Noncommunicable Diseases: Progress Monitor 2020

NONCOMMUNICABLE
DISEASES
PROGRESS MONITOR 2020
NONCOMMUNICABLE
DISEASES
PROGRESS MONITOR 2020
Noncommunicable diseases progress monitor 2020
ISBN 978-92-4-000049-0 (electronic version)

ISBN 978-92-4-000140-4 (print version)
© World Health Organization 2020
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Contents
Acknowledgements iv
Foreword v
Introduction 1
Explanatory notes 4
Progress monitoring indicators 4
Demographics 6
Mortality 6
References 7
Country profiles 9
Appendix 1:
Indicator Definitions and Specifications 205
iii
Acknowledgements
This report was prepared by Leanne Riley, Melanie Cowan and
Marie Clem Carlos from the Surveillance, Monitoring and Reporting
Unit, Department of Noncommunicable Diseases, World Health
Organization (WHO).
Contributions to the report were made by the following colleagues in

WHO Headquarters and Regional Offices: Naveen Agarwal, Fiona Bull,
Roberta Caixeta, May Cho, Alison Commar, Carolina Chavez Cortez,
Kaia Engesveen, Heba Fouad, Alexandra Fleischmann, Sophie Genay-
Diliautas, Larry Grummer-Strawn, Warrick Junsuk Kim, Doris Ma Fat,
Saki Narita, Ghada Nasr, Ivo Rakovac, Nivo Ramanandraibe, Manju
Rani, Dag Rekve, Stefan Savin, Donghee Seo, Hai-Rim Shin, Wendy
Snowdon, Marcus Stahlhofer, Nola Vanualailai, Cherian Varghese, and
Temo Waqanivalu.
Sincere thanks to all WHO Member States for their assistance in

reporting data to WHO which allowed compilation of these indicators.
iv
Foreword
In 2015, world leaders committed to reduce premature deaths from
NCDs by one-third by 2030. We have just 10 years to fulfil that
commitment. This Progress Monitor gives us a pulse on where we are
along that road.
Noncommunicable diseases are the leading cause of premature death

globally. Every year, 41 million people die from heart attacks, stroke,
cancer, chronic respiratory diseases, diabetes or a mental disorder.
That’s more than 70% of all deaths worldwide along with a crippling
economic impact. Taking action against NCDs is therefore not only a
moral imperative, it’s an economic imperative.
Data from 194 countries highlights that there are only 2 indicators out
of 10 that half of all countries are fully meeting. This is a grim sign, and
this decade is critical to advance the work on NCDs in all countries.
WHO has developed ‘best buys’ – a set of 16 practical and cost-

effective interventions that work and can be delivered at the primary
level. Critically these put the emphasis on promoting health and
preventing disease and include this like increasing tobacco taxes;
restricting alcohol advertising; reformulating food products with less
salt, sugar and fat; vaccinating girls against cervical cancer; treating
hypertension and diabetes; and more.
The best buys are a powerful economic tool. We estimate that every
dollar invested in the best buys will yield a return of at least seven
dollars. If implemented globally, they will save 10 million lives by 2025,
and prevent 17 million strokes and heart attacks by 2030.
Primary health care, with its emphasis on promoting health and

preventing disease, is the most inclusive, effective and efficient way
to reduce premature mortality from NCDs and promote mental health
and well-being. In addition to strong primary health care, countries
need strong referral systems with other levels of care.
v
But we also need to go beyond the health sector to address the root
causes of NCDs, in the food we eat, the water we drink, the air we
breathe and the conditions in which people live, work and play. A
whole-of-government approach is essential
I have often said that political leadership is essential for making

progress on NCDs and mental health. But so too are investing in
primary health care, implementing the best buys and initiating creative
partnerships with all sectors.
No country can afford to treat its way out of the NCDs epidemic. We
must prioritize health promotion and disease management. And the
best way to do that is through strong primary health care. We know
what works to combat NCDs.
It’s therefore not a question of whether countries can afford to

implement the best buys, but whether they can afford not to. We have
all the pieces to save lives we just have to put them into place. The
question is, will we? It’s a question we must answer with the decisions
we make today, and every day.
TEDROS ADHANOM GHEBREYESUS

Director-General
World Health Organization
World Health Organization - Noncommunicable Diseases Progress Monitor 2020 vi

Introduction
Noncommunicable diseases (NCDs), such as cardiovascular diseases,
cancer, diabetes and chronic respiratory diseases, are the leading
global cause of death and are responsible for just over 70% of
deaths worldwide. These NCDs share key modifiable behavioural
risk factors like tobacco use, unhealthy diet, lack of physical activity,
and the harmful use of alcohol, which in turn lead to overweight and
obesity, raised blood pressure, and raised cholesterol, and ultimately
disease. They continue to be an important public health challenge in
all countries, including low- and middle-income countries where more
than three quarters of NCD deaths occur.
Effectively tackling NCDs and their key risk factors requires a detailed
understanding of the current status and progress being made at the
country level. Feasible and cost-effective interventions exist to reduce
the burden and impact of NCDs now and in the future. Tracking
national implementation of a key set of tracer actions linked to
these interventions allows for global benchmarking and monitoring
of progress being made against NCDs. It also serves to highlight
challenges and areas requiring further attention.
In May 2015 the World Health Organization published a Technical Note

(1) on how WHO will report in 2017 to the United Nations General
Assembly on the progress achieved in the implementation of national
commitments included in the 2011 UN Political Declaration and the
2014 UN Outcome Document on NCDs. The Technical Note was
updated in September 2017 to ensure consistency with the revised
set of WHO ‘best-buys’ and other recommended interventions for
the prevention and control of noncommunicable diseases which were
endorsed by the World Health Assembly in May 2017. The Technical
Note outlines a set of ten progress monitoring indicators intended
to show the progress achieved in countries in the implementation
of selected national commitments included in the 2014 Outcome
Document. The ten NCD progress monitoring indicators are as follows:
1
Consider setting national
NCD targets for 2025:
Member State has set time-

1
bound national targets based
on WHO guidance
Member State has a functioning system

2
for generating reliable cause-specific
mortality data on a routine basis
Member State has a STEPS survey or

3 Consider developing
a comprehensive health examination national multisectoral
survey every 5 years
policies and plans to
achieve the national
targets by 2025:
4
Member State has an operational
Reduce risk factors for multisectoral national strategy/
action plan that integrates the major
NCDs, building on guidance
NCDs and their shared risk factors
set out in the WHO Global
NCD Action Plan:
5
Member State has implemented the
following five demand-reduction
measures of the WHO FCTC at the
highest level of achievement:
A Reduce affordability by increasing

excise taxes and prices on tobacco
products
Eliminate exposure to second-

B
hand tobacco smoke in all indoor
workplaces, public places and
public transport
C Implement plain/standardized
packaging and/or large graphic health
warnings on all tobacco packages
Enact and enforce comprehensive

