable situations.

Coordinated European action through JACARDI

In this context, Benedetta Armocida presented JACARDI as a concrete example of how coordinated European action can support the objectives of the Safe Hearts Plan by bridging research, policy, and implementation. The Joint Action contributes to strengthening national and regional capacities, fostering collaboration across health systems, and reducing fragmentation in the prevention and management of cardiovascular diseases and diabetes. The discussion concluded with a shared recognition that achieving the ambitions of the EU Safe Hearts Plan will require sustained collaboration between EU, national, regional, and local actors, alongside continued investment in prevention, integrated care, and equity. 

The meeting further demonstrated the added value of creating spaces for dialogue between policymakers, researchers, healthcare professionals, and implementers. Bringing together actors operating at different governance levels allows for the exchange of practical experiences, the identification of shared challenges, and the co-development of solutions that are both evidence-based and feasible in real-world settings. Such multistakeholder engagement is essential to ensure that European strategies are translated into sustainable and impactful actions at the regional and local level.

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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.

L'articolo Building stronger prevention systems in Ukraine: insights from the Kyiv JACARDI meeting proviene da Jacardi.

On 15 January 2026, the European Commission hosted the first stakeholder webinar dedicated to the Safe Hearts Plan, the EU’s first-ever cardiovascular health plan, adopted on 16 December 2025. The online event brought together nearly 500 stakeholders from across Europe and provided a key platform to exchange views on how to support the implementation of the Plan and its flagship initiatives [1].

The webinar [2] marked an important milestone in the roll-out of the Safe Hearts Plan, which aims to tackle cardiovascular diseases (CVDs), the leading cause of mortality in the European Union, through coordinated action on prevention, early detection and screening, and treatment, care and rehabilitation, while addressing cross-cutting challenges such as data and digitalisation, research and innovation, and health inequalities.

Opening the meeting, Commissioner for Health and Animal Welfare, Olivér Várhelyi, underlined the urgency of action and the importance of collaboration with stakeholders to turn the Plan into concrete results.

“Cardiovascular diseases remain Europe’s number one killer, placing a growing burden on our health systems, societies and economies. With the Safe Hearts Plan, we now have a strong policy tool at EU level, but its success will depend on close cooperation with Member States and stakeholders to make it a reality,” said Commissioner Várhelyi.

Supporting early detection and screening

During the webinar, the coordinators of key Joint Actions, JACARDI and JA PreventNCD, presented how their work contributes to the implementation of the Safe Hearts Plan. Dr Benedetta Armocida, coordinator of JACARDI, highlighted the Joint Action’s strong alignment with Pillar 2 of the Plan: early detection and screening, including the flagship initiative on an EU Protocol on Health Checks for CVDs.

JACARDI brings together 21 countries and 81 partners, working to translate EU priorities into concrete, country-level implementation. In particular, Work Package 8 on screening high-risk populations, led by Hanna Tolonen and Luigi Palmieri, is developing common protocols and tools to support Member States in the design, organisation and sustainability of effective screening programmes.

“We are testing and implementing practical solutions that can support the Safe Hearts Plan on the ground. Our pilot projects on early detection and screening aim to generate evidence and tools that help Member States reach high-risk populations, while embedding equity and sustainability across all activities. The aim is to provide further evidence and the result of our pilots to support the implementation of the European plan,” said Dr Armocida.

In practice, JACARDI is implementing 19 pilot projects focused on screening for CVDs and diabetes across different European countries, assessing the feasibility of diverse screening approaches. The Joint Action has also developed an online risk assessment tool selection guide, supporting professionals in selecting appropriate risk prediction methods.

Addressing inequalities is a core priority for JACARDI, fully aligned with the Safe Hearts Plan. Across its 143 pilot projects, the Joint Action promotes equity and diversity, targeting both the general population and high-risk groups, with a focus on integrated care pathways, self-management and social participation.

The webinar also showcased the strong alignment between the Safe Hearts Plan and other EU initiatives. Knut Jønsrud, project manager of JA PreventNCD, emphasised the importance of addressing key risk factors and reducing social inequalities through a life-course approach.

