From evidence to impact: a united call for equity-driven and sustainable action on NCDs

• JACARDI, JA PreventNCD, WHO Europe, OECD and the European Commission’s DG SANTE have published a joint Comment in The Lancet Regional Health, based on the findings of the newly published report ‘Avoidable mortality, risk factors and policies for tackling NCDs: leveraging data for impact’, by WHO Europe.
• The Comment underscores the critical role of cross-national collaboration in translating WHO findings into actionable policies, with a focus on equity, data-driven solutions, and integrated care pathways.
• These organizations call for an accelerated, harmonised and equity-driven European agenda on non-communicable diseases.

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.

From promising ideas to real impact: WHO’s Quick Buys for combating NCDs

What if targeted actions could transform public health across Europe in just five years? This was the question posed at an event organized by the WHO European Region, where experts gathered to unveil and discuss the groundbreaking paper ‘Quick buys for prevention and control of noncommunicable diseases’. The study, conducted by experts in noncommunicable diseases (NCDs) at WHO/Europe, has for the first time analysed exactly how 25 specific public health measures, so-called quick buys, can have a positive impact on population health across Europe and central Asia in as little as 5 years.

NCDs are the leading cause of death and disability worldwide. In Europe, they account for 90% of all deaths and 85% of disability, including mental ill health. A significant proportion of NCD deaths are premature, before the age of 70 and an estimated 60% of all avoidable NCD deaths are due to preventable causes. These could be addressed by reducing alcohol and tobacco use, unhealthy diets and physical inactivity.

However, progress on NCD prevention has stalled, as highlighted by the WHO Europe’s European Health Report 2024 and the UN’s 2025 NCD progress report. These publications show a rise in obesity and diabetes and insufficient progress toward meeting global NCD targets by 2030. With just 25 weeks remaining until the 4th UN High-Level Meeting on NCDs, the clock is ticking to accelerate progress toward reducing premature mortality from NCDs. In line with this objective, JACARDI supports countries in reducing the burden of cardiovascular diseases and diabetes at the individual and health system levels.

From best buys to quick buys: a roadmap for action

Dr Benedetta Armocida, coordinator of JACARDI, emphasized during the event the transformative potential of these interventions. “Advancing cost-effective policies is a global health priority. This paper makes a critical contribution by introducing structured timeframes, an essential component for strategic planning, implementation and impact assessment”.

WHO has previously identified a set of best buys, proven, cost-effective measures to address NCDs. Now, it can show which of those measures deliver the fastest results. The 25 quick buys, published in The Lancet Regional Health – Europe [1], include policies targeting key risk factors and disease groups.

The 25 quick buys with proven impact within 5 years

These measures are designed to yield high-impact results in record time, making them indispensable in the current public health landscape. Professor David Stuckler, from the University of Bocconi and co-author of the paper, echoed the urgency: “This paper is a roadmap for action. There are no more excuses not to implement it”.

The quick buys focus on practical measures. For example, pharmacological treatment of hypertension in adults, treatment of myocardial infarctions with acetylsalicylic acid, and treating strokes with intravenous thrombolytic therapy have all an impact of less than a year.

The role of Joint Actions: JACARDI and JA PreventNCD

As a Joint Action initiative, JACARDI exemplifies how research and policy can align to drive meaningful change.

1. Provide evidence on feasibility, scalability and sustainability

The study on quick buys underscores the need for more natural experiments to assess the real-world impact of interventions. “This is precisely where Joint Actions like JACARDI can play a crucial role. By generating robust implementation research, Joint Actions provide essential evidence on feasibility, scalability and sustainability of interventions. JACARDI serves as a bridge between research and policy, facilitating the translation of evidence into concrete, actionable strategies at national and regional level”, explained Dr Armocida.

2. Creating a platform for knowledge exchange

Stakeholder cooperation and a multi-sectoral approach is another aspect highlighted by the JACARDI coordinator. “By fostering cooperation among Member States and key EU stakeholders and diverse sectors, Joint Actions can create a platform for knowledge exchange, capacity building and coordinated policy responses. This collaborative approach extends beyond national boundaries, contributing to a more integrated and effective NCDs prevention and control framework at European level”, concluded Dr Armocida.

3. Ensuring the effectiveness and equity of monitoring systems

In line with this, Dr Hanna Tolonen, representing JACARDI’s sister project called JA PreventNCD, emphasized the vital importance of monitoring systems in ensuring the effectiveness and equity of public health interventions: “Within JA PreventNCD, we are working on the monitoring aspects to see how countries are currently tracking progress and how we can support them in improving their surveillance activities”.

By leveraging collaborative initiatives like these and integrating evidence-based strategies, the path forward becomes clearer and more achievable. The message from the WHO/Europe event is clear: the time for action is now. This is the way to turn promising ideas into tangible health outcomes for all.

Source:
[1] Gauden Galea, Allison Ekberg, Angela Ciobanu, Marilys Corbex, Jill Farrington, Carina Ferreira-Bores, Daša Kokole, María Lasierra Losada, Maria Neufeld, Ivo Rakovac, Elena Tsoy, Kremlin Wickramasinghe, Julianne Williams, Martin McKee, David Stuckler, Quick buys for prevention and control of noncommunicable diseases

The Lancet Regional Health – Europe, 2025, 101281, ISSN 2666-7762

Knut Inge Klepp and Linda Granlund: It’s important to find ways to build a community

With more than 1,600 health care professionals, scientists and public health experts involved, both JACARDI and JA PreventNCD recognize the necessity of fostering and building a strong sense of community and collaboration. According to the coordinators of JA PreventNCD, Knut Inge Klepp and Linda Granlund, building that sense of unity is no small feat, but is essential to make the most of the extraordinary investment and collective effort to tackle non-communicable diseases across Europe. In this conversation, the two coordinators explore the opportunities presented by this unprecedented joint commitment to prevention and the challenges of coordinating such large-scale projects.

