How to sustainably finance the noncommunicable diseases and mental health response

The case for investment for NCDs and mental health conditions

The staggering scale of the noncommunicable diseases (NCDs) and mental health epidemic results in major economic losses and socioeconomic challenges. Premature deaths and disability reduce human capital and decrease productivity, while simultaneously increasing prevention and treatment costs for people, communities and countries.

Investing in cost-effective, multisectoral health interventions can improve health for all and curb the negative socioeconomic impacts. Economic analysis indicates that investing in cost-effective NCD interventions in low-income countries can generate US$ 230 billion in economic benefits and save close to 7 million lives by 2030.

For every dollar invested in safe and cost-effective NCD policies and programmes there is a return of US$7 per person. Investing in mental health prevention and care is similarly promising: every US$1 invested in treatment for depression and anxiety yields a US$ 4 return in better health and productivity.

Increasing domestic health funding and leveraging development assistance for NCDs and mental health

Yet, funding for NCDs and mental health services remains only a small fraction of health budgets, particularly in many low- and middle-income countries.

For essential NCD and mental health care packages to be implemented, domestic public spending will need to increase substantially. This will allow expanding treatment and prevention services, avoid out-of-pocket payments for individuals, and strengthen equal access to care for all.

Health taxes on harmful products such as tobacco, alcohol, and sugar-sweetened beverages offer a financing mechanism that is triple-effective: they have proven effective in reducing consumption of unhealthy products and improving NCD outcomes, provide much needed income that can be invested in essential health services, and particularly benefit households with lower resources when considering improved health and indirect financial effects.

Development assistance for health remains a powerful financial tool to kick-start NCD and mental health programmes in low-resource settings where major capital investment is needed. Development assistance resources are also well-placed to support public goods such as new medical products, policy tools and innovations in care that facilitate more coordinated and effective action across regions and countries. 

Strategic spending for effective action and impact 

The increased domestic and international financing for NCDs and mental health needs to be strategically invested in evidence-informed, effective and equitable policies and programmes.

Primary health care programmes are the most promising setting for cost-effective interventions. They support more integrated, people-centred approaches to prevention and care, address the broader determinants of health through multisectoral action, and accelerate progress in achieving universal health coverage

To strengthen their health financing mechanisms, governments should further shift away from rigid line-item budgets and fee-for-service models and prioritize coordinated, integrated care for chronic conditions. Increased institutional capacity and digital tools to collaborate across government sectors directly support effective public-sector performance and improve financial protection for people living with NCDs, mental health and neurological conditions.  

Financing for NCDs and mental health: key messages

1. Integrate noncommunicable diseases and mental health responses into public financing systems and improve public financial management through output-based budget processing and by making purchasing of health services more strategic, strengthening fiscal policies, and leveraging taxation to curb the consumption of tobacco, alcohol and sugar-sweetened beverages.
2. Accelerate progress towards universal health coverage by strengthening publicly financed, PHC-based services to enhance financial protection and equitable access to quality care and essential health technologies for people living with noncommunicable diseases and mental health conditions.
3. Prioritize multisectoral investment and action in noncommunicable diseases and mental health as integral to national development plans and international development assistance, enhancing human capital and well-being, boosting inclusive economic growth, reducing impoverishment and mitigating against health system budget pressures.

About the series

This commentary is part of a series highlighting priority areas to accelerate progress in the global NCD and mental health response and address related global health equity challenges ahead of the Fourth High-Level Meeting of the United Nations General Assembly (UNHLM4) in 2025. 

Discover the full series on the Road to 2025 campaign webpage.