Last week’s release of the latest Global Burden of Disease Study results highlighted a reality that global health leaders and experts have long anticipated, yet one that demands even greater urgency today. The analysis spans more than three decades—from 1990 to 2023—across over 200 countries, offering a panoramic view of the shifting causes of mortality worldwide.
Two findings stand out. First, the world has undergone a marked epidemiological transition. Noncommunicable diseases (NCDs)—including conditions like cardiovascular diseases, cancers, diabetes, and chronic respiratory illnesses—have become the leading cause of death globally. Second, the pace and scale of that shift are especially striking in low- and middle-income countries (LMICs), where health systems are often more fragile and resources limited.
These twin observations represent a significant challenge: the burden is heavy and rising, and the capacity to respond is uneven at best. The study signals alarm bells where health systems, investment, data, and policies have yet to catch up to this changed reality.
The shift in landscape brings the work of Access Accelerated into sharper focus. Founded in 2017 as a unique collaboration among leading biopharmaceutical companies, Access Accelerated was created based on a recognition of this very turning point—the growing NCD burden in LMICs, the gap in coordinated action, and the need for sustainable, scalable responses.
Since then, Access Accelerated has worked alongside partners, including the World Bank and leading NGOs, and its member companies, to work with LMICs to strengthen their responses to NCDs within the broader goal of universal health coverage and primary healthcare strengthening.
What the findings show and how we’re responding
1. NCDs create new public health challenges, especially in resource-constrained settings
NCDs account for the leading cause of deaths globally, with 77% of premature deaths occurring in LMICs. This changes the center of gravity for global health, demanding that health systems manage chronic, long-term conditions at scale.
Over the past years, Access Accelerated has mobilized multistakeholder collaborations, funded local NCD initiatives that have scaled to national programs, and worked to integrate NCD care within primary healthcare services and UHC benefit packages.
2. Data, investment, and solutions must align with country needs
While the burden has clearly shifted, funding and action have lagged far behind. Investment in NCDs remains weak—historically receiving only around 1–2% of global development assistance for health —with limited resources at country level. Yet sustainable health financing for NCDs is an essential driver of progress. The path forward requires both mobilizing additional resources—more money for health—and allocating resources to achieve the greatest local impact—more health for money. Generating high-quality data from needs assessments and programmatic impact reports is essential, enabling governments and partners to identify where investments will yield the most meaningful outcomes.
In 2023, Access Accelerated entered a new phase with a strengthened focus on sustainable financing. Through a renewed technical partnership with the World Bank and in collaboration with Results for Development (R4D), we launched the Financing Accelerator Network for NCDs (FAN) in November 2024 to tackle one of the greatest barriers to the NCD response: sustainable health financing for NCDs. FAN brings together a coalition of health and financing leaders, experts, and innovators from the private, public, and development sectors, to foster innovative, country-led financing solutions that can be sustained over time.
Countries are stepping up—making new resource and health service delivery commitments—with targeted support from global and regional partners, like Access Accelerated and the FAN. The World Bank alone has mobilized $2.6 billion in country-level support for NCD-related priorities over the past year, an encouraging signal of growing momentum and shared purpose.
3. Integration offers a powerful opportunity for resilience and reach
Much is to be celebrated in the progress made in reducing deaths from infectious diseases. The challenge ahead is to integrate the responses to both infectious and chronic diseases. Integrated care represents an important opportunity at two levels:
- Across disease areas: Bringing together infectious disease and NCD services, particularly at the primary-care level, where providers are often the first and most accessible point of contact.
- Across the continuum of care: Strengthening prevention, diagnosis, treatment, and after-care to address multi-morbidity and interconnected conditions such as cardiovascular, renal, and metabolic diseases.
Our work increasingly includes health financing models that break down silos and build bridges between disease program areas. Through the FAN’s country members, we are supporting efforts to strengthen health financing systems, so they are capable of addressing the full spectrum of the needs of people living with – or at risk of developing – NCDs.
4. Progress must be locally driven and globally supported
Experience shows that one size will not fit all. Each country’s needs are unique; what works in one health system may not in another. The challenge is to design responses that are anchored in local engagement and local leadership, grounded in data, and supported by global expertise.
Through the FAN, we bring together three interconnected functions—FAN Foresight (on-demand technical support and insight), the FAN Forum (cross country learning opportunities), and the FAN Fund (catalytic seed funding to advance financing for NCDs). These three areas of support are designed to respond to country priorities, strengthen local ownership, and catalyze sustainable, context-specific financing solutions.
Meeting the moment
The findings from the Global Burden of Disease study remind us that global health is evolving. The ‘new’ reality, defined by continuing infectious disease and increasing NCD burdens, ageing populations, and multi-morbidity, defines the current agenda. But the solution is not to replace one focus with another; it is to connect them; keeping people at the center.
As countries navigate this changing health landscape, Access Accelerated is committed to supporting local leaders and stakeholders through the FAN, advancing sustainable financing, fostering knowledge, and mobilizing partnerships, with integration, sustainability, and country leadership at the core of our approach.