D
bans on tobacco advertising,
promotion and sponsorship
E Implement effective mass media

campaigns that educate the public
about the harms of smoking/tobacco
use and second hand smoke
World Health Organization - Noncommunicable Diseases Progress Monitor 2020 2

Member State has implemented, as
6
appropriate according to national
circumstances, the following three
measures to reduce the harmful use of
alcohol as per the WHO Global Strategy A Enact and enforce restrictions on
to Reduce the Harmful Use of Alcohol: the physical availability of retailed
alcohol (via reduced hours of sale)
Enact and enforce bans or

B
comprehensive restrictions on
exposure to alcohol advertising
(across multiple types of media)
C Increase excise taxes on alcoholic
beverages
Member State has implemented

7 Adopt national policies to
reduce population salt/sodium
the following four measures to A consumption
reduce unhealthy diets:
Adopt national policies that limit
saturated fatty acids and virtually
B eliminate industrially produced trans
fatty acids in the food supply
WHO set of recommendations

C on marketing of foods and non-
alcoholic beverages to children
Member State has

8 Legislation/regulations fully
implementing the International
implemented at least one D Code of Marketing of Breast-milk
recent national public Substitutes
awareness and motivational
communication for physical
activity, including mass media
campaigns for physical activity
behavioural change 9 Member State has evidence-based
national guidelines/protocols/standards
Strengthen health for the management of major NCDs
systems to address through a primary care approach,
NCDs through people- recognized/approved by government or
centred primary health competent authorities
care and universal 10
Member State has provision of drug
health coverage, therapy, including glycaemic control, and
building on guidance counselling for eligible persons at high
set out in WHO Global risk to prevent heart attacks and strokes,
NCD Action Plan with emphasis on the primary care level

Explanatory Notes
This report presents information for each country
related to their achievement of the NCD progress
monitoring indicators. The profiles also include
information on the population, percentage
and number of deaths from NCDs, and the risk
of premature death from the four main NCDs
(cardiovascular diseases, cancer, diabetes or chronic
respiratory diseases) – the indicator used to monitor
the Sustainable Development Goal target 3.4 on
NCDs. The data presented in the country pages
are derived from several sources, each of which is
explained in the following notes.
Progress monitoring indicators
Details of the progress monitoring indicators, including detailed

definitions, specifications, data sources and assessment criteria are
included in Appendix 1. For each indicator the following symbols
denote the level of achievement: ● = fully achieved, ◐ = partially
achieved, ○ = not achieved, “NA” = not applicable to country due
to national situation, “DK” = country responded “don’t know” to that
question in the survey, and “NR” = no response or missing data.
Assessment of indicators 1, 3, 4, 7a, 7b, 7c, 8, 9 and 10 were taken

from Member State responses to the 2019 NCD Country Capacity
Survey (NCD CCS). The 2019 NCD CCS questionnaire was completed
through an online web-based platform by the NCD focal points or
designated colleagues within the Ministry of Health (MOH) or a
national institute or agency in all WHO Member States (194 countries)
between March and June 2019. The questions were developed in a
manner intended to obtain objective information about adequacy
4
of capacity and countries were required to provide supporting
documentation to enable review by WHO in order to validate the
responses. Where discrepancies were noted between the country
response and the documents provided for validation, a clarification
request was returned to the country for their consideration and an
updating of their response.
Assessment of indicators 7a, 7b and 7c were additionally reviewed

against responses obtained by WHO in the 2nd Global Nutrition
Policy Review and supporting documentation contained in the WHO
Global database on the Implementation of Nutrition Action (GINA).
Assessment of indicator 2 related to the system for generating

mortality data was based on data collected by WHO and stored in the
WHO mortality database through a routine annual call for data.
Assessment of indicator 5 was based on data collected from Member

States in 2019 for the production of the WHO Report on the Global
Tobacco Epidemic. The WHO assessment was shared with national
authorities for review and approval.
Indicator 6 achievement status was based on the responses of country

focal points, officially nominated by the Ministry of Health, to the
2019 Global survey on progress on SDG health target 3.5 conducted
by WHO. Responses were reviewed and validated by WHO, and
subsequently endorsed by the Member States. This indicator is
marked with a footnote for those countries who did not respond to
the 2019 Global survey on progress on SDG health target 3.5 and who
thus have data only from the previous round (2016) of the survey.
Indicator 7d achievement status was based on the analysis by WHO,

UNICEF, and IBFAN/ICDC of copies of all national legislation on the
International Code of Marketing of Breast-milk Substitutes for the
production of the report on Marketing of breast-milk substitutes:
National implementation of the international code Status Report 2018.
5
Demographics
The 2016 population estimates from the 2017 United Nations

Population Division World Population Prospects (2) are reported in
each profile.
Mortality
Percentage of deaths from NCDs and total number of NCD deaths

are reported for 2016 for all countries with a population greater than
90,000. These data were drawn from the 2016 all-cause mortality rates
estimated from revised life tables, published in World Health Statistics
2018 (3). Total number of deaths by age and sex were estimated for
each country by applying these death rates to the estimated resident
populations prepared by the United Nations Population Division in
its 2017 revision (2). Vital registration systems which record deaths
with sufficient completeness and quality of cause of death information
were used as the preferred data source. Detailed information on
methods for mortality and causes of death estimates were published
previously (4).
The risk of premature death from target NCDs presented in the

profiles is the probability of dying between ages 30 and 70 years from
the four main NCDs and was estimated for 2015 using age-specific
death rates (in 5-year age groups, e.g. 30-34… 65-69, for those
between 30 and 70) of the combined four main NCD categories, for
each Member State (4). Using the life table method, the risk of death
between the exact ages of 30 and 70, from any of the four causes
and in the absence of other causes of death, was calculated using
the equation below. The ICD codes used are: Cardiovascular disease:
I00-I99, Cancer: C00-C97, Diabetes: E10-E14, and Chronic respiratory
disease: J30-J98.
6
Five-year death rates were then translated into the probability of death
for each NCD using the following formula:
The unconditional probability of death, for the 30-70 age range, was
calculated last:
References
1. http://www.who.int/nmh/events/2015/technical-note-en.pdf?ua=1,
accessed 4 September 2017.
2. World Population Prospects: The 2017 Revision, Key Findings and

Advance Tables. New York, United Nations Population Division, 2017.
3. World Health Statistics 2018: monitoring health for the SDGs, Sustainable
Development Goals. Geneva, World Health Organization, 2018.
4. WHO methods and data sources for country-level causes of death 2000-
2016. Geneva, World Health Organization, 2018.
7
8
Country
Profiles

Afghanistan
34 656 000 44% 109 500 30%

Total population Percentage of deaths Total number of Probability of premature
from NCDs NCD deaths mortality from target NCDs
1 National NCD targets and indicators ○
2 Mortality data ○
3 Risk factor surveys ◐
4 National integrated NCD policy/strategy/action plan ●
5 Tobacco demand-reduction measures:

A increased excise taxes and prices ○
B smoke-free policies ●
C large graphic health warnings/plain packaging ○
D bans on advertising, promotion and sponsorship ●
E mass media campaigns ○
6 Harmful use of alcohol reduction measures:

A restrictions on physical availability ●
B advertising bans or comprehensive restrictions ●
C increased excise taxes ●
7 Unhealthy diet reduction measures:

A salt/sodium policies ○
B saturated fatty acids and trans-fats policies ○
C marketing to children restrictions ○
D marketing of breast-milk substitutes restrictions ●
8 Public education and awareness campaign on physical activity ○
9 Guidelines for management of cancer, CVD, diabetes and CRD ○
10 Drug therapy/counselling to prevent heart attacks and strokes ○
● fully achieved ◐ partially achieved ○ not achieved

Albania
2 926 000 93% 24 300 17%

from NCDs NCD deaths mortality from NCDs
1 National NCD targets and indicators ●
2 Mortality data ◐

A increased excise taxes and prices ◐
C large graphic health warnings/plain packaging ◐
6 Harmful use of alcohol reduction measures:†

A restrictions on physical availability ◐
B advertising bans or comprehensive restrictions ○
C increased excise taxes ◐

C marketing to children restrictions ●
9 Guidelines for management of cancer, CVD, diabetes and CRD ◐

† = see Explanatory Notes

Algeria
40 606 000 76% 144 000 14%

4 National integrated NCD policy/strategy/action plan ◐

B smoke-free policies ◐
D bans on advertising, promotion and sponsorship ◐
E mass media campaigns NR

A restrictions on physical availability ○
C increased excise taxes ○

D marketing of breast-milk substitutes restrictions ◐

NR No Response

Andorra
77 000 - - -
from NCDs† NCD deaths mortality from NCDs
4 National integrated NCD policy/strategy/action plan ○

A increased excise taxes and prices ●
D bans on advertising, promotion and sponsorship ○


10 Drug therapy/counselling to prevent heart attacks and strokes DK

† = see Explanatory Notes DK Don’t know

Angola
28 813 000 27% 61 900 17%




B saturated fatty acids and trans-fats policies DK
D marketing of breast-milk substitutes restrictions ○

NR No Response DK Don’t know

Antigua and Barbuda
101 000 82% 530 23%

2 Mortality data ●
3 Risk factor surveys ○



8 Public education and awareness campaign on physical activity ●


Argentina
43 847 000 78% 254 500 16%

3 Risk factor surveys ●

C large graphic health warnings/plain packaging ●
E mass media campaigns ◐

B advertising bans or comprehensive restrictions ◐

A salt/sodium policies ◐
B saturated fatty acids and trans-fats policies ●
8 Public education and awareness campaign on physical activity ◐
9 Guidelines for management of cancer, CVD, diabetes and CRD ●
10 Drug therapy/counselling to prevent heart attacks and strokes ◐