“Several flagship initiatives of the Safe Hearts Plan, such as modernising tobacco control legislation and strengthening health literacy, are closely aligned with our work. A people-centred, equity-focused approach and cross-sectoral collaboration are essential to achieving lasting impact,” said Jønsrud.

A coordinated EU response

Antonio Parenti, director for Public Health, Cancer and Human Security in the Directorate General for Human and Food Security of the European Commission (DG SANTE), stressed the scale of the challenge posed by CVDs and the need for decisive, coordinated action at EU level.

“CVDs cost the EU more than €280 billion every year. Without strong and coordinated action, this burden will continue to grow, affecting future generations, health systems and economic resilience. The Safe Hearts Plan is our collective response to this challenge,” Parenti stated.

He highlighted the Plan’s three pillars and its ten flagship initiatives, designed to improve population health, foster innovation and support sustainable healthcare systems. Prevention remains a cornerstone of the Plan, as nearly 80% of CVDs can be prevented through lifestyle changes, alongside strengthened, patient-centred and multidisciplinary care [3].

Next steps

The European Commission will now collect and analyse the feedback and ideas shared by stakeholders during the webinar. A second stakeholder webinar is planned for the second half of 2026, ensuring continued dialogue as the Safe Hearts Plan moves into its implementation phase.

For JACARDI, the webinar confirmed the relevance of Joint Actions as key instruments to support EU health policies and demonstrated how collaborative, evidence-based approaches can help reduce the burden of CVDs across Europe.

[1] About the Safe Hearts Plan flagship initiatives

Adopted in December 2025, the EU Safe Hearts Plan is underpinned by ten flagship initiatives designed to deliver clear EU added value across prevention, care and innovation, while supporting Member States in addressing cardiovascular diseases in a coordinated and sustainable way:d

• A lifelong, personalised and digitally enabled prevention programme – ‘EU cares for your heart’
• Empowering consumers through information on food processing in the EU
• Modernising tobacco control legislation
• The Commission will examine which appropriate tools, including possible financial actions, could be deployed to support/fund public health actions in the field of primary prevention and stimulate food reformulation and healthier consumer choices
• Proposal for a Council recommendation on vaccination against respiratory infections as a preventive measure for cardiovascular diseases
• EU protocol on health checks for cardiovascular diseases
• Proposal for a Council recommendation on personalised treatment and monitoring of cardiovascular diseases
• Incubator for innovation and integration of AI and digital technologies in cardiovascular healthcare
• EU cardiovascular health inequalities dashboard
• Cardiovascular Disease Research and Innovation Roadmap

[2] Stakeholder Webinar the Safe Hearts Plan – Meeting documents
[3] Questions and answers on the EU Safe Hearts Plan

L'articolo How JACARDI can support the implementation of the EU Safe Hearts Plan proviene da Jacardi.

The new online risk test has already garnered over 120,000 users in just one month, signaling a widespread public interest. In fact, drawing from extensive population-level health data, the tool estimates a person’s likelihood of developing: type 2 diabetes, cardiovascular diseases, and memory disorders (such as dementia). The risk for type 2 diabetes and heart disease is projected over 10 years, while memory disorders are evaluated over a 20-year timeline.

The test was developed by a team of experts, including Prof. Jaana Lindström, Research Manager at THL and Sari Koski, Director of Diabetes Courses and Knowledge Production at the Finnish Diabetes Association, under JACARDI’s Work Package on Screening, led by Hanna Tolonen from THL. It does not function as a diagnostic tool, yet it offers a general risk assessment based on an individual’s lifestyle and health background, providing valuable insights even before symptoms emerge. It is especially helpful for individuals who may not yet have access to clinical testing or regular medical evaluations.

The test is available online and can be completed in minutes, anonymously and free of charge. It is designed for adults of all ages and is especially relevant for those who are unaware of their risk factors. It can be used independently at home.

Each user receives a personalized summary of their risk, along with science-backed lifestyle suggestions. These include advice in areas, such as diet and nutrition, physical activity, sleep and recovery, and stress management.

