Building stronger primary care to tackle NCDs and mental health

Noncommunicable diseases, known as NCDs, remain some of the world’s most pressing — yet frequently preventable — health challenges. Their growing burden took center stage at the fourth high-level meeting on NCDs and mental health, or HLM4, in September. World leaders, health experts, civil society, and the private sector came together to review progress toward global NCD targets and the persistent gaps in prevention, policy, and care.

The HLM4 political declaration — which had the support of a majority of countries and is expected to be passed by the United Nations General Assembly in the coming weeks — seeks to close some of these gaps by outlining a series of targets for Member States.

“The target for at least 80% of countries to have implemented NCD policies is ambitious,” Lena Wahlhed, director for alliance development at HemoCue, told Devex. “While progress has been made, there’s still a great deal to do — particularly in strengthening primary health care as the foundation for universal health coverage.”

Discussions at HLM4 centered on the need for integrated, people-centered care which would reach those who most need it.

“The reality is that NCDs do not adhere to country borders — they affect the global community, often with dire consequences,” Wahlhed said, emphasizing that sustainable partnerships and locally driven innovation will be key to achieving universal access to care. “Health is a human right, and ensuring everyone is cared for is our shared responsibility.”

Speaking to Devex, Wahlhed explained that a patient-centered approach starts with timely and accurate diagnosis — ensuring people receive the right care at the right time. Strengthening access to essential diagnostic tools at the primary health care, or PHC, level, she said, can improve outcomes while reducing the long-term burden of noncommunicable diseases.

This conversation has been edited for length and clarity.

What does a patient-centered approach to NCD care, grounded in timely and accurate diagnosis, look like in practice?

It means truly putting the patient at the center — listening to the person in front of [you], assessing their situation, and creating space to act. In practice, having access to essential diagnostics alongside a physical examination can help guide immediate next steps to prevent deterioration, enable treatment, or even achieve a cure.

It also means fostering respectful dialogue and ensuring patients are part of the decision-making process. Likewise, when it comes to chronic conditions, understanding the broader context of a person’s life allows for more holistic support.

HLM4 highlighted the need to connect infectious disease and NCD programs better. How can primary care serve as a practical entry point that bridges these two areas of care?

As we’ve discussed in previous dialogues, these connections [between infectious diseases and NCDs] are clear. TB and diabetes are linked; HIV/AIDS is connected to diabetes and secondary infections; and the risk of cervical cancer is higher among women living with HIV.

Having a single point of contact for care could make a real difference. And if that point of care is in a more neutral space, such as a primary health center, it could also help reduce stigma. This is of significant importance also for patients with mental health problems, who may find additional NCDs following their diagnosis and related treatment.

We often hear about innovation in treatment or financing, but not as much about innovation in diagnostics. What advances do you see as most promising for strengthening PHC in low-resource settings?

I always say that the best innovation is the one that lasts — the kind that continues to provide value in a way that’s cost- and time-efficient, and sustainable within the geography where it’s meant to be used, by the people it’s meant to serve, and for its intended purpose. In that sense, innovation should be tailored to what is truly needed, not just what can be done.

I believe that implementing the World Health Organization’s essential diagnostics list at the local level is a very good place to start. It offers clear, evidence-based guidance on which diagnostics are needed at the first line of care, and those tools can make a real difference for patients in many settings.

Beyond access to diagnostics, we also need systems for patient record-keeping and long-term data tracking. That’s especially important for NCDs, which are chronic conditions. Having a system in place allows us to monitor patients’ progress over time.

Strengthening PHC requires more than technology; it also depends on policy and financing. What should governments and donors prioritize to make diagnostics more accessible at the community and primary care levels?

Primary care requires not only trained staff and equipped facilities, but also the right tools to both detect and treat. We can’t have one piece of the puzzle without the other; they have to work hand in hand.

Distance can also be a major factor: Bringing diagnostics closer to the point of care makes them far more accessible and helps support both communities and local health workers in the vital role they play. From a supplier’s perspective, I see that as part of our responsibility.

What key takeaways from HLM4 would you highlight? How do you see diagnostics being positioned in the discussions and proposed commitments (even as we wait for a formal vote on the political declaration)?

There was so much of real value in this HLM, not only new [proposed] commitments, but also continuity with what’s been decided in the past — including the emphasis on equity, integration of NCDs with mental health and well-being, and a comprehensive, people-centered approach that leaves no one behind.

First, I noted the strong focus on global partnerships: We can’t do this alone. And universal health coverage came through clearly as fundamental to preventing and managing NCDs. The [draft] declaration highlights the need for integrated, sustainable, resilient, and well-financed health systems, with particular attention to primary health care. Another key takeaway for me was the call to reach more remote and hard-to-access areas, [along with] the acknowledgement that there are cost-effective and evidence-based interventions for preventing, screening, diagnosing, treating, and caring for people living with or at elevated risk of NCDs.

I also noted the focus on eradicating hunger, as well as addressing anemia in women and children. There are point-of-care diagnostic tools available today that can directly support these goals.

As WHO has said, “Without diagnostics, medicine is blind.” It’s a powerful statement, and I believe it’s true, especially when it comes to point-of-care diagnostics. But no tool has value on its own. Its real impact comes when it’s integrated into context and action can be taken right where it’s needed, for the people who need it most.

What next steps in the NCD space do you think are the most urgent as they relate to strengthening diagnostics and PHC?

If we don’t focus on vulnerable populations, they will continue to suffer the most. NCDs often come with comorbidities, making prevention, early detection, and treatment essential. A person with diabetes, for example, may also experience mental health challenges or kidney disease — a reality particularly evident in low- and middle-income countries.

Ultimately, realizing the right to health requires universal health coverage, access to essential diagnostics and medicines at the point of care, and integration into national public health strategies — with strong partnerships and sustainable funding to make it all possible.

Strengthening primary health care starts with ensuring that essential diagnostics are available where they’re needed most. Discover how HemoCue is helping make universal health coverage a reality by visiting our website.

Visit Accelerating Action — a series highlighting pathways for funding NCD prevention and control, spotlighting innovative financing models and cross-sector collaborations.

This content is sponsored by HemoCue as part of our Accelerating Action series. To learn more about this series, click here.