PHSSR Policy Roadmaps for Acting Early on NCDs Synthesis Report 2025

60 Acting early on NCDs The Partnership for Health System Sustainability and ResilienceSome countries adapted their screening services during the crisis. The Spain report notes that some Autonomous Communities established protocols to maintain early detection of diseases such as cancer through home-based screenings or at specific centres separate from COVID-19 zones, though the lack of technological infrastructure in some regions limited its reach. The Spanish Ministry of Health also recognised increased mental health disorders, publishing a Mental Health Action Plan 2022-2024 to address this need. Moving forward, incorporating these lessons into contingency plans, enhancing digital infrastructure, and ensuring the integration of NCD services into emergency response frameworks will be essential to mitigate the impact of future crises on vulnerable populations. Digital transformation under pressure The pandemic demonstrated both the potential and limitations of digital health solutions for chronic disease management. Multiple countries’ quick adoption of telemedicine showed that many perceived barriers to innovation reflect organisational inertia rather than genuine technical impossibility. Telemedicine utilisation increased dramatically across all countries, with some reporting 50-fold increases in virtual consultations during peak pandemic periods. Patients with chronic conditions demonstrated willingness and ability to engage with remote monitoring technologies, digital medication management platforms, and virtual education programmes when traditional in-person services were unavailable. However, the digital divide meant that these innovations were not equally accessible. Japan reports that 50.9% of citizens aged over 70 do not use smartphones or tablets, effectively excluding them from mobile health applications and digital services (Cabinet Office Japan, 2023a). Spain documents that 78% of chronic patients over 70 lack autonomy with digital tools, requiring assistance for basic functions like accessing test results or booking appointments (Plataforma de Organizaciones de Pacientes, 2023). This digital divide is not simply a matter of device access but reflects deeper issues of digital literacy, interface design that ignores aging-related limitations, and assumptions about technological engagement that do not match the realities of older populations. Building resilience for future disruptions Despite clear evidence of NCD patients’ vulnerability during the pandemic and the amplification of existing system weaknesses, the lessons learned have yet to be systematically incorporated into updated emergency preparedness protocols across most countries. Few countries have developed explicit plans for triaging essential NCD services during resource constraints, maintaining care coordination when in-person visits are limited, or ensuring equitable access to digital health solutions during system disruptions. The development of crisis-resilient NCD care systems requires changes in how countries approach emergency preparedness, moving beyond acute care surge capacity to consider the full spectrum of health services needed to maintain population health during extended disruptions. This includes identifying essential services that must be maintained, developing protocols for remote management, ensuring medication supply chains, and creating communication strategies that reach vulnerable populations. Some countries have begun developing more robust continuity plans. Spain is investing in digital infrastructure to enable rapid scaling of telemedicine when needed. However, these remain largely isolated initiatives rather than systematic preparedness strategies.