By taking the test, individuals are encouraged to make small but impactful changes to their daily habits, changes that could significantly reduce their chances of developing chronic illnesses in the future.

Since its launch in late May 2025, the test has exceeded expectations; the section related to memory disorders has seen particularly high engagement.

This level of adoption underscores a growing interest among the Finnish population in self-directed health promotion and self-care. The success of the initiative also reflects how digital tools can complement traditional healthcare services by raising awareness, prompting early action, and reducing long-term healthcare costs.

Health authorities are enthusiastic about the test’s potential. Prof. Jaana Lindström, from THL, emphasized its preventive power, stating that recognizing risk is key to taking action in time.

Sari Koski, representing the Finnish Diabetes Association, highlighted the importance of modest lifestyle adjustments by saying that even small changes can lead to significant health benefits over time.

This perspective is supported by stark national statistics. Every year in Finland:

• Approximately 23,000 people are diagnosed with type 2 diabetes
• Around 22,000 with coronary artery disease
• About 23,000 begin experiencing memory-related disorders

These figures underline the urgent need for tools that enhance citizens’ awareness of chronic disease risk factors and promote early detection and lifestyle interventions.

For this reason, the launch of this new test quickly gained widespread attention, as the campaign was covered extensively by both major national and local media outlets across Finland. Leading publications highlighted the test’s potential to empower individuals to take control of their health. Regional news platforms played a key role in disseminating the information, ensuring that citizens across the country, from urban centers to rural municipalities, were informed about the tool.

The risk test serves not only as a personal wellness tool but also as a potential model for broader public health efforts. This strategy is not only beneficial for the individual but also contributes to the sustainability of the healthcare system.

Moreover, initiatives like this one are economically sensible: they help curb the rising costs of treating chronic conditions and allow more people to stay healthier and more productive for longer.

Finland’s new online risk test represents a timely and impactful tool for public health promotion. While not a replacement for medical diagnosis, it opens the door to greater personal responsibility and awareness. By bridging digital innovation with health promotion, it empowers citizens to act before illness strikes, and that might just be the key to a healthier future for all.

L'articolo New online risk test by the Finnish Diabetes Association garners over 120,000 users in just one month proviene da Jacardi.

The event underscored how ongoing stakeholder engagement is vital to disseminate results, explore upscaling opportunities, develop evidence-based national policies and lay the groundwork for future cross-country collaborations. We invite readers to learn more about this ambitious intervention – running in parallel to our own pilot implementations – which is already demonstrating early results, implementation insights, and an inspiring commitment to meaningful change in health self-management.

A people-centric, digital health solution for preventing and managing diabetes and hypertension

The Horizon2020-funded DigiCare4You project offers a new model for the early prevention and management of type 2 diabetes (T2D) and hypertension (HTN) by engaging schools, communities, and healthcare systems in an intersectoral approach. At its core, the project empowers families and connects health and education sectors, equipping individuals with digital tools to better manage their health.Building on the evidence-based Feel4Diabetes study, DigiCare4You is being implemented in two high-income (Greece, Spain) and two middle-income countries (Albania, Bulgaria), targeting over 10,000 families across socio-economic groups.

Screen, support, empower – the DigiCare4You approach

DigiCare4You applies a two-step screening model leveraging existing child growth monitoring activities in schools and health centers through which parents and caregivers are approached to complete the FINDRISC questionnaire as the first screening step. Adults identified as at risk are then referred for a second screening, which includes anthropometric and clinical assessments to detect conditions such as prediabetes, type 2 diabetes, or hypertension.

Those confirmed at risk are subsequently invited to join the DigiCare4You two-year, mHealth-supported intervention programme, focused on lifestyle change, self-management, and family support. A multilingual mobile app offers access to health data, tracking tools, and educational resources and even recipies. Importantly, the intervention supports healthier behaviors in both adults and children through school and community-based activities.

DigiCare4You combines digital innovation, equity-driven outreach, and participatory research, while integrating into existing systems and investing in health professional training – ensuring sustainable, real-world impact.