Armenia
2 925 000 93% 26 300 22%




B saturated fatty acids and trans-fats policies ◐

NR No Response

Australia
24 126 000 89% 142 700 9%


E mass media campaigns ●



DK Don’t know

Austria
8 712 000 92% 74 400 11%


B smoke-free policies ○


10 Drug therapy/counselling to prevent heart attacks and strokes ●

Azerbaijan
9 725 000 87% 54 100 22%

1 National NCD targets and indicators ◐


B advertising bans or comprehensive restrictions NR


NR No Response

Bahamas
391 000 74% 1 800 15%


A increased excise taxes and prices NR




Bahrain
1 425 000 83% 2 300 11%




A salt/sodium policies ●

Bangladesh
163 000 000 67% 572 600 22%





Barbados
285 000 83% 2 700 16%






Belarus
9 480 000 91% 107 500 24%





Belgium
11 358 000 86% 94 900 11%





Belize
367 000 67% 1 400 22%





DK Don’t know

Benin
10 872 000 36% 35 100 20%





Bhutan
798 000 69% 3 200 23%


A increased excise taxes and prices NA



NA Not applicable

Bolivia (Plurinational State of)
10 888 000 64% 45 900 17%





Bosnia and Herzegovina
3 517 000 94% 36 300 18%






Botswana
2 250 000 46% 7 200 20%





Brazil
207 700 000 74% 975 400 17%





Brunei Darussalam
423 000 85% 1 400 17%


A increased excise taxes and prices NA



NA Not applicable

Bulgaria
7 131 000 95% 101 300 24%



C increased excise taxes NR


NR No Response

Burkina Faso
18 646 000 33% 52 100 22%





Burundi
10 524 000 32% 30 500 23%





Cabo Verde
540 000 70% 2 100 17%





Cambodia
15 762 000 64% 59 900 21%



A restrictions on physical availability NR


NR No Response

Cameroon
23 439 000 35% 82 700 22%





† = see Explanatory Notes NR No Response

Canada
36 290 000 88% 226 200 10%





NR No Response

Central African Republic
4 595 000 26% 15 600 23%





NR No Response

Chad
14 453 000 27% 47 400 24%





Chile
17 910 000 85% 92 900 12%





China
1 404 000 000 89% 9 259 000 17%





Colombia
48 653 000 75% 211 400 16%





NR No Response

Comoros
796 000 42% 2 400 23%




9 Guidelines for management of cancer, CVD, diabetes and CRD DK


Congo
5 126 000 35% 13 300 17%




C marketing to children restrictions DK

DK Don’t know

Cook Islands
17 000 - - -





Costa Rica
4 857 000 83% 20 500 12%





Côte d’Ivoire
23 696 000 37% 102 900 29%





Croatia
4 213 000 92% 47 600 17%





Cuba
11 476 000 84% 82 400 16%





NR No Response

Cyprus
1 170 000 91% 7 500 11%






Czechia
10 611 000 90% 96 900 15%





DK Don’t know

Democratic People’s
Republic of Korea
25 369 000 84% 186 100 26%




† = see Explanatory Notes NR No Response DK Don’t know

Democratic Republic
of the Congo
78 736 000 28% 207 500 19%



B saturated fatty acids and trans-fats policies NR


Denmark
5 712 000 90% 46 400 11%





Djibouti
942 000 44% 3 300 20%






Dominica
74 000 - - -





Dominican Republic
10 649 000 72% 47 500 19%





Ecuador
16 385 000 72% 60 700 13%





NR No Response

Egypt
95 689 000 84% 511 500 28%





El Salvador
6 345 000 74% 31 100 14%





Equatorial Guinea
1 221 000 36% 4 200 22%






Eritrea
4 955 000 45% 15 500 24%






Estonia
1 312 000 93% 14 200 17%





Eswatini
1 343 000 37% 4 800 27%





Ethiopia
102 400 000 39% 275 000 18%





Fiji
899 000 84% 5 500 31%






Finland
5 503 000 93% 49 700 10%





France
64 721 000 88% 488 500 11%





Gabon
1 980 000 41% 6 200 14%






Gambia
2 039 000 34% 5 300 20%






Georgia
3 925 000 94% 53 200 25%





Germany
81 915 000 91% 839 500 12%





Ghana
28 207 000 43% 94 400 21%






Greece
11 184 000 86% 104 400 12%





DK Don’t know

Grenada
107 000 81% 630 21%





Guatemala
16 582 000 59% 47 500 15%





NR No Response

Guinea
12 396 000 35% 41 100 22%





NR No Response

Guinea-Bissau
1 816 000 30% 5 000 20%






Guyana
773 000 68% 4 400 31%





Haiti
10 847 000 57% 52 700 27%






Honduras
9 113 000 66% 26 200 14%





Hungary
9 753 000 94% 119 200 23%





NR No Response

Iceland
332 000 90% 2 000 9%





India
1 324 000 000 63% 5 995 000 23%





NR No Response

Indonesia
261 100 000 73% 1 365 000 26%





Iran (Islamic Republic of)
80 277 000 82% 304 400 15%





Iraq
37 203 000 55% 103 800 21%






Ireland
4 726 000 91% 27 800 10%





Israel
8 192 000 86% 38 200 10%





Italy
59 430 000 91% 584 700 10%





Jamaica
2 881 000 80% 15 800 15%





NR No Response

Japan
127 700 000 82% 1 080 000 8%




8 Public education and awareness campaign on physical activity DK

DK Don’t know

Jordan
9 456 000 78% 28 500 19%





Kazakhstan
17 988 000 86% 127 200 27%





NR No Response

Kenya
48 462 000 27% 77 100 13%





Kiribati
114 000 64% 510 28%






Kuwait
4 053 000 72% 8 000 17%






Kyrgyzstan
5 956 000 83% 30 100 25%





Lao People’s Democratic
Republic
6 758 000 60% 28 200 27%




NR No Response

Latvia
1 971 000 92% 25 500 22%





Lebanon
6 007 000 91% 34 700 18%





Lesotho
2 204 000 32% 9 700 27%






Liberia
4 614 000 31% 11 500 18%





Libya
6 293 000 72% 24 200 20%





Lithuania
2 908 000 90% 36 700 21%





Luxembourg
576 000 88% 3 500 10%






Madagascar
24 895 000 43% 67 400 23%






Malawi
18 092 000 32% 38 900 16%






Malaysia
31 187 000 74% 113 400 17%






Maldives
428 000 84% 1 100 13%





Mali
17 995 000 30% 56 100 25%






Malta
429 000 90% 3 200 11%





NR No Response

Marshall Islands
53 000 - - -





Mauritania
4 301 000 37% 12 000 18%





DK Don’t know

Mauritius
1 262 000 89% 8 900 23%






Mexico
127 500 000 80% 521 800 16%





NR No Response

Micronesia
(Federated States of)
105 000 75% 480 26%




Monaco
38 000 - - -





Mongolia
3 027 000 80% 14 900 30%





NR No Response

Montenegro
629 000 95% 6 200 21%






Morocco
35 277 000 80% 144 900 12%





Mozambique
28 829 000 27% 69 100 18%





NR No Response

Myanmar
52 885 000 68% 291 600 24%





NR No Response

Namibia
2 480 000 41% 7 700 21%






Nauru
11 000 - - -





Nepal
28 983 000 66% 121 100 22%





NR No Response

Netherlands
16 987 000 90% 133 500 11%





New Zealand
4 661 000 89% 27 400 10%




A salt/sodium policies DK

DK Don’t know

Nicaragua
6 150 000 76% 22 300 14%

4 National integrated NCD policy/strategy/action plan DK




DK Don’t know

Niger
20 673 000 27% 53 800 20%






Nigeria
186 000 000 29% 617 300 22%





Niue
1 600 - - -





North Macedonia
2 081 000 95% 19 200 20%





DK Don’t know

Norway
5 255 000 87% 35 600 9%





Oman
4 425 000 72% 8 100 18%





Pakistan
193 200 000 58% 811 300 25%





Palau
22 000 - - -





Panama
4 034 000 75% 15 200 13%





Papua New Guinea
8 085 000 56% 31 400 30%





Paraguay
6 725 000 74% 27 000 18%





DK Don’t know

Peru
31 774 000 69% 119 400 13%





NR No Response

Philippines
103 300 000 67% 446 300 27%





Poland
38 224 000 90% 354 100 19%





DK Don’t know

Portugal
10 372 000 86% 91 800 11%





Qatar
2 570 000 69% 2 700 15%





Republic of Korea
50 792 000 80% 224 400 8%





Republic of Moldova
4 060 000 90% 42 200 25%





Romania
19 778 000 92% 237 300 21%





Russian Federation
144 000 000 87% 1 635 000 25%





Rwanda
11 918 000 44% 29 100 18%





Saint Kitts and Nevis
55 000 - - -





Saint Lucia
178 000 82% 1 100 19%





Saint Vincent
and the Grenadines
110 000 81% 720 23%




Samoa
195 000 81% 770 21%




9 Guidelines for management of cancer, CVD, diabetes and CRD NR


San Marino
33 000 - - -





Sao Tome and Principe
200 000 55% 620 19%





NR No Response

Saudi Arabia
32 276 000 73% 83 100 16%





Senegal
15 412 000 42% 39 700 18%






Serbia
8 820 000 95% 101 500 19%





NR No Response

Seychelles
94 000 81% 630 21%





Sierra Leone
7 396 000 33% 29 700 30%





Singapore
5 622 000 74% 20 900 9%





DK Don’t know

Slovakia
5 444 000 89% 45 600 17%





Slovenia
2 078 000 88% 17 700 13%





Solomon Islands
599 000 69% 1 900 24%






Somalia
14 318 000 24% 40 000 22%





South Africa
56 015 000 51% 269 500 26%





DK Don’t know

South Sudan
12 231 000 27% 33 100 20%





NR No Response

Spain
46 348 000 91% 382 700 10%





Sri Lanka
20 798 000 83% 118 700 17%





NR No Response

Sudan
39 579 000 52% 147 100 26%





Suriname
558 000 76% 3 000 22%





DK Don’t know

Sweden
9 838 000 90% 82 000 9%





Switzerland
8 402 000 90% 60 700 9%





Syrian Arab Republic
18 430 000 45% 67 800 22%





Tajikistan
8 735 000 69% 31 900 25%





Thailand
68 864 000 74% 399 100 14%





Timor-Leste
1 269 000 45% 3 300 20%






Togo
7 606 000 38% 24 300 24%






Tonga
107 000 83% 520 23%





Trinidad and Tobago
1 365 000 81% 9 800 21%






Tunisia
11 403 000 86% 61 900 16%





NR No Response

Turkey
79 512 000 89% 407 300 16%





