Some countries are taking bold action: Poland increased medical school admissions by 92.3%;61 Germany expanded medical assistant roles for task-shifting. Yet workforce composition remains poorly matched to NCD needs. Primary care faces critical shortages with only 6% of Greek physicians in general practice vs. an EU average of 21%.62 Greece has the EU’s highest physician density yet the lowest nursing density, creating an imbalance that forces patients to bypass primary care entirely and seek specialist care for routine conditions. Geographical maldistribution leaves rural areas systematically underserved. Ageing workforces compound the challenges, with Polish physicians averaging over 50 years of age. Task-shifting initiatives show promise but remain limited by regulatory barriers and professional resistance. Medical education maintains a traditional emphasis on acute care with limited focus on prevention, health promotion and integrated chronic disease management. Health systems struggle to attract clinicians into the roles most critical for NCD prevention and management. Younger doctors increasingly favour part-time work and technology- oriented specialties.63,64,65 These patterns reflect not just individual preferences but incentive structures. –Develop comprehensive workforce planning: Create long-term strategies that genuinely reflect future population health needs rather than perpetuating historical patterns. Model demographic transitions and disease trends while considering how new care models might affect workforce demands. –Address geographical and specialty maldistribution: Create compelling reasons for practice in underserved areas through combinations of financial incentives, career development opportunities and infrastructure support. This might include service obligations for publicly funded education or rotational models maintaining urban connections. –Expand professional roles: Enable all health professions to work at full scope of practice while creating new roles specifically designed for chronic disease prevention and management. Pharmacists and nurses could manage stable chronic conditions within appropriate frameworks, requiring aligned regulatory, legal and payment systems. –Reform professional education: Shift from traditional acute care focus to prepare graduates for chronic disease management reality. Embed prevention, behaviour change and multimorbidity management throughout curricula. Ensure interprofessional education teaches collaborative practice. –Create sustainable careers: Address the persistent shortage of primary care and prevention specialists by tackling income disparities with specialists while providing intellectual stimulation. Reduce the administrative burden and ensure prevention activities are properly resourced within job plans. –Invest in demand reduction: Rather than assuming that endless workforce expansion can meet growing NCD demands, develop evidence-based self-management programmes genuinely enabling patients to manage their conditions. Use group consultations, peer support and validated digital tools.Policy levers Acting Early on Non-Communicable Diseases: A Framework for Health System Transformation 19

Acting Early on Non-Communicable Diseases 2026