Early results revealed: first findings inspire confidence

The Capacity Building and Recommendations Development (CBRD) Workshop gathered international experts at the midpoint of project implementation to review progress and shape the upcoming Roadmap for Scale-Up.Prof. Brian Oldenburg elevated the spirit of the event stating that: “Early findings are promising enough to say that there is a positive story to be told here.” Indeed, early results are compelling:

• Fewer adults with intermediate hyperglycaemia progressed to T2D; many returned to normal glucose levels.
• Participants with T2D improved their HbA1c.
• Adults with obesity experienced weight loss, BMI reduction, and lower cholesterol—without increased medication reliance.

From research to real-world impact

The workshop emphasized the transition from effectiveness to implementation research – examining how interventions work in real-life conditions. Dr Rajesh Vedanthan facilitated a compelling discussion in which implementers candidly shared successes and challenges.

Key takeaways from country implementers:

• Strong consensus: “Yes, we would start and do it again.”
• Motivation stems from seeing behavior change within families—especially when children and caregivers reinforce each other’s progress.
• Burnout among healthcare staff is a concern—but aligning DigiCare4You with existing systems proved an effective strategy.
• Local ownership and trust, especially through primary care systems and schools, were pivotal.
• Participants emphasized the importance of engaging families holistically, with one Bulgarian team member noting how “changing the behavior at home” can be one of the most lasting outcomes.

Additionally, one noted barrier to engagement was previous unsuccessful attempts at weight control, highlighting the need for tailored motivational support.

Cost-effectiveness, scalability, and the road ahead

Preliminary analyses suggest strong cost-effectiveness, especially when targeting adults with intermediate hyperglycaemia in MICs. A Scalability Decision Support Tool was developed to assess implementation readiness across five domains: NCD care context, digital literacy, support systems, screening capacity, and digital integration. These insights inform the forthcoming Roadmap for Scale-Up.

JACARDI Relevance

The presence of experts involved in both JACARDI and DigiCare4You highlights the existence of a vibrant, cross-country network of professionals dedicated to cardiovascular and diabetes care. The workshop featured members of the JACARDI Stakeholder Advisory Board, including a policy advisor from the European Diabetes Federation, epidemiologist and researcher from EUPHA, healthcare professionals involved in the pilot implementation in Portugal, representatives from the industry developing digital tools, and communication experts. Together, these individuals demonstrate the strength of this interconnected community.

Such events provide valuable opportunities to learn, grow and exchange knowledge, and have the potential to shape and enhance the quality of ongoing interventions. Given the different timelines of these projects, the initial findings of the DigiCare4You project can provide valuable insights for the JACARDI teams, given that the implementation of the pilots has only just begun.

Looking ahead

In its final year, DigiCare4You will focus on completing the intervention, finalizing cost-effectiveness studies, and refining its scalability tools. A second CBRD workshop will present final results and a full Roadmap for Scale-Up, providing a concrete guide for policy and replication.

As the burden of type 2 diabetes (T2D) in Europe is expected to reach 72 million people by 2050, DigiCare4You is emerging as a promising prevention model. “We design a programme, and when we start to implement it, we are confronted with the reality on the ground. Reality is revealed, and we act according to people’s needs,” said Prof. Yannis Manios, Project Coordinator. Meeting people where they are – with empathy, innovation and commitment – may be the most powerful intervention of all.

Discover more about the DigiCare4You project here.

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Spotlight on ICIC25 – Lisbon, Portugal | May 14–16, 2025

JACARDI had a strong presence at the 25th International Conference on Integrated Care (ICIC25) with three distinct contributions representing different work packages:

Irati Erreguerena (Work Package 6 – Health literacy) delivered an oral presentation on a co-designed health literacy program for adolescents in the Basque Country, Spain. Her talk highlighted how WHO’s Health Literacy Development Model, and the Ophelia (Optimising Health Literacy and Access) co-design methodology were applied to empower younger populations with knowledge and tools for chronic disease prevention.

Yhasmine Hamu (Work Package 9 – Integrated care pathways) presented on the implementation of a value-based integrated care model, sharing strategies to address care fragmentation and improve outcomes for people with chronic conditions.

