NCD Countdown 2030: pathways to achieving Sustainable Development Goal target 3.4
Open accessAbstract
The Sustainable Development Goal (SDG) target 3.4 is to reduce premature mortality from non-communicable diseases (NCDs) by a third by 2030 relative to 2015 levels, and to promote mental health and wellbeing. We used data on cause-specific mortality to characterise the risk and trends in NCD mortality in each country and evaluate combinations of reductions in NCD causes of death that can achieve SDG target 3.4. Among NCDs, ischaemic heart disease is responsible for the highest risk of premature death in more than half of all countries for women, and more than three-quarters for men. However, stroke, other cardiovascular diseases, and some cancers are associated with a similar risk, and in many countries, a higher risk of premature death than ischaemic heart disease. Although premature mortality from NCDs is declining in most countries, for most the pace of change is too slow to achieve SDG target 3.4. To investigate the options available to each country for achieving SDG target 3.4, we considered different scenarios, each representing a combination of fast (annual rate achieved by the tenth best performing percentile of all countries) and average (median of all countries) declines in risk of premature death from NCDs. Pathways analysis shows that every country has options for achieving SDG target 3.4. No country could achieve the target by addressing a single disease. In at least half the countries, achieving the target requires improvements in the rate of decline in at least five causes for women and in at least seven causes for men to the same rate achieved by the tenth best performing percentile of all countries. 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-will reduce NCD causes of death necessary to achieve SDG target 3.4 in most countries.
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Tobacco control has been identified as a crucial and necessary part of reaching global non-communicable disease goals, with one in six non-communicable disease-related deaths being attributable to smoking tobacco use.
“Tobacco control has been identified as a crucial and necessary part of reaching these goals, with one in six non-communicable disease-related deaths being attributable to smoking tobacco use.”
From Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019 (2021) · cites this paper as [13]
The 'Leveraging the pathways to achieve SDG target 3.4' section calls tobacco control an essential component of strategies to reach the target. Our copy does not give the claimed estimate that one in six NCD-related deaths is attributable to smoking tobacco; searches for that estimate and its variants found no supporting passage. (LLM, conf=0.88)
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- Authors
- Bennett, J. E., Kontis, V., Mathers, C. D., Guillot, M., Rehm, J., Chalkidou, K., Kengne, A. P., Carrillo-Larco, R. M., Bawah, A. A., Dain, K., Varghese, C., Riley, L. M., Bonita, R., Kruk, M. E., Beaglehole, R., & Ezzati, M.
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2020-09
- Volume
- 396
- Issue
- 10255
- Pages
- 918-934
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC7470795
- OpenAlex
- W3107993577
- Cited by
- 447
- References
- 20
- Citations by year
- 2026: 60 · 2025: 87 · 2024: 72 · 2023: 74 · 2022: 96 · 2021: 49 · 2020: 9
- FWCI
- 40.85
- Type
- journal article
- Language
- en
- Update notices
- erratum (2020-11-28)
- Open access
- bronze
- doi.org
- Locations
- The Lancet (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Archined (submittedVersion)
- Spiral (Imperial College London) (submittedVersion, cc-by-nc-nd)
- Funders
- Research England
- Topics
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
- Health Sciences › Health Professions › Health Information Management › Global Health and Epidemiology
- Keywords
- non-communicable diseases, premature mortality, Sustainable Development Goal 3.4, ischemic heart disease, stroke, cardiovascular disease, cancer, tobacco control, alcohol control, antihypertensive therapy, diabetes treatment, cardiovascular disease prevention, asthma, chronic obstructive pulmonary disease, cancer screening, mental health, mortality trends, health system interventions
- MeSH terms
- Noncommunicable Diseases, Sustainable Development, Adult, Aged, Cardiovascular Diseases, Cause of Death, Chronic Disease, Diabetes Mellitus, Female, Humans, Male, Mental Health, Middle Aged, Mortality, Neoplasms, Primary Prevention, Respiratory Tract Diseases, Myocardial Ischemia, Stroke, Secondary Prevention, Mortality, Premature
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