Death rates from chronic diseases such as cancer, heart disease, and stroke declined in four out of five countries between 2010 and 2019. Still, the pace of improvement slowed compared to the previous decade.
This is the finding of a major new analysis. It was led by Imperial College London and published in The Lancet. The study was supported by the UK Medical Research Council, the National Institute for Health and Care Research (NIHR), and the NCD Alliance. The study tracked global progress in reducing mortality from non-communicable diseases (NCDs) across 185 countries in the decade before the COVID-19 pandemic.
Researchers found that although mortality declined in most countries, nearly two-thirds (60 percent) experienced a slowdown in the rate of reduction compared to the early 2000s. The report is believed to be the most comprehensive assessment of NCD mortality to date, benchmarking national performance both historically and against regional peers.
Where progress has been made — and lost
The greatest declines came from reductions in cardiovascular deaths, including heart attacks and strokes. Improvements in cancer survival, particularly stomach, colorectal, cervical, breast, lung, and prostate cancers, also contributed.
These successes were offset by increases in deaths from dementia, alcohol use disorder, and cancers such as pancreatic and liver, dampening overall progress. Professor Majid Ezzati, senior author of the study, said the findings show both progress and warning signs:
“Our latest report shows that while the majority of countries are making progress to reduce the risk of dying from chronic disease, compared to the previous decade, progress has slowed, stalled, or even reversed in some nations.”
Regional findings
- High-income nations: South Korea performed best, achieving the world’s lowest chronic disease mortality risk for women and ranking fourth for men. Denmark, Norway, and Sweden also saw sustained improvements. By contrast, the United States and Germany fared poorly, with the U.S. showing the smallest decline among all high-income countries.
- Central and Eastern Europe: Moldova and Russia recorded notable reductions, driven largely by cardiovascular and alcohol control policies.
- Latin America and Caribbean: Chile and Colombia emerged as regional leaders, but countries like Jamaica and Antigua and Barbuda saw mortality increases, particularly from cardiovascular and kidney diseases.
- India and China: India recorded rising chronic disease mortality, particularly among women, with heart disease and diabetes leading the increase. China achieved substantial declines, including the largest reduction in COPD deaths globally, aided by tobacco and air pollution control policies.
The global slowdown
Overall, 60 percent of countries experienced a slowdown or reversal of progress from 2010 to 2019. High-income regions that had achieved rapid declines in the early 2000s now show signs of plateauing.
Contributing factors include:
- Plateauing in preventive medication coverage for hypertension and diabetes
- Slowing expansion of cancer screening programs
- Unequal access to healthcare, particularly for working-age adults
Working-age mortality trends were particularly influential. Countries such as Finland, Norway, and Denmark limited overall slowdown through strong declines in deaths among younger adults. The United States, however, saw stagnation or increases in younger age groups, worsening overall performance.
Data limitations and policy implications
Researchers acknowledged data limitations, with fewer than one-third of countries maintaining complete death registration, particularly in Pacific Island nations and low-income regions of Africa and South Asia. Year-to-year mortality fluctuations in small populations also added uncertainty.
Despite these challenges, the findings underscore the urgent need to renew proven strategies, including tobacco and alcohol control, widespread use of preventive medicines, early detection through screening, and equitable access to care.
Leanne Riley, Unit Head at the World Health Organization and study co-author, said:
“These data reveal a complex global picture. Encouraging progress is evident in some areas, but the overall burden remains unacceptably high. To change course, we must regain momentum and accelerate efforts through effective policies and equitable access to care.”
Looking ahead
The report’s release comes just weeks before the United Nations General Assembly (UNGA 80) and the Fourth High-Level Meeting on NCDs, where experts and policymakers will review progress and set renewed commitments.
Professor Ezzati stressed that the slowdown should be seen as a call to action:
“If we are to get back to the rapid improvements we saw early in the millennium, we need investment in the types of healthcare programmes and policies that have been proven effective in reducing deaths. This means not only more resources but also more focus on evidence-based action.”