Gergely Varga (Representing both Work Package 9 – Integrated care pathways and Work Package 5 – Methodological framework) contributed a poster that outlined a situational analysis methodology designed to support integrated care.

Faculty of Public Health Summer Scientific Meeting – Dublin, Ireland | May 20–21, 2025

Sonja Moore (Work Package 8 – Screening) presented findings from a scoping literature review on the use of natriuretic peptides in cardiovascular risk stratification and management. Her poster focused on current strategies and approaches for using these biomarkers in patient populations without diagnosed heart failure, a topic gaining traction in preventive cardiology. The review aimed to inform more targeted screening protocols and identify gaps in clinical practice across Europe.

COMET Conference – Poznań, Poland | June 25–27, 2025

Richard Osborne (Work Package 6 – Health Literacy) represented JACARDI at the 23rd International and Interdisciplinary Conference on Communication, Medicine, and Ethics (COMET). His oral presentation focused on scaling up health literacy development as a strategy to prevent and manage non-communicable diseases. The talk stressed the need for strategic investment in communication and co-design at the system level.

1st European Public Health Economics Conference
– Palermo, Italy | June 26–27, 2025

Katie Ellwood (Work Package 8 – Screening) presented a pilot study from JACARDI aiming to establish the most cost-effective threshold for using NT-proBNP blood marker in cardiovascular disease (CVD) risk stratification. The analysis models the impact of different thresholds over a 30-year horizon in a large population cohort. This pioneering work within JACARDI bridges clinical practice with health economics, helping to inform sustainable, evidence-based screening strategies.

These scientific initiatives reflect JACARDI’s commitment to knowledge-sharing, collaboration, and measurable impact. Consortium members not only showcased research but also engaged with policymakers, practitioners, and academics, advancing the mission to improve cardiovascular and diabetes outcomes across Europe. The autumn season offers a variety of relevant conferences, kicking off right at the end of summer with the Congress of the European Society of Cardiology, taking place from 29 August to 1 September.

L'articolo JACARDI’s voices on the scientific stage across Europe proviene da Jacardi.

Non-communicable diseases (NCDs) remain the leading cause of death and disability in Europe, and recent trends reveal both progress and setbacks. While tobacco use, hypertension prevalence, and alcohol consumption have declined since 2010, obesity and diabetes rates continue to rise alarmingly, and physical inactivity shows no signs of improvement. This mixed picture is compounded by a slowdown in the implementation of vital public health policies since the COVID-19 pandemic.

These findings are discussed in a Comment published in The Lancet Regional Health and developed through a collaborative effort bringing together JACARDI, JA PreventNCD, WHO Europe, OECD (Organisation for Economic Co-operation and Development), and the European Commission’s DG SANTE. The publication summarises the findings of the report Avoidable mortality, risk factors and policies for tackling noncommunicable diseases – leveraging data for impact: monitoring commitments in the WHO European Region ahead of the Fourth United Nations High-Level Meeting, by WHO Europe, reinforcing the urgency of renewed action. It emphasises the need for comprehensive solutions that prioritise strengthening health systems, accelerating the implementation of proven interventions, effective policies, and integrating equity-driven approaches.

The Comment presents key insights taken from the WHO Europe Report on the current state of NCD prevention and management in Europe. It highlights key challenges, such as the decline in the number of countries that have fully implemented NCD surveys, which fell from 28% in 2021 to 19% in 2023, and the reduction in the number of countries with operational multisectoral NCD strategies, which decreased from 60% to 55% during this period.

Despite these challenges, the authors note that 85% of European countries have adopted management guidelines for the four major NCDs: cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases; demonstrating significant foundational progress.

“These figures paint a complex picture. Despite decades of progress in reducing premature mortality from the four major NCDs prioritised by global agenda, currently the region is off track to meet its 2025 targets. Moreover, the rise in obesity and diabetes and the slowdown in policy implementation highlight the urgent need to reinvigorate our efforts”, comments first author 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.

The Scientific Coordinator of JA PreventNCD, Prof Knut-Inge Klepp, concurs and is particularly concerned regarding the slowdown in the implementation of population level policy interventions:

“We know how critical such policies are if we are to succeed in having a significant and lasting impact across population groups in Europe. Inequalities in NCD-related health remain a key challenge across and within European countries”.

