Photo: Amanda Folsom at center, attending a side event during the 80th session of the UN General Assembly (Credit: Sarah Merians Photography and Devex).
By Amanda Folsom, Managing Director, Global Evidence and Learning, Results for Development
The 81st session of the United Nations General Assembly (UNGA) offered a moment to take stock of where global health is heading and what needs to happen next. Shortly afterwards, the World Health Organization published its latest Global Health Estimates (2000–2023). The figures reveal a clear shift in the world’s health landscape: noncommunicable diseases (NCDs) accounted for nearly three-quarters (74%) of all global deaths in 2023, up from 58% in 2000. Eight of the ten leading causes of death worldwide are now NCDs.
Behind these number are the consequences for people and families living with NCDs, as well as increasing pressure on health systems and economies. As the burden of disease changes, countries face an urgent question: how health systems finance and deliver quality, long-term care that people need? Initiatives like the Financing Accelerator Network for NCDs (FAN) are supporting countries to address these questions as they navigate a rapidly changing health landscape.
The sessions at this year’s UNGA highlighted several themes that can help shape this response. Many reflect work already underway through the FAN:
- Country leadership and ownership are the defining shift. Progress is strongest when countries have control over priorities, plans, budgets, and implementation, with external partners aligning behind national priorities and reinforcing national systems rather than creating fragmented ones. Across FAN, this principle is reflected in the core groups that lead the work in each member country, bringing together government, civil society, and other national stakeholders to define priorities and drive action.
- Integration is a practical test of health system resilience. NCDs cannot be treated as an isolated agenda. Prevention, early detection, and long-term care need to be integrated into primary health care (PHC) and Universal Health Coverage (UHC) benefit packages. This was at the heart of FAN’s recent workshop in Accra, where country teams worked together to identify practical steps to integrate NCDs into UHC reforms.
- Sustainable health financing is about more than raising additional resources. Sustainable financing encompasses how resources are managed, allocated, and spent – through public financial management budgeting, strategic purchasing and provider payment to make more effective use of domestic resources. FAN is helping to make financing for NCDs a practical part of wider health-financing reform, particularly as countries face rising NCD burdens and constrained external resources.
- The focus now needs to be on the “how”. There is susbstantial agreement on what needs to happen: strengthened prevention, PHC, UHC, integrated NCD care, sustainable financing, and country ownership. The persistent gap is the “how”: how to adapt and integrate evidence and innovation to local contexts, finance priorities, overcome implementation barriers, and learn quickly to sustain and scale what is working.
The FAN supports countries to address the “how” gap. Priority questions include: Where do NCDs sit in national budgets and health benefit packages? How can medicines and diagnostics be financed and made available? How can strategic purchasing and provider payment support better prevention and care? How can external and private-sector resources align with national priorities? And how can countries make difficult allocation decisions as health needs grow and donor financing shifts?
There are already examples of countries working through these questions. Following FAN’s recent Sub-Saharan Africa regional workshop led by the African Institute for Development Policy (AFIDEP), country representatives from Cameroon, Ghana, Kenya, Rwanda, Somalia and Uganda have developed time-bound NCD Financing action plans. In Kenya, the Ministry of Health and NCD Alliance Kenya are convening this month to advance the FAN-funded project developing a new Economic Modelling Framework, to generate local evidence to help assess the economic burden of NCDs, identify financing gaps, and guide more efficient domestic investment.
At the same time, we are taking this collaborative model forward with partners across Latin America and the Caribbean as we gather countries across the region in Buenos Aires next week to translate regional evidence into country-led initiatives that strengthen financing for NCDs.
The changing global health landscape, combined with reductions in health aid and shrinking fiscal space, has created a growing gap in the technical assistance available to countries. As my colleagues highlighted in a recent piece for R4D, this calls for new approaches to country support. Platforms like FAN offer an opportunity to rethink how technical assistance is delivered through more flexible, demand-driven partnerships that connect to countries with the expertise they need, while keeping national priorities and leadership at the center.
As we look ahead to the third International Dialogue on Sustainable Financing for NCDs and Mental Health in February and the 2027 UN High-Level Meeting on UHC next year, there is an opportunity to bring these country experiences to the global conversation about what it takes to move from commitments to implementation. Sharing lessons from country-led approaches, strengthening coordination and rethinking how technical support is delivered will be essential to improving NCD prevention and care for people living with and at risk of NCDs, their communities and countries.