• New research from Future Health – published today at the World Health Assembly in Geneva – finds that the majority of Governments around the world are off track to meet their aim of reducing premature mortality from major diseases such as cardiovascular (CVD) by a third by 2030
• The White Paper finds that on current progress countries will only deliver a reduction in premature mortality from major diseases of 15.5% by 2030; this is 17.8% below the one third reduction committed to through the UN Sustainable Development Goals (SDG)
• Just 34 of 185 (18%) countries are on track to meet the target (SDG 3.4), with 151 set to miss the UN goal (82%)
• The paper entitled The power of connection: Strengthening health policy responses to cardiovascular, renal and metabolic (CRM) diseases (Power of connection-lo-res) argues that with CVD set to remain the most significant driver of premature mortality globally until 2050, that a new more interconnected approach to tackling the condition; one that includes action on diabetes, liver and kidney diseases is essential to accelerate progress towards the SDG
• The research examined action on interconnected policy approaches to tackling CRM diseases across sixteen geographies in Europe, North America, South America, Asia and the Middle East and identifies examples of emerging good practice that supports greater interconnectedness; but it also highlights a series of barriers including siloed health system funding, poor health data infrastructure and an absence of more holistic patient engagement strategies that are limiting progress
• The White Paper sets out a delivery framework for policymakers to overcome these barriers and embed and prioritise interconnected CRM policies within major health policies including national health plans, CVD prevention strategies, clinical guidelines and health service delivery models

A new White Paper from Future Health – launched to coincide with the 78^th World Health Assembly in Geneva today – sets out a call to action for Governments and policymakers to prioritise more interconnected action to reduce the burden from CRM diseases.

The research – sponsored by Boehringer Ingelheim but carried out independently by Future Health – finds that Governments are set to only deliver a 15.5% reduction in 2015 levels of premature mortality from non-communicable diseases such as CVD by 2030. This represents less than half of the progress needed to reach the one third reduction target in the UN SDGs.

The most recent data show that whilst three countries Maldives, Oman and Antigua and Barbuda have already met the one third reduction target, 37 have seen rates of premature mortality deteriorate since the start of 2015. This means they are further away from success now than at the start of the initiative.

Overall 34 countries are on track to meet the 2030 reduction target, but a significant majority of countries (151) are not.

Report author Richard Sloggett argues that a more interconnected approach to tackling the world’s biggest killer, CVD, through coordinated action across diabetes, liver and kidney diseases is now essential to deliver the necessary reductions in deaths globally.

The White Paper argues that along with mental health, CRM diseases are one of two major disease clusters that policymakers need to prioritise for more interconnected approaches. The research highlights the following data showing the interconnected nature of CRM diseases:

• Patients with Heart Failure are four times more likely to develop type 2 diabetes
• Those living with type 2 diabetes have a two-to four-fold higher risk of developing CVD
• Chronic Kidney Disease prevalence in those with type 2 Diabetes is around 40% and 50% among individuals with heart failure
• CVD is also much more likely to be diagnosed among those with Chronic Kidney Disease than in the general population
• Around 23% of people living with Non-alcoholic fatty liver disease (NAFLD) have diabetes and 51% are obese. NAFLD, especially in its more severe form (NASH), is associated with higher risk of CVD given the close association with cardiometabolic risk factors, with CVD being the leading cause of death among patients with NASH

The research analysed in depth action across sixteen different geographies to tackling CRM diseases through a more interconnected approach. The White Paper finds that whilst there are examples of specific interconnected initiatives, the approaches adopted are still often not one of full interconnectedness, but rather one of association or relationship between individual conditions (e.g. diabetes and CVD) or related risk factors between conditions (e.g. obesity and CVD).

The research identifies seven enablers to help policymakers build more interconnected approaches to:

• Utilising data, new technology and the opportunity of disease clusters to deliver more interconnected health policies
• Prioritising the funding for data systems, AI tools and new diagnostics to support population health and the screening and earlier diagnosis of patients
• Shifting incentives and payment models to break down silos and support interconnectedness
• Working with clinical leaders to develop multimorbidity care models with a greater focus on primary care
• Empowering patients to improve self-management and break down barriers to care
• Upscaling research into multimorbidity and into better understanding how disease clusters like CRM are interconnected
• Working on an aligned cross government approach to improving health outcomes

The White Paper’s delivery framework sets out how, by building these enablers, policymakers can then embed more interconnected approaches to reducing the impacts of CRM diseases within:

• National health plans aimed at improving population health outcomes and tackling health inequalities
• CVD plans aimed at specifically preventing and reducing the numbers with and impact of CVD
• Clinical guidelines for CRM diseases and integrated pathways of care for patients

Richard Sloggett, White Paper author and Programme Director at the Future Health Research Centre said: “This White Paper is a wake-up call for Governments and policymakers around the world. The majority of governments are off track to meet their aim of reducing premature mortality from major diseases such as cardiovascular disease by a third by 2030.

Policymakers do increasingly recognise the importance of tackling major diseases such as cardiovascular diseases, through more interconnected approaches. But making such change a reality in health systems is hard, particularly as many countries face challenging economic circumstances.

This White Paper aims to foster collaboration and learning across countries on how to prioritise and successfully build more interconnected policies across CRM diseases to help improve patient outcomes and reduce pressures on healthcare systems.

By using the enablers for change identified in this White Paper and embedding such approaches within national health plans, CVD reduction strategies, clinical guidelines and new models of how care is delivered, more interconnected health policies can accelerate much needed action across CRM diseases to reduce premature deaths from CVD which remains and is set remain the world’s biggest killer.”