Turkmenistan
5 663 000 76% 30 100 29%





Tuvalu
11 000 - - -





Uganda
41 488 000 33% 97 600 22%





Ukraine
44 439 000 91% 578 200 25%





United Arab Emirates
9 270 000 77% 11 600 17%





United Kingdom
65 789 000 89% 533 100 11%





NR No Response

United Republic of Tanzania
55 572 000 33% 134 600 18%






United States of America
322 200 000 88% 2 474 000 15%





DK Don’t know

Uruguay
3 444 000 85% 27 800 17%






Uzbekistan
31 447 000 84% 143 500 25%






Vanuatu
270 000 74% 980 23%





Venezuela
(Bolivarian Republic of)
31 568 000 70% 125 800 18%





Viet Nam
94 569 000 77% 424 000 17%





Yemen
27 584 000 57% 98 600 31%





Zambia
16 591 000 29% 36 400 18%





Zimbabwe
16 150 000 33% 42 900 19%





Appendix 1.
Indicator Definitions
and Specifications

Member State has set time-bound national targets
Indicator 1
based on WHO guidance
Definition Country has set national NCD targets. The NCD-related targets should
be time-bound and based on the 9 voluntary global targets and the
WHO Global Monitoring Framework.
Data collection tool and WHO NCD Country Capacity Survey tool – The NCD CCS is
achievement criteria completed by a team at the country level to ensure a comprehensive
response is compiled.
This indicator is considered fully achieved if a country responds “Yes”
to the question “Are there a set of time-bound national targets
for NCDs based on the 9 voluntary global targets from the WHO
Global Monitoring Framework for NCDs?”, and provides the needed
supporting documentation. Targets must be time-bound, based on the
9 global targets, and need to address NCD mortality, as well as key risk
factors in the country and/or health systems.
This indicator is considered partially achieved if the country responds
“Yes” to the question “Are there a set of time-bound national targets
for NCDs based on the 9 voluntary global targets from the WHO
Global Monitoring Framework for NCDs ?”, but the targets do
not cover two of the three areas addressed in the 9 global targets
(including mortality) or they are not time-bound.
Data validation process Countries are asked to submit a copy of their targets when submitting
their response to the NCD CCS. WHO will confirm that document
provided is indeed a set of national NCD targets, addressing NCD
mortality, as well as key risk factors in the country, and/or health
systems, based on the 9 global targets, and that these targets
are time-bound (e.g. include such language as “by 2025”). Where
discrepancies are noted, these are referred back to the country for
clarification and modification.
Expected frequency Every 2 years.

of data collection
Links to tool http://www.who.int/ncds/surveillance/ncd-capacity/en/
206
Member State has a functioning system for generating
Indicator 2
reliable cause-specific mortality data on a routine basis
Definition Country has a vital registration system that captures deaths and
the causes of death routinely. The International Form of Medical
Certificate of the Cause of Death is completed by certifiers. The
International Classification of Diseases (ICD) is used to code the causes
of death. The data compiled are made available to policy-makers and
researchers.
Data collection tool and The WHO collects mortality data, including cause of death, from civil
achievement criteria registration systems in the WHO mortality database through a routine
annual call for data. Data are considered to generate reliable cause-
specific mortality data on a routine basis if:
• Data from the five most recent reporting years are, on average,
at least 70% usable. Usability is calculated as
(Completeness (%))*(1- Proportion Garbage)1
• At least five years of cause-of-death data have been reported to
the WHO in the last 10 years.
• The most recent year of data reported to the WHO is no more
than five years old.
This indicator is considered fully achieved if the country meets all of
the above criteria.
This indicator is considered partially achieved if the country does not
meet all of the above criteria but has submitted some vital registration
data to WHO.
Data validation process Data submitted are verified and inconsistencies are referred back to
countries to resolve.
Expected frequency Yearly

of data collection
Links to tool http://www.who.int/healthinfo/tool_cod_2010.pdf
1 For further details, see page 5 of the following document: http://www.who.int/healthinfo/global_burden_disease/GlobalCOD_

method_2000_2015.pdf
207
Member State has a STEPS survey or a comprehensive
Indicator 3
health examination survey every 5 years
Definition Country has completed a STEPS survey or another risk factor survey
which includes physical measurements and biochemical assessments
covering the key behavioural and metabolic risk factors for NCDs.
Country must indicate that survey frequency is at least every 5 years.
This indicator is considered fully achieved if the country responds
“Yes” to each of the following for adults: “Have surveys of risk factors
(may be a single RF or multiple) been conducted in your country for
all of the following:” “Harmful alcohol use” (optional for the Member
States where there is a ban on alcohol), “Physical inactivity”, “Tobacco
use”, “Raised blood glucose/diabetes”, “Raised blood pressure/
hypertension”, “Overweight and obesity”, and “Salt / Sodium intake”.
For risk factors “Raised blood glucose/diabetes”, “Raised blood
pressure/hypertension”, and “Overweight and obesity”, the data must
be measured, not self-reported. Additionally, for each risk factor, the
country must indicate that the last survey was conducted in the past 5
years (i.e. 2014 or later for the 2019 CCS survey responses) and must
respond “Every 1 to 2 years” or “Every 3 to 5 years” to the subquestion
“How often is the survey conducted?”. The country must also provide
the needed supporting documentation.
that at least 3, but not all, of the above risk factors are covered, or
the surveys were conducted more than 5 years ago but less than 10
years ago.
Data validation process Countries are asked to submit a copy of their survey report(s) when
submitting their response to the NCD CCS. Where discrepancies are
noted, these are referred back to the country for clarification and
modification. Data are also checked against the STEPS tracking system
which records details of STEPS surveys undertaken by countries.
Expected frequency Every 2 years

of data collection
208
Member State has an operational multisectoral
Indicator 4 national strategy/action plan that integrates the
major NCDs and their shared risk factors
Definition Country has a multisectoral, national integrated NCD and risk

factor policy/strategy/action plan that addresses the 4 main NCDs
(cardiovascular diseases, diabetes, cancer, chronic respiratory disease)
and their main risk factors (tobacco use, unhealthy diet, physical
inactivity, harmful use of alcohol).
“Multisectoral” refers to engagement with one or more government
sectors outside of health. “Operational” refers to a policy, strategy or
action plan which is being used and implemented in the country, and
has resources and funding available to implement it.
“Yes” to the questions “Does your country have a national NCD
policy, strategy or action plan which integrates several NCDs and
their risk factors?” and to the subquestion “ Is it multisectoral?”.
Countries also have to respond “operational” to the subquestion
“Indicate its stage” and “Yes” to all of the subquestions pertaining
to the 4 main risk factors and 4 main NCDs: “Does it address one or
more of the following major risk factors?” “Harmful use of alcohol”
(optional for the Member States where there is a ban on alcohol),
“Unhealthy diet”, “Physical inactivity”, “tobacco” (all 4 must have
“Yes”) and “Does it combine early detection, treatment and care for:”
“Cancer”, “Cardiovascular diseases”, “Chronic respiratory diseases”
and “Diabetes” (all 4 must have “Yes”). Country must also provide the
needed supporting documentation.
“Yes” to the questions “Does your country have a national NCD policy,
strategy or action plan which integrates several NCDs and their risk
factors?” and to the subquestion “ Is it multisectoral?”. Countries also
have to respond “operational” to the subquestion “Indicate its stage”
and “Yes” to at least two of the 4 main risk factors and at least two of
the 4 main NCDs.
Data validation process Countries are asked to submit a copy of their policy/strategy/
action plan when submitting their response to the NCD CCS. Where

