How likely are Eastern European and Central Asian Countries to Achieve Global NCD Targets?

Abstract Background In Europe, premature deaths from noncommunicable diseases (NCDs) have declined significantly, except in twelve countries of Eastern Europe and Central Asia (EECA), namely Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine and Uzbekistan. Analyses of the long-term trends of NCD premature mortality in EECA are limited making it hard to know what to expect over the next years. Methods We used the 1990-2019 Global Burden of Disease database to analyze NCD trends and identify country-specific change points by using piecewise linear regression. We assessed the likelihood of achieving NCD global targets (GTs) to reduce premature mortality among persons 30-69 years old from four NCDs: cardiovascular diseases (CVD), cancers, diabetes mellitus (DM) and chronic respiratory diseases (CRD) by 25% from 2010 to 2025 (WHO25X25 target) and by 33% from 2015 to 2030 (SDG 3.4.1). Results Only Kazakhstan and Russia are likely to achieve NCD-GTs. For Kazakhstan, WHO25X25 and SDG 3.4.1 GTs mortality rates were 494.3 and 374.8 per 100,000 population respectively; the corresponding predicted values (PVs) were 360.6 [CI 260.1-461.1] and 245.1 [CI 113.4-376.8]. For Russia, WHO25X25 and SDG 3.4.1 GTs were 560.5 and 442.8 per 100,000 population respectively; the corresponding PVs were 427.7 [CI 270.3-585.1] and 311.0 [CI 102.8-519.1]. Achieving NCD-GTs is also possible for Kyrgyzstan. For the rest of EECA countries achieving NCD-GTs is unlikely. All EECA countries have increasing premature mortality from DM, eleven - from CRD and cancers, and six - from CVD. Most EECA countries have higher NCD rates and slower progress among men compared with women. Conclusions In most EECA countries the trend towards achieving NCD-GTs is slow or reversed. Further quantitative and qualitative research is needed to understand the underlying reasons. Separate indicators are needed to monitor countries’ progress for cancers, DM and CRDs. Key messages • Most EECA countries have slow or reversed trend in achieving NCD-GTs. All EECA have increasing premature mortality from DM, eleven – from CRD and cancers, and six – from CVD. • Further research is needed to understand the underlying reasons for slow progress towards NCD-GTs in EECA. Separate indicators are needed to monitor progress for cancers, DM and CRDs.