The Lancet journal has published a study that explores pathways to achieve SDG target 3.4 (By 2030, reduce by one third premature mortality from non-communicable diseases (NCDs) through prevention and treatment and promote mental health and well-being). The study finds that premature mortality from NCDs is declining in most countries, but the rate of change is not enough to achieve the 2030 objective.

The study was conducted by NCD Countdown 2030 collaborators. This collaboration seeks to inform policies, track progress, and enhance accountability towards reducing the burden of NCDs. The authors highlight that “non-communicable diseases are the leading cause of death and ill health and account for seven of ten deaths worldwide.” They note that the risk of dying from NCDs varies across countries, which “suggests that countries might need to take different routes towards achieving SDG target 3.4 by addressing different combinations of diseases.” The study evaluates combinations of feasible reductions in specific NCDs to achieve the target and finds that each country has one or more pathways to achieve it. 

The research focuses on the indicator used to measure progress towards SDG target 3.4. This indicator assesses the cumulative probability of dying from cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes (four NCDs) between 30-70 years of age. The study uses data on cause-specific mortality for these NCDs to characterize the risk and trends in NCD mortality in each country, and then evaluates combinations of reductions in NCD causes of death that can achieve the SDG target. 

Based on data from 2010-16, women in 17 of 176 countries and men in 15 of 176 countries are expected to achieve SDG target 3.4. At the other end of the spectrum, the data from this time period show that the the probability of dying from one of the four NCDs for 30-70 year olds has stagnated or increased among women in 14 countries and men in 20 countries. 

According to the study, no country could achieve SDG target 3.4 by addressing only one NCD. Half the countries will require improvements in the rate of decline in at least five causes for women and in at least seven causes for men. The study reports that in order to achieve this target, the following interventions are needed in order to reduce NCD causes of death:

• tobacco and alcohol control and effective health-system interventions, including hypertension and diabetes treatment;
• primary and secondary cardiovascular disease prevention in high-risk individuals;
• low-dose inhaled corticosteroids and bronchodilators for asthma and chronic obstructive pulmonary disease;
• treatment of acute cardiovascular diseases, diabetes complications, and exacerbations of asthma and chronic obstructive pulmonary disease; and
• effective cancer screening and treatment. 

The study highlights that “reducing the burden of NCDs to achieve SDG target 3.4 requires a combination of prevention, early detection, and treatment.” It suggests that national NCD strategies should be based on the combination of local epidemiology and feasibility as well as an accessible and equitable health system. [Publication: NCD Countdown 2030: pathways to achieving Sustainable Development Goal target 3.4