Driving change

The European Union’s flagship initiatives under the EU4Health Programme are pivotal in addressing these challenges. JACARDI and JA PreventNCD are at the forefront of strengthening cross-national collaboration and implementing integrated strategies for NCD prevention and management.

JA PreventNCD targets primary prevention by tackling root causes such as unhealthy diets, tobacco and alcohol use, and lack of physical activity. JACARDI, meanwhile, focuses on secondary and tertiary prevention, aiming to enhance outcomes for cardiovascular diseases and diabetes through evidence-based interventions and integrated care pathways. Together, these initiatives exemplify the EU’s commitment to tackling NCDs across the care continuum, supported by a combined budget of €160 million and participation from 27 European countries.

The WHO NCD Global Monitoring Framework, which includes nine global voluntary targets, notably the headline goal of a 25% reduction in premature mortality from NCDs by 2025, is about to expire. That is why the authors provide a clear roadmap for advancing the fight against NCDs, ensuring systematic policy implementation and strengthening data infrastructures to translate commitments into measurable health outcomes.

“There are no more excuses. We have the knowledge and the tools. What remains is the will to implement them swiftly and hold ourselves accountable for delivering real results. This is not just a matter of public health; this is a matter of justice, security, and competitiveness, and a shared future”, says Dr Hans Henri P. Kluge, World Health Organization Regional Director for Europe.

Armocida and Klepp underscore the power of collaboration in achieving meaningful change: “We truly believe this joint effort reflects the strength and unity across Europe, bringing together a diverse group of organisations, initiatives, and stakeholders committed to reducing the burden of NCDs. The collaborative authorship of this Comment itself serves as an example of the collective commitment and shared vision needed to address one of the region’s most pressing public health challenges.”

The Comment calls for an accelerated, harmonised, and equity-driven European agenda on NCDs, particularly in the lead-up to the 2025 UN High-Level Meeting on NCDs.

The JA PreventNCD and JACARDI Joint Actions encourage policymakers, researchers, and public health advocates to explore this vital publication and join in building a healthier, more equitable future for Europe.

JACARDI (Grant Agreement 101126953) and JA PreventNCD (Grant Agreement 101128023) projects have received funding from the EU4Health Programme 2021-2027.

L'articolo From evidence to impact: a united call for equity-driven and sustainable action on NCDs proviene da Jacardi.

What does JACARDI mean to you and your organization in terms of its mission and values?

For EPHA and myself, JACARDI is a crucial initiative in combating cardiovascular diseases, diabetes, and other non-communicable diseases in Europe. Its focus on prevention, disease management, and cross-sectoral collaboration aligns with EPHA’s values of health equity and evidence-based policy. JACARDI’s comprehensive approach addresses these conditions and considers the broader social and commercial determinants of health, enhancing our joint advocacy for sustainable public health policies in the EU.

Based on your experience in public health, what do you consider the main barriers to reducing the prevalence of cardiovascular disease (CVD) and diabetes in the EU, and how can these challenges be addressed?

Public health, particularly regarding non-communicable diseases like CVDs and diabetes, faces many challenges, including the influence of health-harming industries and varying public health policies across member states. To effectively counter these diseases we advocate for more stringent regulations on industries that negatively impact health, such as the tobacco, alcohol and ultra-processed food sectors. It is also vital to improve the coordination and integration of health policies across the EU for greater efficiency and uniformity.

Bridging the gap between political action and healthcare practice requires early stakeholder input in policy making. Leveraging the collective strength of civil society to advocate for these changes and prioritising public health in the political agenda is essential. JACARDI’s work addresses many of these critical areas.

In your experience, what are the most critical economic and political factors to consider when implementing health initiatives across different global settings?

Effectively addressing cardiovascular disease and diabetes requires understanding both economic and political contexts. Economically, resource availability and stable health financing are crucial for sustaining initiatives. Politically, long-term commitment from governments and stakeholders is necessary to implement robust health policies. Early engagement with policymakers ensures health initiatives align with regional and national priorities, improving their effectiveness.

