No Health Without Health Workers: Closing the Gap on NCDs

Noncommunicable disease (NCDs) are the leading cause of death and disability worldwide, claiming at least 43 million lives in 2021 alone according to the World Health Organization. In Sub-Saharan Africa, the growing strain placed on the health system by NCDs has been especially striking with Africa Centres for Disease Control and Prevention data showing that NCDs accounted for 24 per cent of deaths in 2000, rising to 37 per cent by 2019. 

Despite these alarming statistics, health systems in low and middle-income countries (LMICs) remain unprepared. With health workforce shortages projected to reach 11 million by 2030, the capacity to prevent, detect and treat NCDs is limited.  

The upcoming 4th UN High-Level Meeting (HLM) on NCDs, taking place in September 2025 is therefore a pivotal moment for governments and global stakeholders to adopt ambitious yet achievable political declarations towards combating NCDs.  

The Zero Draft Political Declaration – that is, the initial version of the proposed HLM outcome document prepared by the President of the United Nations (UN) General Assembly and co-facilitators – outlines many critical priorities, namely integrated primary healthcare, digital innovation, sustainable financing, and stronger accountability. Whilst all these priorities are necessary, little attention is given to the health workforce itself. Although mentioned briefly in paragraph 37, the draft does not sufficiently acknowledge the truth: there is no health without health workers. The health workforce should be recognised as a central priority in addressing this health emergency. 

Our work in Ethiopia and Kenya delivered through Health Partnerships, has strategically strengthened the health workforce, decentralised care and improved access to NCD services. Through locally led innovations such as cascade training models, community engagement, and integration of mental health into broader NCD care, these initiatives have expanded prevention, screening and treatment services at both the primary and community levels. From our work relating to NCDs in both Ethiopia and Kenya, we have seen the great potential of health partnership initiatives, with both cases highlighting how partnerships, workforce strengthening, and decentralised approaches can produce scalable, sustainable results.  

In Ethiopia, decentralising NCD care to health centres and posts has allowed rural communities to access life-saving services closer to home. Since 2018, over 620 health workers have been trained, with more than a million people benefitting from this rural community outreach and screening.  

In Kenya, integrating mental health into oncology care through a cascade training model, enabled community health promoters to reach thousands with culturally sensitive, stigma-reducing interventions. Patients, health workers and communities alike, reported improved understanding and care.  

These efforts demonstrate that strategically investing in the health workforce, combined with collaborative and context-specific approaches, can enable sustainable and scalable people-centred NCD care in low resource settings. 

Drawing on lessons from this year’s UK-Africa Health Summit hosted by Global Health Partnerships, alongside decades of health partnership work and lived experiences, we recommend the following interventions to improve NCDs at the national and global levels: 

1. Strengthen Strategic Health Workforce Planning: Build inclusive and sustainable career pathways for NCD-specialist roles, while incentivising equitable distribution of health workers, especially in rural areas.  
2. Promote Prevention and Community and Decentralised Models of Care: Empower community health workers to deliver prevention, screening, and ongoing support as well as embed task sharing in primary healthcare systems.  
3. Leverage Digital, Data and Locally Led Innovations: Scale community-appropriate digital tools, strengthen national health information systems, harness diaspora expertise and bi-directional learning partnerships to enhance capacity.  
4. Enable Sustainable Financing for NCD Workforce Interventions: Secure long-term investment in health workforce interventions and align donor resources with national strategies.  

As governments prepare for the 2025 HLM, they face a critical choice. Will they issue another declaration of good intentions, or will they commit to the foundational investment that NCD care truly requires: a resilient, skilled, and supported workforce? 

The answer will determine whether progress on NCDs remains stalled, or whether the next decade sees a decisive shift towards equity, access, and universal health coverage.  

Addressing health workforce gaps ought to be a central priority. Because without health workers, there can be no NCD response.