As I look back on 2025, one of the highlights was attending and speaking on behalf of Boehringer Ingelheim at the fourth United Nations General Assembly high-level meeting on noncommunicable diseases and mental health, or HLM4, in New York. Standing alongside heads of state and government, ministers of health, and civil society representatives from around the world, we reaffirmed our commitment to improving outcomes for patients with noncommunicable diseases, or NCDs, and mental health conditions, through our pharmaceutical innovation and beyond.
This meeting could not have come at a more opportune moment. NCDs, including cardiovascular, renal, and metabolic — or CRM —diseases, are the leading cause of death worldwide, claiming approximately 43 million lives each year. The global burden continues to rise at an unprecedented rate, making it vital that the global community comes together to tackle this urgent public health challenge.
Therefore, after months of in-depth negotiation, I was delighted to see world leaders formally adopt the political declaration on NCDs and mental health earlier this week. The declaration outlines a shared vision for the prevention and control of NCDs and the promotion of mental health and well-being toward 2030. It marks an important moment of global cooperation in NCDs and mental health and provides a strong foundation for the implementation of evidence-based, cost-effective, and affordable actions that countries can take at the national level in 2026 and beyond.
In particular, I am pleased to see the political declaration highlight the multimorbidity and cooccurrence of NCDs and the challenges this causes, especially in terms of screening, early diagnosis, and treatment.
This is particularly true of CRM diseases, including chronic kidney disease, or CKD, diabetes, obesity, and metabolic dysfunction-associated steatohepatitis, which affect over 1 billion people globally. They coexist and both progress and amplify one another, increasing the likelihood of the poorest health outcomes — including serious cardiovascular events — which can ultimately lead to hospitalization and premature death.
Take CKD as an example, which is closely linked to the risk of heart attack and stroke. It is estimated that approximately 10% of the global population suffers from CKD. This equates to more than 674 million people, a significant number of whom are undiagnosed — and this prevalence is increasing. What’s more? Symptoms rarely present until the advanced stages of the disease. As a result, many cases are diagnosed too late, when complications and comorbidities have already developed.
Indeed, people with CKD are more likely to die of cardiovascular causes than reach the stage where they require dialysis. It is estimated that by 2027, per 100,000 CKD patients, there will be over 8,000 cases of heart failure, over 10,000 cases of myocardial infarction, and over 7,000 cases of stroke. As cardiovascular disease remains the world’s biggest killer, thus, preserving the kidney to protect the heart is of particular importance for public health.
It’s clear that interconnected conditions require integrated care approaches, but when I speak to people living with CRM conditions, they often describe having to see multiple specialists and coordinate their own care. This includes navigating conflicting treatments, tests, and appointments without guidance or support in systems that tend to focus on one disease at a time.
One of the most powerful actions we can take to help make interconnected care a reality for patients is expanding early screening and diagnosis, while strengthening primary health care across the world. In many cases, the tools exist, but there is a need to ensure that our systems for delivering them are connected and fully resourced. For example, in the case of CKD, a simple urine test can detect early signs of the disease and enable timely treatment to avoid dialysis, transplant, and the development of associated conditions. The same urine test can also indicate if a patient is at risk of cardiovascular disease. Yet it is still underutilized in clinical practice. It is therefore essential that we see greater integration of routine CKD screening into primary care at the national level, especially for high-risk populations, including people living with diabetes, hypertension, and cardiovascular disease.
It is great to see strong support for this approach in the political declaration, which calls for strengthening primary prevention and scaling up early screening for conditions such as cardiovascular disease, CKD, and metabolic dysfunction-associated steatotic liver disease , which is closely linked with obesity.
However, there are also areas where we can go further. For example, while the political declaration highlights that obesity is driven by multiple factors — including the unaffordability and unavailability of healthy diets and lack of physical activity — it stops short of recognizing obesity as a chronic, metabolic disease and does not mention the strong connection between obesity and liver health. This shift in perspective will be key to promoting and enabling effective care for patients in the long term.
There is an economic case to be made for investing in health early: Every dollar put toward scaling up NCD interventions results in a return of seven dollars in increased employment, productivity, and longer life expectancy. Early and targeted screening of CKD alone could save health systems billions by reducing the risk of disease progression and the likelihood of costly cardiovascular events.
However, at Boehringer Ingelheim, we know that breakthrough pharmaceutical innovation and convincing health economics aren’t enough. Medicines only create value when they reach those who need them.
Delivering systems-level change is highly complex and challenging. It requires a huge cross-government and multisectoral effort. As we look ahead to 2026, let us now take this opportunity to build on the strong consensus and momentum from HLM4 and translate the global commitments in the political declaration into national action to improve outcomes for patients around the world.