of data collection
209
Member State has implemented measures to
Indicator 5A reduce affordability by increasing excise taxes
and prices on tobacco products
Definition Country has total taxes set at a level that accounts for more than 75%
of the retail price of tobacco products.
Data collection tool and Data collected from governments for the production of the WHO
achievement criteria Report on the Global Tobacco Epidemic.
Total taxes (including excise tax, value added/sales tax, import duties
(where applicable) and any other taxes levied) are calculated as a
proportion of the price of the tobacco product. Currently, this is
calculated in relation to the most sold brand of cigarettes.
This indicator is considered fully achieved if the country has total taxes
more than 75% of the price of the most sold brand of cigarettes.
This indicator is considered partially achieved if the country has total
taxes from 51% up to 75% of the retail price of the most sold brand
of cigarettes.
Data validation process WHO assessment is shared with national authorities for review and
approval.

of data collection
Links to tool http://www.who.int/tobacco/global_report/

https://www.who.int/tobacco/global_report/Technical-note-I.pdf?ua=1
210
Member State has implemented measures to eliminate
Indicator 5B exposure to second-hand tobacco smoke in all indoor
workplaces, public places and public transport
Definition Country has all public places completely smoke-free (or at least
90% of the population covered by complete subnational smoke-free
legislation).“Completely” means that smoking is not permitted, with no
exemptions allowed, except in residences and indoor places that serve
as equivalents to long-term residential facilities, such as prisons and
long-term health and social care facilities such as psychiatric units and
nursing homes. Ventilation and any form of designated smoking rooms
and/or areas do not protect from the harms of second-hand tobacco
smoke, and the only laws that provide protection are those that result
in the complete absence of smoking in all public places.
Data collection tool and Legal instruments are analysed for the production of the WHO Report
achievement criteria on the Global Tobacco Epidemic.
Legislation is assessed to determine whether smoke-free laws provided
for a complete indoor smoke-free environment at all times, in all the
facilities of each of the following eight places: health care facilities;
educational facilities other than universities; universities; government
facilities; indoor offices and workplaces not considered in any other
category; restaurants or facilities that serve mostly food; cafes, pubs
and bars or facilities that serve mostly beverages; public transport.
This indicator is considered fully achieved if all public places in the
country are completely smoke-free (or at least 90% of the population
covered by complete subnational smoke-free legislation).
This indicator is considered partially achieved if three to seven public
places are completely smoke-free, or the law allows designated smoking
rooms with strict technical requirements in five or more places.
approval.

of data collection

211
Member State has implemented plain/
Indicator 5C standardized packaging and/or large graphic
health warnings on all tobacco packages
Definition Country mandates plain/standardized packaging and/or large graphic

warnings with all appropriate characteristics. Appropriate characteristics
for large graphic warnings include:
• specific health warnings mandated;
• appearing on individual packages as well as on any outside
packaging and labelling used in retail sale;
• describing specific harmful effects of tobacco use on health;
• are large, clear, visible and legible (e.g. specific colours and font
style and sizes are mandated);
• rotating health warnings and/or messages;
• pictures or pictograms; and
• written in (all) the principal language(s) of the country.
Appropriate characteristics for plain/standardized packaging include:
• restrictions or prohibitions on the use of logos, colours, brand images
or promotional information on packaging other than brand names
and product names displayed in a standard colour and font style;
• standardized shape, size and materials of tobacco packaging; and
• no advertising or promotion inside or attached to the package or
tobacco product.
Data collection tool and Legislation is assessed to determine the size of the warnings (the
achievement criteria front and back of the cigarette pack are averaged to calculate the
percentage of the total pack surface area covered by warnings) and
warning characteristics.
This indicator is considered fully achieved if the country has plain/
standardized packaging and/or large graphic health warnings which
are defined as covering on average at least 50% of the front and back
of the package with all appropriate characteristics as detailed above.
This indicator is considered partially achieved if there are medium-size
warnings, which are defined as covering on average between 30 and
49% of the front and back of package, with some or all appropriate
characteristics, or large warnings that are missing some appropriate
characteristics.
approval.

of data collection

212
Member State has enacted and enforced
Indicator 5D comprehensive bans on tobacco advertising,
promotion and sponsorship
Definition Country has a ban on all forms of direct and indirect advertising.
Direct advertising bans include: national television and radio; local
magazines and newspapers; billboards and outdoor advertising; point
of sale. Indirect advertising bans include: free distribution of tobacco
products in the mail or through other means; promotional discounts;
non-tobacco products identified with tobacco brand names (brand
stretching); brand names of non-tobacco products used for tobacco
products (brand sharing); appearance of tobacco brands (product
placement) or tobacco products in television and/or films; and
sponsorship (contributions and/or publicity of contributions).
Data collection tool and Legislation is assessed to determine whether the law completely bans
achievement criteria all forms of direct and indirect tobacco advertising, promotion and
sponsorship.
This indicator is considered fully achieved if the country has a ban on
all forms of direct and indirect advertising.
This indicator is considered partially achieved if the country has a ban
on national TV, radio and print media, but not on all other forms of
direct and/or indirect advertising.
approval.

of data collection

213
Member State has implemented effective
Indicator 5E mass media campaigns that educate the public about the
harms of smoking/tobacco use and second-hand smoke
Definition Country has implemented a national anti-tobacco mass media

campaign designed to support tobacco control, of at least 3
weeks duration with all appropriate characteristics. Appropriate
characteristics include:
• campaign was part of a comprehensive tobacco control
programme;
• before the campaign, research was undertaken or reviewed to
gain a thorough understanding of the target audience;
• campaign communications materials were pre-tested with the
target audience and refined in line with campaign objectives;
• air time (radio, television) and/or placement (billboards, print
advertising, etc.) was obtained by purchasing or securing it using
either the organization’s own internal resources or an external
media planner or agency (this information indicates whether
the campaign adopted a thorough media planning and buying
process to effectively and efficiently reach its target audience);
• the implementing agency worked with journalists to gain
publicity or news coverage for the campaign;
• process evaluation was undertaken to assess how effectively the
campaign had been implemented;
• an outcome evaluation process was implemented to assess
campaign impact; and
• the campaign was aired on television and/or radio.
Data collection tool and Eligible campaigns are assessed according to the appropriate
achievement criteria characteristics to determine whether it signifies the use of a
comprehensive communication approach.
This indicator is considered fully achieved if the country has a
campaign conducted with at least seven appropriate characteristics
including airing on television and/or radio.
This indicator is considered partially achieved if the country has a
campaign conducted with one to six of the appropriate characteristics.
approval.

