The curtain is up on the fourth Global NCD Alliance Forum! It is only five years (almost to the day) since the last Forum, held in Sharjah just as COVID-19 was just beginning to make its presence felt in the headlines. An astonishing amount has changed in global health in the intervening time – but, throughout it all, NCDs have remained a constant threat.

Now is, in fact, the perfect time to bring together advocates for change in NCDs from around the world because in September, the United Nations will hold its fourth High-level Meeting on NCDs (UNHLM). This opportunity is providing real impetus for our three days of presentations, discussions, knowledge-sharing and solutions-building.

The 2025 Global Forum has moved south-west to Rwanda, the first time that the Forum has been held in Sub-Saharan Africa. This beautiful country just south of the equator is providing a lush, green welcome to the 700 delegates who have flown into Kigali from 66 countries.

A challenging moment … but an important opportunity

Our opening session began with a welcome from Nadine Karema, Executive Director, Partners in Health, Rwanda. Dr Monica Arora, President of the NCD Alliance, stressed that governments are falling short on their commitments, with the prevalence of risk factors remaining stubbornly high. This must delight the companies that produce unhealthy products: ‘Profits are still trumping lives.’

Dr Joseph Mucumbitsi, Chairperson of the Rwanda NCD Alliance, highlighted that Rwanda stands at a pivotal moment: progress in maternal and child health and control of communicable diseases has raised healthy life expectancy by over 20 years, but ‘these gains are threatened by the silent and deadly rise of NCDs’.

Next, Dr Gina Agiostratidou, Program Director at the Leona M. and Harry B. Helmsley Charitable Trust, talked about the need to eliminate silos, to keep people with lived experience at the forefront, to build bridges across multiple health issues, and to collaborate with partners across all sectors: ‘I am optimistic that we will look back to this Forum as a turning point for reaching the future.’

After a video message from Dr Tedros Adhanom Ghebreyesus, Director General of WHO, Dr Yvan Butera, Minister of State for Health, Ministry of Health Rwanda, provided some inspiring examples of steps that are making a demonstrable difference in NCD prevention in Rwanda. He then officially opened the Forum, stating that ‘this is a call to action at a pivotal moment in global health’

The opening plenary focused on NCDs in the Africa region. Moderator Dr Githinji Gitahi (CEO of AMREF Health Africa) highlighted the specific challenge of the moment: that the already small investment in NCDs is likely to come under even greater pressure as the world’s aid budgets are dramatically squeezed with ‘the few dollars we have likely to be channelled away to cover the gaps in communicable disease’.

‘NCDs remain one of the greatest health and economic challenges of our time’

– Dr Jean Kaseya, Director General, Africa CDC

A lively panel session heard from Lea Kilenga (Africa Sickle Cell Organisation), who stressed the vital role that civil society involvement has played in progress on NCDs since the last Forum: ‘Civil society is the biggest instrument to uphold the right to health, by empowering community voices.’ Professor Claude Mambo Muvunyi (Rwanda Biomedical Centre) explained how Africa as a region faces many priorities, but that foreign aid has, in the past, focused on infectious disease – which in part explains today’s gap between planning on NCDs and implementation of NCD services. For Dr Kouamivi Agboyibor (WHO AFRO), political engagement is essential as, without this, NCD policies will not be sufficiently adopted, endorsed and financed.

‘Implementation, implementation, implementation!’

– Dr Mary Efua Commeh (Ghana Health Service)

Itete Karagire (East African Community – EAC) introduced the collaborative process behind a new Regional Framework on NCDs, which will guide East Africa’s response to addressing NCDs for the next five years.

Inspiring, mobilising and powering up

The formal proceedings of the day ended with the first of three sets of thematic parallel sessions. Each session is organised by NCD Alliance members and they fall under the three key subthemes of the Forum:

Inspire leadership

• Tailored national strategic planning for NCDs plays a key role in advancing implementation of global targets at country level. Planning should incorporate evidence-based interventions combined with strong, sustained political commitment.[1]
• Law and data can play a vital part in implementing NCD best buys, including in the African region. Legislation may need to be coupled with awareness campaigns to ensure, for example, better compliance with tobacco-control laws – and this is particularly important in rural areas.[2]

‘Implementing laws will cost nothing, but it will reduce the cost of not implementing them’

– Rachel Kitonyo Devotsu (McCabe Centre for Law and Cancer)

Mobilise sustainable financing

• Closing the NCD and mental health financing gap built on last year’s WHO/World Bank Second International Financing Dialogue on NCDs, which was an important chance to engage ministers both of health and of finance. The discussion included a suggestion to look much more closely at the concept of the commercial determinants specifically of mental health.[3]

‘Global health solidarity is very important: richer countries have to help poorer countries meet health justice needs’

– Kwanele Asante (South African NCD Alliance)

• The wide-ranging discussion on the Lusaka Agenda framework to strengthen health systems included a call for the development of regional manufacturing capacity for essential medicines and diagnostics to build resilience in health systems in the African region.[4]
• Effective taxation policies in tobacco and alcohol control provide win-win-wins: generating revenue, reducing consumption, and improving public health. Examples highlighted the importance of shifting the narrative to emphasise the public health and economic benefits of taxation.[5]

Power up communities

• Youth leading the way on NCDs continued discussion begun at the Youth pre-conference session, with examples of successful youth-led campaigns including Nigeria’s Don’t Be Manipulated campaign (engaging youth and celebrities to expose industry tactics targeting young people) and South Africa’s Green Youth Network (mobilising young people around environmental and health awareness).[6]

‘Youth engagement in policy-making isn’t just about being present; it’s about being heard.

We must be bold, strategic, and persistent in challenging systems that exclude us’

– Bintou Camara Bityeki (Campaign For Tobacco Free Kids)

• Meaningful involvement of people living with NCDs is essential as they are the experts in their own conditions. People in conflict situations face a double burden: their health condition and the humanitarian crisis within which they live, which often limits their access to health care.[7]

The day rounded off with a welcome dinner, held in a vast tent next to the already-vast Kigali Conference Centre, complete with singing and dancing, with many of us enthusiastically joining in. Today promises to be just as interesting, with the same sense of community and of hope.

***

A big NCD Alliance thank you to today’s thematic parallel session organisers and rapporteurs:

[1] WHO Rwanda, the Rwanda Biomedical Centre, Rwanda NCD Alliance and Africa CDC. Rapporteur: Aime Manzi.
[2] McCabe Centre for Law and Cancer, the Rwanda NCD Alliance and Development Gateway. Rapporteur: Farah Feteha.
[3] United for Global Mental Health and the World Obesity Federation. Rapporteur: Shitanshu Dhakal.
[4] StopAIDS, WACI Health, CSEM, HFFC and the African Consultancy Bureau. Rapporteur: Heyder Rasheed.
[5] The Global Alliance for Tobacco Control, VALDI/Ghana NCD Alliance, NCD Alliance Lanka, Movendi International and Cancer Research UK. Rapporteur: Juan Camilo Herrera Palacio.
[6] Campaign for Tobacco-Free Kids and Gatefield. Rapporteur: Shaima Yaser Ali Shahrah.
[7] WHO Global Coordination Mechanism. Rapporteur: Chenwi Claris Nchangnwi.

About the author: 

Katy Cooper (X: @healthkaty Bluesky: @healthkaty.bsky.social) is lead rapporteur for this year’s Global Forum, the third time she has taken this role. She brings with her 20 years of experience as an independent consultant and writer in global NCDs. She chairs the UK Working Group on NCDs (a member of the NCD Alliance), which brings together 25 UK civil society organisations to highlight NCDs as a core priority for international development.