Mohammad Hanief
In a significant milestone for global public health, world leaders gathering at the Eightieth United Nations General Assembly in New York have adopted a historic political declaration that for the first time brings noncommunicable diseases and mental health together under a single, integrated global framework. The declaration, adopted in December 2025 following extensive intergovernmental negotiations, reflects growing international recognition that physical and mental health challenges are deeply interconnected and must be addressed collectively to secure sustainable development, economic stability, and social equity.
The declaration, titled Equity and Integration: Transforming Lives and Livelihoods through Leadership and Action on Noncommunicable Diseases and the Promotion of Mental Health and Well-being, represents the outcome of years of advocacy and policy discussions, culminating in the fourth high-level meeting of the UN General Assembly on the prevention and control of noncommunicable diseases and the promotion of mental health and well-being held earlier in September. It builds on previous global commitments while significantly expanding their scope, ambition, and accountability mechanisms.
Noncommunicable diseases, including cardiovascular diseases, cancers, chronic respiratory illnesses, and diabetes, remain the leading causes of death worldwide. Each year, an estimated 18 million people die prematurely from these conditions, many before reaching the age of 70. At the same time, mental health conditions affect more than one billion people globally, cutting across age, gender, geography, and income levels. Together, these health challenges place enormous strain on health systems, families, and economies, particularly in low- and middle-income countries where access to prevention, diagnosis, and treatment remains uneven.
The declaration acknowledges that many of the drivers of noncommunicable diseases, such as unhealthy diets, tobacco use, harmful alcohol consumption, physical inactivity, and exposure to air pollution, are preventable and closely linked to mental health outcomes. Rapid urbanization, climate change, digital exposure, and social inequalities have further intensified these risks, leading to rising disease burdens in virtually every country. As a result, the declaration frames noncommunicable diseases and mental health not only as medical concerns, but as fundamental development issues with far-reaching social and economic consequences.
One of the most consequential aspects of the declaration is the establishment of specific, time-bound global targets to be achieved by 2030. These targets are designed to accelerate action and measure progress in concrete terms. They include a substantial reduction in tobacco use worldwide, a significant increase in the number of people with controlled hypertension, and a dramatic expansion of access to mental health care. By defining these objectives as fast-track outcomes, the declaration seeks to shift global efforts from broad aspirations to measurable impact.
Beyond outcome targets, the declaration outlines ambitious system-level benchmarks intended to strengthen national capacity to respond effectively to noncommunicable diseases and mental health conditions. These include commitments to enact comprehensive policy, legislative, and regulatory measures; ensure the availability of essential medicines and basic technologies at the primary health care level; expand financial protection to reduce out-of-pocket costs for essential services; implement multisectoral national action plans; and develop robust surveillance and monitoring systems. Together, these measures aim to embed prevention and care within stronger, more resilient health systems.
The declaration is notable for its breadth and inclusivity, reflecting lessons learned from the COVID-19 pandemic and emerging global challenges. For the first time, it explicitly recognizes a wider range of noncommunicable disease areas, including oral health, lung health, childhood cancer, liver and kidney diseases, and rare conditions that have historically received limited policy attention. It also expands the discussion of environmental determinants of health, highlighting the impacts of air pollution, unsafe cooking practices, lead exposure, and hazardous chemicals on both physical and mental well-being.
In response to the rapidly evolving digital landscape, the declaration addresses emerging risks linked to social media use, excessive screen time, exposure to harmful content, and the spread of misinformation. These factors are increasingly understood to influence mental health, particularly among children and adolescents, and to shape behaviors related to diet, physical activity, and substance use. The inclusion of digital harms marks a recognition that modern health challenges extend beyond traditional biomedical boundaries.
Regulatory action features prominently in the declaration, with a sharper focus on controlling tobacco products, including e-cigarettes and novel nicotine delivery systems, as well as restricting the marketing of unhealthy foods to children. Commitments to front-of-pack nutrition labeling and the elimination of industrial trans fats reflect a growing emphasis on creating healthier food environments through evidence-based policy interventions.
Equity lies at the heart of the declaration. It emphasizes the disproportionate burden of noncommunicable diseases and mental health conditions borne by marginalized populations, including people living in poverty, climate-vulnerable communities, Small Island Developing States, and populations affected by humanitarian crises. The text underscores the importance of involving people with lived experience in policy design and implementation, ensuring that responses are informed by real-world needs and grounded in human rights principles.
Financing emerges as a central concern throughout the declaration, particularly in light of global economic pressures that threaten health spending. The document calls for adequate, predictable, and sustained funding through increased domestic investment, enhanced international cooperation, and more coordinated multilateral financing mechanisms. By strengthening financial commitments, the declaration seeks to close persistent gaps between policy ambition and implementation on the ground.
Importantly, the declaration frames action on noncommunicable diseases and mental health as a shared responsibility that extends beyond ministries of health. It advocates for a whole-of-government and whole-of-society approach, recognizing that progress depends on coordinated action across sectors such as education, finance, urban planning, environment, labor, and digital governance. Civil society organizations, youth groups, persons with disabilities, and community leaders are identified as essential partners in driving change and sustaining momentum.
Accountability is a defining feature of the new framework. The declaration reinforces the role of monitoring, reporting, and review processes to track progress and maintain political commitment. The UN Secretary-General is tasked with reporting on advancements toward the 2030 targets ahead of the next high-level meeting, while the World Health Organization and other UN agencies will support countries in translating global commitments into national policies and programs. This emphasis on accountability reflects growing demand for transparency and results in global health governance. As the world looks toward 2030, the adoption of this declaration signals a renewed determination to confront some of the most persistent and complex health challenges of our time. By integrating noncommunicable diseases and mental health within a unified vision, world leaders have acknowledged the inseparable nature of physical, mental, social, and economic well-being. Whether this historic commitment delivers on its promise will depend on sustained political will, adequate financing, and meaningful action at national and local levels. What is clear, however, is that the declaration has set a new benchmark for global cooperation in pursuit of healthier, more equitable societies.
(The author is a senior analyst based in Kashmir)