The JACARDI model, emphasising cross-country and sector cooperation, including other joint actions like the JA PreventNCD, offers a blueprint for addressing these challenges. Through collaboration, JACARDI enhances the implementation of adaptable and resilient health strategies, serving as a framework for other global health initiatives.

What role do lifestyle changes, such as diet and physical activity, play in the prevention and management of CVD and diabetes, and how can public health policies better support these changes?

Lifestyle changes are fundamental in the prevention and management of cardiovascular diseases (CVD) and diabetes. Encouraging healthy eating habits and regular physical activity can significantly reduce the incidence of these conditions, but it cannot rely solely on the individual. Public health policies play a key role by facilitating access to healthy food options and promoting physical activity through the creation of safe and accessible public spaces.

Integrating lifestyle interventions into national health policies can have a positive impact on public health. From JACARDI’s perspective, this is being addressed through initiatives that improve health literacy and encourage active participation from diverse populations. Furthermore, educational campaigns and programmes in schools and workplaces can motivate behavioural changes.

Finally, comprehensive policy approaches are crucial and it is essential that public policies tackle health misinformation and provide citizens with the necessary tools to assess the information that they are exposed to.

How do you see JACARDI’s role in addressing the growing prevalence of cardiovascular disease and diabetes in Europe?

JACARDI is a beacon of proactive change in Europe’s healthcare landscape. Its comprehensive approach to disease management and prevention addresses the rising prevalence of CVD and diabetes, focusing on prevention, early diagnosis, and effective management.

Beyond immediate health interventions, JACARDI integrates diverse healthcare approaches, ensuring inclusivity and adaptability for both urban and underserved populations. This ensures no one is left behind. Through these efforts, JACARDI strengthens European health systems’ ability to manage and prevent these diseases, promoting a healthier and more equitable future for all European citizens.

In a career that spans a quarter of a century and three countries, it was her unceasing quest for more impact and purpose in her work that brought Milka Sokolović to EPHA. As Director General, she instigates alliances and forges partnerships, while advocating for equitable solutions to European public health challenges, insisting on the vital role of civil society in reaching those solutions.

Milka Sokolović holds a degree in Biology from the University of Belgrade, and a PhD in Medicine from the University of Amsterdam. Through her research and academic roles at the Universities of Belgrade and Amsterdam, and her leadership roles at the European Food Information Council (EUFIC) and the European Nutrition Leadership Platform (ENLP), she has developed a remarkable expertise in scientific research, communication, and strategic partnerships.

Milka is skilled at developing and implementing organisational strategies, equipped with robust leadership competencies, and armed with ample enthusiasm, driven by Goethe’s “Knowing is not enough, we must apply. Willing is not enough, we must do.”

Learn more about EPHA here and connect with Milka Sokolović here.

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What significance does JACARDI hold for you and your organization in terms of its mission and values?

The mission of the European Society of Cardiology (ESC) is to reduce the burden of cardiovascular disease (CVD). Our society is very supportive of the great work being undertaken through JACARDI, which aims to support European countries in reducing the burden of CVD and diabetes and improve quality of care for the individuals affected.

How do you see JACARDI’s role in tackling the increasing prevalence of cardiovascular disease and diabetes in Europe?

I believe that JACARDI, through its numerous science-based pilot projects in 18 EU countries and with its network of 76 partners, has great potential to foster community spirit, knowledge sharing and to create value for tackling the increasing prevalence of CVD and diabetes across Europe. I think that JACARDI’s main strength is the integrated approach addressing both diseases simultaneously with a focus on the entire patient journey.

How do you think JACARDI will influence future collaboration on cardiovascular disease and diabetes prevention in Europe?

JACARDI specifically reflects the realities of patients who live with two comorbidities. We know CVD remains the predominant cause of death and disability in Europe. In the European Union, 62 million people live with CVD and 5 million new cases are diagnosed every year. In addition, 1 in 10 adults live with diabetes. What we also know is that people with diabetes have a two to three times higher cardiovascular risk than people without diabetes. They also see their life expectancy reduced by 10-14 years.

