Assessing the progress in implementing population-based policies to reduce the burden of noncommunicable diseases in Eastern Europe and Central Asia, 2010-2024.

Abstract

Premature mortality from noncommunicable diseases (NCDs) remains high in twelve Eastern Europe and Central Asia (EECA) countries-Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan. Although WHO-recommended 'Best Buys' offer effective strategies to reduce NCDs, their implementation in EECA remains poorly documented. We conducted a cross-country, retrospective analysis of the adoption and implementation of population-level NCD 'Best Buys' interventions targeting tobacco, alcohol, diet, and physical activity across EECA from 2010 (or earliest available year) to 2024 (or latest available year), aiming to identify progress, gaps, and priorities for action. Data were sourced from WHO NCD Country Capacity Surveys and other global databases and monitoring reports. A scoring system (0-1) captured implementation status, and spider charts and summary tables visualized trends over time. Tobacco control showed the most progress, with widespread adoption of taxation and graphic warnings. However, the implementation of smoke-free laws, cessation support, and media campaigns was inconsistent. Alcohol policies varied: most countries increased taxes and banned advertising, but gaps persisted in sales restrictions, health warnings, and treatment services. Adoption of nutrition policies remained inconsistent, with substantial gaps in food reformulation, labelling, fiscal tools, and education. Physical activity campaigns were common, but integration into healthcare systems was poorly documented. Disparities in implementation were observed across and within countries, in terms of the number and combination of 'Best Buys' strategies adopted. Despite some progress, major gaps remain in the implementation of population-level NCD 'Best Buys' across EECA. Greater prioritization of cost-effective tobacco, alcohol, nutrition, and physical activity strategies is needed. Subregional and country-level analyses of NCD 'Best Buys' implementation over time can help policymakers identify progress and gaps, guiding targeted, evidence-informed action to address shared behavioural risks and thereby prevent many NCDs and contribute to equitable and sustainable health outcomes.