What does JACARDI mean to you personally and to JA PreventNCD?

Knut Inge Klepp: There are so many synergies and so many opportunities for collaboration. It’s really useful to be able to work closely with the coordination team at JACARDI. Having colleagues you can share your victories and challenges with strengthens us as a team.

Linda Granlund: I agree with Knut Inge. Working closely with JACARDI is incredibly valuable for us, both as coordinators and as collaborators. It allows us to discuss details, but also to make sure that we avoid any overlap. On a personal note, I have lived with type 1 diabetes for 42 years, so staying informed about the developments in this field is not only professionally important but also deeply relevant to me.

Thank you for sharing! As Dr. Gauden Galea of WHO Europe explained at the Synergy meeting in Brussels this autumn (Strengthening NCD Monitoring Systems in the EU: A Collaborative Approach), after the COVID pandemic, the momentum for prevention and treatment of noncommunicable diseases was lost and the focus shifted to other areas of public health. How do you see the situation now?

Knut Inge Klepp: Well, we have these two joint actions, where the European Commission and the Member States have combined their efforts together, along with the smaller action grants. In total, almost 200 million euros are on the table. I think that reflects a significant turning point. Moving forward, our focus will be on making the best use of the substantial financial support, human capital and political commitment behind these projects.

Linda Granlund: When the Commissioner emphasized this focus, it signaled a significant shift, underscored by strong engagement and active involvement from Member States. With 21 countries participating in JACARDI and 25 in JA Prevent, it’s clear that these nations are committing substantial effort and resources to support our work.

How do you maintain focus while providing flexibility for task leaders and experts?

Linda Granlund: It’s important, to refer back to the background documents, Europe’s Beating Cancer Plan and the Healthier Together initiative. These provide essential guidance amid the many details of the project, work packages, tasks and subtasks. Without anchoring our efforts to these overarching goals, it’s easy to lose focus.

Knut Inge Klepp: First and foremost, it’s important to recognize that this is a significant challenge and we are fully committed to addressing it. Building on what Linda mentioned, our main objective is to ensure that our work aligns with the background documents. We regularly review these objectives and ask work package leaders, task leaders, subtask leaders and even pilot leaders to reflect on how their efforts contribute to the overall objectives. This ongoing process ensures that we are constantly reminded of what we are working towards and what we want to achieve.

Coordinating a project of this scale requires resilience, flexibility, bulletproof management and scientific rigor. What has been the most unexpected challenge you have faced so far in your first year, requiring you to think outside of the box?

Knut Inge Klepp: There are many challenges. One thing we’ve focused on recently is realizing that while we have frequent contact with a smaller group of work package leaders and maybe the task leaders and so on, there are probably between 500 and 1,000 people involved in this project – many of whom we haven’t met personally. We’ve interacted with a lot of them on screen, but it’s also important to find ways to build community, ownership of the project and a common culture. And that is also something that you are very consciously working on within JACARDI.

Linda Granlund: We have talked a lot about the different cultures involved when you have 25 countries working together. Finding a common tone is very important. How do we talk about the project? What do we emphasize? This process takes time, especially as the people involved come from different backgrounds, even if some share similar expertise.

Your dedication to creating a more health-promoting environment in Europe is well reflected in your work with a Youth Advisory Group. In your vision, what’s the NCD issue you envision for them to have to solve when you hand over the future?

Knut Inge Klepp: I started working on my first international non-communicable disease (NCD) prevention project in 1979. That was 45 years ago. Looking back, 30 years seems like a pretty short time. The scale and the context are different, but it’s striking that some of the issues we’re dealing with are quite similar. I think one of the values of this youth panel is their ability to bring a perspective that is grounded in their reality. In terms of health issues, we are seeing the convergence of NCDs with mental health and infectious diseases. The pandemic highlighted the vulnerability of people with underlying NCDs to infectious diseases. Addressing these interconnected challenges is something that today’s young people will have to deal with, even as we continue to work towards solutions in the present.

Linda Granlund: I think when we hand over the results in four or five years, we’ll have an understanding of that. Collaboration across sectors is essential, as we now focus on addressing the underlying factors that contribute to preventing NCDs. These are primarily related to the health care system, but we need to involve the other sectors more, such as the school sector, the transport sector, and create a mutual understanding of why they need to be involved and in what capacity. With the support of the EU Commission, this approach will benefit all the countries involved.

Learn more and connect:
JA Prevent NCD

Linda Granlund is the Division Director for Public Health at the Norwegian Directorate of Health, a role she has held since 2015. With over 20 years of experience, she has led initiatives to improve public health and nutrition. Previously, Linda worked in roles including Director of Health and Nutrition at a Norwegian food company that produces and markets some of the country’s most well-known and beloved food products, where she advanced projects to promote healthier eating. Linda also served as Vice Chair of Diabetesforbundet, the Norwegian Diabetes Association, advocating for better diabetes care. Her expertise spans health policy, nutrition, and public health advocacy.

Connect on Linkedin here.

Knut Inge Klepp is the Executive Director of the Division of Mental and Physical Health at the Norwegian Institute of Public Health. He has had an extensive career in public health, previously serving as the Director General of Public Health at the Norwegian Directorate of Health. Klepp is also an adjunct professor at the University of Oslo. His academic focus includes adolescent nutrition, obesity prevention, and nutrition policy. He has led numerous EU research projects, has published over 250 papers in peer reviewed journals and contributed significantly to international health initiatives, including WHO’s efforts to reduce non-communicable diseases.

Learn more about Knut Inge Klepp and his work here and connect on LinkedIn here.