It is important to diagnose CVD and diabetes as early as possible to prevent complications and reduce healthcare costs. Recognizing these interlinkages between these two comorbidities is also crucial in the context of the incoming European Cardiovascular Health Plan from the European Commission. I believe that diabetes will be included within this plan.

So, joint health checks based on common risk factors for both diseases, such as high body mass index (BMI), high blood pressure, tobacco and alcohol consumption, high blood glucose and high LDL cholesterol are sensible and cost-effective options for the identification of high cardiovascular risk in individuals.

Based on your experience chairing the ESC Guidelines on Diabetes and Cardiovascular Disease, how can JACARDI’s research contribute to shaping future clinical guidelines in Europe?

Our ESC Guidelines on Diabetes and Cardiovascular Disease are an excellent tool to implement evidence-based, person-centered treatment strategies. This is what we call personalized medicine, which we know is effective in reducing cardiovascular risk in patients with diabetes. I believe that findings from JACARDI may potentially help the implementation of our guidelines in the daily clinical practice.

A critical step is ensuring that the clear target outlined in the ESC guidelines, to achieve better outcomes for people living with diabetes and CVD, is met for all patients. However, we are not there yet.

In this regard, data availability, data sharing and utilization are really crucial to improve patients’ and healthcare professionals’ adherence to the guidelines. One of the Work Packages of JACARDI aims to optimize the way individuals, communities, and organizations access, understand and use health information. These can be very helpful in shaping future guidelines.

With your background in cardiovascular pharmacology, what role do you think pharmacological innovations will play in complementing JACARDI’s efforts to reduce the burden of cardiovascular disease and diabetes?

I believe that a wide range of stakeholders have an important part to play in improving cardiovascular health in our population. This also includes the innovations coming from pharma and device companies. We hope that the innovation pipeline will continue to improve in the coming years as many clinical needs remain unmet.

Collaboration is definitely key and this is why the ESC is also a proud partner of the European Alliance for Cardiovascular Health (EACH), which comprises 21 leading organizations, including medical societies, industries and patients organizations.

Given your leadership experience in the European Society of Cardiology, how can JACARDI help drive policy changes at the European level to improve cardiovascular and diabetes care across diverse healthcare systems?

The ESC together with the European Alliance for Cardiovascular Health, has been advocating for a European Cardiovascular Health Plan for many years. Now finally, the policy context is extremely positive. The President of the EU Commission put CVD on the agenda and the Commissioner for Health has committed to developing a European Cardiovascular Health Plan, similar in ambition to Europe’s Beating Cancer Plan.

This was announced on the 3rd of December 2024, on the same day the Ministers of Health from the 27 Member States of the European Union approved the Council Conclusions on the Improvement of Cardiovascular Health in the EU.

It is clear that the plan is coming. What we need to ensure is that there is significant funding attached to the plan, proportionate to the burden of CVD. I believe the magnitude of work and effort from JACARDI also shows the interest at Member State level of this being a priority topic.

Policy change can only happen when it is driven at both the EU and national levels. And JACARDI showcases this important complementary nature with 80% of the close to €60 million in funding coming from the EU and the remaining 20% from the 21 participating European countries. I think collaboration is key and the driving force behind making real progress.

Prof. Francesco Cosentino is a Professor of Cardiology at the Karolinska Institute and University Hospital in Stockholm, Vice-President of the European Society of Cardiology (ESC) from 2020 to 2022 and co-Chair of the ESC Advocacy Committee from 2022 to 2024. He chaired the 2019 ESC Guidelines on Diabetes and Cardiovascular Disease and serves as Deputy Editor of the European Heart Journal and Consulting Editor of Cardiovascular Research Journal.

As a leading researcher, he has received grants and awards from national and international research councils and private foundations and has authored over 200 original articles in top-ranking, peer-reviewed journals. As a member of JACARDI’s Stakeholder Advisory Board, he contributes to work packages focused on data insights (WP7), screening (WP8), patient pathways (WP9), and patient self-management (WP10).

Learn more about Francesco Cosentino and his work here, and about ESC here.

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