of data collection

214
Member State has enacted and enforced
Indicator 6A restrictions on the physical availability of retailed
alcohol (via reduced hours of sale)
Definition Country has a licensing system or monopoly on retail sales of beer,

wine, spirits.
Country has restrictions for on-/off-premise sales of beer, wine, spirits
regarding hours, days and locations of sales.
Country has legal age limits for being sold and served alcoholic
beverages.
Data collection tool and Data is collected through the WHO Global survey on progress on SDG
achievement criteria health target 3.5.
This indicator is considered fully achieved if:
• a licensing system or monopoly exists on retail sales of beer, wine
and spirits;
• restrictions exist for on- and off-premise sales of beer, wine, and
spirits regarding hours and locations of sales and restrictions exist
for off-premise sales of beer, wine, and spirits regarding days of
sales; and
• legal age limits for being sold and served alcoholic beverages are
18 years or above for beer, wine, and spirits.
This indicator is considered partially achieved if there are any, but not
all, positive responses to the three indicators above.
Data validation process Focal points, officially nominated by the Ministry of Health, respond to
the Global survey on progress on SDG health target 3.5. Responses are
reviewed and validated by WHO, and subsequently endorsed by the
Member States.
Expected frequency Every 3-4 years

of data collection
Links to tool https://www.who.int/substance_abuse/activities/survey_

health3.5_2019.pdf?ua=1
215
Member State has enacted and enforced bans or
Indicator 6B comprehensive restrictions on exposure to alcohol
advertising (across multiple types of media)
Definition Country has regulatory or co-regulatory frameworks for alcohol

advertising through different channels (public service/national TV,
commercial/private TV, national radio, local radio, print media,
billboards, points of sale, cinema, internet, social media).
Country has a detection system for infringements on marketing
restrictions.
• restrictions exist on alcohol advertising for beer, wine, and spirits
through all channels; and
• detection system exists for infringements on marketing
restrictions.
This indicator is considered partially achieved if there are restrictions
on at least public service/national TV, national radio and billboards but
no detection system exists for infringements.
Data validation process Focal points, officially nominated by the Ministry of Health, respond
to the Global survey on progress on SDG health target 3.5. Responses
are reviewed and validated by WHO, and subsequently endorsed by
the Member States.

of data collection

216
Member State has increased excise taxes
Indicator 6C
on alcoholic beverages
Definition Country has excise tax on beer, wine, spirits.

Country adjusts level of taxation for inflation for alcoholic beverages.
• excise tax on all alcoholic beverages (beer, wine, and spirits) is
implemented;
• there are no tax incentives or rebates for production of other
alcoholic beverages; and
• adjustment of level of taxation for inflation for beer, wine, and
spirits is implemented.
This indicator is considered partially achieved if there is excise tax on
alcoholic beverages as specified above.
Data validation process Focal points, officially nominated by the Ministry of Health, respond to
the Global survey on progress on SDG health target 3.5. Responses are
reviewed and validated by WHO, and subsequently endorsed by the
Member States.

of data collection

217
Member State has adopted national policies
Indicator 7A
to reduce population salt/sodium consumption
Definition Country has implemented national policies to reduce population

salt/sodium consumption, including reformulation of food products;
establishment of a supportive environment in public institutions to
enable lower sodium options to be provided; behaviour change
communication and mass media campaigns; and front-of-pack
labelling.
“Yes” to the question “Is your country implementing any policies to
reduce population salt consumption?” and to the subquestions “Are
these targeted at: product reformulation by industry across the food
supply; regulation of salt content of food served in specific settings
such as hospitals, schools, workplaces; public awareness programme;
front-of-pack nutrition labeling? (must have “Yes” to product
reformulation by industry across the food supply and/or regulation of
salt content of food, and “Yes” to public awareness programme and
nutrition labeling”). Country must also provide the needed supporting
documentation.
reduce population salt consumption?”, and “Yes” to at least one of
the four subquestions “Are these targeted at: product reformulation
by industry across the food supply; regulation of salt content of food
served in specific settings such as hospitals, schools, workplaces;
public awareness programme; front-of-pack nutrition labeling?”.
Data validation process Countries are asked to submit a copy of their policy(ies) when
submitting their response to the NCD CCS. Responses are cross-
validated with data obtained through the Global Nutrition Policy
Review and the WHO Global database on the Implementation of
Nutrition Action (GINA). Where discrepancies are noted, these are
referred back to the country for clarification and modification.

of data collection
218
Member State adopted national policies
Indicator 7B that limit saturated fatty acids and virtually eliminate
industrially produced trans-fatty acids in the food supply
Definition Country has implemented a policy(ies) to limit saturated fatty acids and
virtually eliminate industrially produced trans-fats in the food supply.
“Yes” to the questions “Is your country implementing any national
policies to reduce population saturated fatty acid intake?” and “Is your
country implementing any national policies to eliminate industrially
produced trans-fatty acids (i.e. partially hydrogenated oils) in the food
supply?”, and provides the needed supporting documentation.
“Yes” to either of the aforementioned questions.

of data collection
219
Member State has implemented the WHO set of
Indicator 7C recommendations on marketing of foods and non-
alcoholic beverages to children
Definition Country has implemented a policy(ies) to reduce the impact on

children of marketing of foods and non-alcoholic beverages high in
saturated fats, trans-fatty acids, free sugars, or salt.
reduce the impact on children of marketing of foods and non-alcoholic
beverages high in saturated fats, trans-fatty acids, free sugars, or
salt?”, and provides the needed supporting documentation.

of data collection
220
Member State has legislation/regulations fully
Indicator 7D implementing the International Code of Marketing of
Breast-milk Substitutes
Definition Country has implemented legislation/regulations that fully implement

the International Code of Marketing of Breast-milk Substitutes.
Data collection tool and Copies of all laws and regulations on the International Code of
achievement criteria Marketing of Breast-milk Substitutes are compiled by WHO every
two years. WHO routinely requests countries to submit copies of
Code legislation when they learn of changes. Additionally, copies of
legislation were obtained from UNICEF and IBFAN/ICDC and legal
databases (Lexis/Nexis and FAO-LEX), EUR-LEX, national gazettes and
internet search engines.
This indicator is considered fully achieved if the country is assessed as
having national legal measures categorized as “full provisions in law”,
whereby countries have enacted legislation or adopted regulations,
decrees or other legally binding measures encompassing all or nearly
all provisions of the Code and subsequent WHA resolutions.
This indicator is considered partially achieved if the country is assessed
as having national legal measures categorized as “many provisions
in law” or “few provisions in law”, whereby countries have enacted
legislation or adopted regulations, decrees or other legally binding
measures encompassing many or few provisions of the Code and
subsequent WHA resolutions.
Data validation process WHO, UNICEF, and IBFAN/ICDC analyse all legislation and
regulations to determine which provisions of the Code were covered.
All three organizations agree upon the categorization based on the
provisions included.

