HLM4: was it worth it? - it's up to us

So much time, energy and hope has been poured into preparation for the High-level Meeting on NCDs and Mental Health at the United Nations in New York last week... It has to be worth the effort! Millions of people – almost certainly including you and me – could live longer, healthier, happier lives if the promise of the Political Declaration is realised.

Sure, not everything went the way one might like. There were no major pledges from governments and no new global money put on the table. The raucous voice of the main dissenter – RFK Jr – dragged the headlines away from what can be achieved to what cannot. The active and meaningful involvement of people living with NCDs – so crucial for understanding and for progress – was mentioned by only a handful of ministers. The watering-down of the Political Declaration has been depressing to witness, but kudos to those governments that voiced their frustration that ‘compromises have denuded commitment’.

But there have been so many positives! This Political Declaration – unlike those from 2011, 2014 and 2018 – includes targets on NCDs for the first time. The preparation for the HLM – years in the making – has consolidated the evidence and understanding on the impact of NCDs and mental health, not least in humanitarian settings. Prevention – so dear to my own heart – was on everyone’s lips. Government engagement in the run-up to the HLM has been an opportunity for civil society organisations to open a channel to their governments: the UK Working Group on NCDs has been talking to our foreign office and health department for many months about priorities for the Political Declaration – and we hope to continue those conversations. There were numerous statements of support for multilateralism (and WHO in particular) as being crucial in solving this huge global health challenge. Country after country after country – more than 130 in total – were willing to stand up at the biggest forum of them all, the United Nations, and state their support for addressing NCDs and mental health.

So, given these competing realities, only time can really tell what a difference it has made:

• Only time will tell if the Political Declaration sits on governmental shelves or if it inspires policymakers (with support from civil society) to work to meet and – I hope – exceed the relatively unambitious targets.

• Only time will tell if the new channels for advocacy that have opened over the last few months remain open and welcoming to new views and voices.

• Only time will tell if the media recognise the urgency of what needs to be done, running the issue of NCDs consistently, loudly, and with people at the centre of stories.

The High-level Meeting was just one day. But the political will and public pressure for change needs to continue for the 2,000+ days until the next HLM in 2031, and beyond.

There is no question that our work – my work – must redouble.

Let’s make this happen.