Base reference:

Pan American Health Organization (PAHO). Progress Indicators of Non-Communicable Diseases 2025: Surveillance and Monitoring of NCDs. Second edition. OPS/NMH/NV/25-0006. Washington D.C.: PAHO; 2025.

Summary

The 2025 report of the Pan American Health Organization (PAHO) on non-communicable diseases (NCDs) presents a comparative evaluation of the progress of the 35 Member States against 22 indicators of policies, surveillance, access to treatments and prevention.

The results show important progress in tobacco control and healthy eating policies, but persistent lags in the reduction of harmful alcohol consumption, promotion of physical activity and availability of essential medicines. This critical analysis identifies structural gaps in governance, surveillance and multi-sector implementation, proposing strategic actions to accelerate compliance with the Sustainable Development Goals (SDG 3.4) in the Region of the Americas.

Introduction

Non-communicable diseases (NCDs), mainly cardiovascular diseases, cancer, diabetes and chronic respiratory diseases, account for more than 80% of deaths in the Region of the Americas and continue to be a critical threat to sustainable development (Pan American Health Organization [PAHO], 2025). The World Health Organization (WHO) has defined a set of best investments and recommended strategies to reduce risk factors associated with NCDs, including tobacco use, alcohol, physical inactivity and unhealthy diets (World Health Organization [WHO], 2024).

Monitoring these indicators is essential to evaluate compliance with the commitments assumed by Member States within the framework of the Sustainable Development Goals, particularly SDG 3.4, which proposes to reduce premature mortality from NCDs by 30% by 2030. In this context, PAHO prepared the second edition of the NCD Progress Indicators 2025, aimed at evaluating surveillance, national plans and the adoption of cost-effective interventions.

Methodology

The PAHO report (2025) compiles information from the 35 Member States, based on 22 indicators grouped into four dimensions:

1. Surveillance and monitoring: Includes the existence of national goals, periodic surveys and mortality registration systems.

2. Multisector plansales: Evaluates the updating and operationalization of national action plans for NCDs.

3. Policies on risk factors: Covers measures related to tobacco (WHO Framework Convention on Tobacco Control), alcohol, healthy eating and physical activity.

4. Access to services and technologies:Consider the availability of clinical guidelines, medications, essential technologies and vaccination against human papillomavirus (HPV).

The assessment classifies progress into three levels: fully achieved (green), partially achieved (yellow) and not achieved (red). The data was collected between 2021 and 2023, with technical review and verification by PAHO.

Results

The regional analysis shows a heterogeneous panorama in progress towards the 2025 indicators:

– Surveillance: Only 14% of countries carry out periodic national surveys with physical and biological measurements. 54% have aligned their national goals with the WHO global framework and 60% generate reliable mortality data.

– National Plans: 37% of countries lack an updated operational action plan, which limits intersectoral coordination.

-Tobacco: Tobacco control shows significant progress, especially in smoke-free environments and graphic health warnings; However, enforcement of excise taxes and advertising bans remains weak.

-Alcohol: Although 17 countries have increased taxes, overall progress remains limited, showing little regulation in advertising and availability.

-Healthy Eating: Ten countries (28%) implemented front labeling and seven (20%) adopted octagonal seals recommended by PAHO. Additionally, 34% made progress in food reformulation, particularly in salt reduction and elimination of trans fats.

-Physical Activity: Only nine countries (26%) have carried out sustained national promotion campaigns.

-Access to Services: 43% report availability of essential medications and technologies for chronic respiratory diseases. HPV vaccination remains below 90% in most countries

The countries with the greatest global achievements are Chile, Brazil, Canada, Uruguay and Costa Rica, which reach more than 59% of the indicators.

Discussion

The uneven progress between the indicators reflects the persistent fragmentationn institutional and structural limitations of health systems in the region. Although anti-smoking policies constitute an example of successful implementation of the WHO’s “best investments”, other areas, especially alcohol control and the promotion of physical activity, show lags attributable to economic, political and industry interference factors (Baker et al., 2022).

The results also show a critical gap in epidemiological surveillance, essential for evidence-based planning. The limited capacity of countries to carry out periodic surveys and consolidate integrated information systems hinders the monitoring of the impact of public policies (Nugent et al., 2023).

Likewise, the limited updating of national multisectoral action plans highlights the need to strengthen inter-institutional governance. In most cases, the plans exist at the regulatory level, but they lack sustainable financing mechanisms and intersectoral articulation, which limits their real effectiveness (PAHO, 2025).

From a technical perspective, it is necessary to intensify regulatory measures on ultra-processed foods, sugary drinks and alcohol, and incorporate more aggressive fiscal and social marketing instruments. In addition, it is recommended to strengthen investment in primary care and the availability of essential technologies, guaranteeing equity in access and sustainability of the programs.

Finally, although the region shows notable progress compared to 2015, the current pace is not sufficient to achieve the goals of SDG 3.4 before 2030. A coordinated response is required, based on evidence and with high-level political commitment.

Conclusions

The PAHO 2025 report constitutes a strategic regional monitoring tool that allows identifying critical gaps in the response to NCDs. The results suggest that, although the Region of the Americas is moving towards meeting the progress indicators, the heterogeneity between countries and the weakness of execution mechanisms could compromise the achievement of global goals. Strengthening health governance, investment in surveillance and the adoption of comprehensive regulatory measures will be key to accelerating the transition towards this goal that PAHO proposes and which goes towards compliance with SDG 3.4.

The report represents a methodological advance by integrating regulatory surveillance with operational public policy indicators, strengthening regional comparability and accountability.

See themanagement indicators for 2025 by clicking here.

References

–Baker, P., Friel, S., Schram, A., & Lawrence, M. (2022). Industry interference in NCD policy: Lessons from tobacco, alcohol, and ultra-processed foods. BMJ Global Health, 7, e008256.

-Global Burden of Disease Collaborative Network. (2024). Global Burden of Disease Study 2024 Results. Seattle, WA: Institute for Health Metrics and Evaluation (IHME).

-Nugent, R., Barreto, S. M., Anderson, C., & Buse, K. (2023). Global progress on NCD policy implementation: Bridging the gap between commitments and action. The Lancet Global Health, 11(8), e1234–e1248.

-World Health Organization. (2024). Tackling NCDs: Best buys and other recommended interventions for the prevention and control of noncommunicable diseases (2nd ed.). Geneva: WHO.

-Pan American Health Organization. (2025). Progress indicators of non-communicable diseases 2025: Surveillance and monitoring of NCDs (Second edition, PAHO/NMH/NV/25-0006). Washington, D.C.: PAHO.