of data collection
Links to tool https://apps.who.int/iris/bitstream/hand

le/10665/272649/9789241565592-eng.pdf?ua=1
221
Member State has implemented at least one recent
national public awareness programme and motivational
Indicator 8
communication for physical activity, including mass media
campaigns for physical activity behavioural change
Definition Country has implemented at least one recent (within the past 2 years)
national public awareness programme on physical activity.
“Yes” to the following question: “Has your country implemented any
national public education and awareness campaign on physical activity
within the past 2 years?” and supporting documents provide clear
evidence demonstrating that one or more of the following activities
have been undertaken within the past 2 years:
1. national public-facing mass media education and awareness
campaign on physical activity, AND/OR
2. national promotional initiatives supporting a regional or multi-
country physical activity (sports) campaigns aimed at increasing
awareness and encouraging participation in physical activity (e.g.
European Sports Week, Caribbean Wellness Week), AND/OR
3. regular promotional days, held across the year, on physical
activity either using the same theme (e.g. “car-free” Sundays) or
a physical activity theme is clearly linked with the implementation
of multiple health promotion days (e.g. World Heart Day, World
Diabetes Day). Undertaking a single promotional day per year is
not sufficient to fulfil this criteria.
This indicator is considered partially achieved if the supporting
documents provide evidence demonstrating that the country has
implemented in the past 2 years one or more community-based
initiatives or programmes promoting physical activity and/or
increasing access to opportunities for physical activity in community
settings (e.g. through schools, parks, workplace, health care) but
without any evidence of a public-facing mass media education and
awareness campaign.
Data validation process Countries are asked to submit a copy of any documentation of the
programme and/or a link to the programme website when submitting
their response to the NCD CCS. Where discrepancies are noted, these
are referred back to the country for clarification and modification.

of data collection
222
Member State has evidence-based national guidelines/
protocols/standards for the management of major NCDs
Indicator 9
through a primary care approach, recognized/approved by
government or competent authorities
Definition Government approved evidence-based national guidelines/protocols/

standards for the management (diagnosis and treatment) of the four
main NCDs – cardiovascular diseases, diabetes, cancer and chronic
respiratory diseases.
This indicator is based on the number of countries who indicate
that national guidelines/protocols/standards exist for all four NCDs
(cardiovascular diseases, diabetes, cancer and chronic respiratory
diseases).
This indicator is considered fully achieved if national guidelines/
protocols/standards exist for all four NCDs (cardiovascular diseases,
diabetes, cancer and chronic respiratory diseases), and the country
provides the needed supporting documentation.
This indicator is considered partially achieved if the country has
guidelines/protocols/standards for at least two of the four NCDs
(cardiovascular diseases, diabetes, cancer and chronic respiratory
diseases), but not for all four.
Data validation process Countries are asked to submit a copy of the guidelines/protocols/
standards when submitting their response to the NCD CCS. Where

of data collection
223
Member State has provision of drug therapy, including
glycaemic control, and counselling for eligible persons
Indicator 10
at high risk to prevent heart attacks and strokes, with
emphasis on the primary care level
Definition Country has provision of drug therapy (including glycaemic control

for diabetes mellitus and control of hypertension using a total risk
approach), and counselling to individuals who have had a heart attack
or stroke and to persons with high risk (≥ 30%, or ≥20%) of a fatal and
non-fatal cardiovascular event in the next 10 years.
This indicator is based on the number of countries who respond
“more than 50%” to the question “What proportion of primary health
care facilities are offering cardiovascular risk stratification for the
management of patients at high risk for heart attack and stroke?”.
Additionally, countries must have said all the following drugs were
“generally available” in the primary care facilities of the public health
sector: insulin, aspirin, metformin, thiazide diuretics, ACE inhibitors or
Angiotensin II receptor blockers (at least one of the two), CC blockers,
statins, and sulphonylurea(s).
This indicator is considered fully achieved if the country reports
that more than 50% of primary health care facilities are offering
cardiovascular risk stratification for the management of patients at
high risk for heart attack and stroke and that all drugs listed above
were generally available in the primary care facilities of the public
health sector.
This indicator is considered partially achieved if the country reports
that between 25% to 50% of primary health care facilities are offering
cardiovascular risk stratification for the management of patients at
high risk for heart attack and stroke and that all of the drugs listed
above were generally available in the primary care facilities of the
public health sector.
Data validation process NCD focal points, officially nominated by the Ministry of Health,
provide the official response to WHO through the NCD Country
Capacity Survey tool.

of data collection
224
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ISBN 978-92-4-000049-0 (electronic version)

© World Health Organization 2020

Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris.

Contributions to the report were made by the following colleagues in

Sincere thanks to all WHO Member States for their assistance in

Noncommunicable diseases are the leading cause of premature death

WHO has developed ‘best buys’ – a set of 16 practical and cost-

Primary health care, with its emphasis on promoting health and

I have often said that political leadership is essential for making

It’s therefore not a question of whether countries can afford to

TEDROS ADHANOM GHEBREYESUS

World Health Organization - Noncommunicable Diseases Progress Monitor 2020 vi

In May 2015 the World Health Organization published a Technical Note

Member State has set time-

Member State has a functioning system

Member State has a STEPS survey or

A Reduce affordability by increasing

Eliminate exposure to second-

Enact and enforce comprehensive

E Implement effective mass media

World Health Organization - Noncommunicable Diseases Progress Monitor 2020 2

Enact and enforce bans or

Member State has implemented

WHO set of recommendations

Member State has

World Health Organization - Noncommunicable Diseases Progress Monitor 2020 3

Progress monitoring indicators

Details of the progress monitoring indicators, including detailed

Assessment of indicators 1, 3, 4, 7a, 7b, 7c, 8, 9 and 10 were taken

Assessment of indicators 7a, 7b and 7c were additionally reviewed

Assessment of indicator 2 related to the system for generating

Assessment of indicator 5 was based on data collected from Member

Indicator 6 achievement status was based on the responses of country

Indicator 7d achievement status was based on the analysis by WHO,

The 2016 population estimates from the 2017 United Nations

Percentage of deaths from NCDs and total number of NCD deaths

The risk of premature death from target NCDs presented in the

2. World Population Prospects: The 2017 Revision, Key Findings and

World Health Organization - Noncommunicable Diseases Progress Monitor 2020 9

34 656 000 44% 109 500 30%

1 National NCD targets and indicators ○

3 Risk factor surveys ◐

4 National integrated NCD policy/strategy/action plan ●

5 Tobacco demand-reduction measures:

6 Harmful use of alcohol reduction measures:

7 Unhealthy diet reduction measures:

8 Public education and awareness campaign on physical activity ○

9 Guidelines for management of cancer, CVD, diabetes and CRD ○

10 Drug therapy/counselling to prevent heart attacks and strokes ○

● fully achieved ◐ partially achieved ○ not achieved

World Health Organization - Noncommunicable Diseases Progress Monitor 2020 10

2 926 000 93% 24 300 17%

1 National NCD targets and indicators ●

3 Risk factor surveys ◐

4 National integrated NCD policy/strategy/action plan ●

5 Tobacco demand-reduction measures:

6 Harmful use of alcohol reduction measures:†

7 Unhealthy diet reduction measures: