PHSSR Policy Roadmaps for Acting Early on NCDs Synthesis Report 2025

67 Acting early on NCDs The Partnership for Health System Sustainability and Resiliencedevelopment necessarily relied on alternative data sources of questionable quality and completeness. France’s cancer registries through the Francim network provide detailed insights whilst covering approximately one-quarter of the population, acknowledging incomplete national representation but providing high-quality data for covered areas. Spain has developed multiple disease-specific registries, including a National Registry of Type 1 Diabetes in 2022, though these currently operate without interoperability, limiting analysis of multimorbidity patterns. Most registries focus on hospitalised patients, offering important burden data though missing earlier disease stages relevant for prevention planning. The fragmentation of registry systems reflects broader governance challenges in creating unified approaches across autonomous regions. National surveillance systems provide essential population health monitoring with varying sophistication. Canada’s federal surveillance system successfully aggregates data from all provinces and territories to track 20 chronic diseases, demonstrating that comprehensive coverage across jurisdictions is achievable despite federal structures (Government of Canada, 2024a). Spain conducts regular surveys meeting WHO standards for NCD risk factors, documenting regional variations in service access. Poland’s weather alert systems identify climate impacts on health but lack protocols for adjusting clinical management during extreme events, illustrating the gap between data collection and operational response. Translating data into policy The mechanisms for translating surveillance findings and data into policy action vary considerably across countries, with formal response pathways appearing critical for effective evidence use. Canada’s comprehensive cancer surveillance has informed the Canadian Strategy for Cancer Control (2019–2029), a national framework with defined priority areas, accountability mechanisms, and ongoing monitoring led by the Canadian Partnership Against Cancer (CPAC) (Canadian Partnership Against Cancer, 2019), demonstrating how surveillance can support comprehensive planning with defined accountability mechanisms. However, beyond cancer and more recently diabetes, most major NCDs still lack equivalent national frameworks, suggesting that the availability of surveillance data alone does not guarantee policy development (Public Health Agency of Canada, 2022; HeartLife Foundation, 2024b). Similarly, the relatively limited research use of Japan’s comprehensive National Database of Health Insurance Claims and Specific Health Checkups, which had only 50 applications between 2018–2023, suggests that access barriers and data gaps may constrain policy utility even in sophisticated systems (MHLW, 2024g). Countries generally lack formal requirements for policies to reference national data sources or respond to surveillance findings. Without mandatory links between evidence and policy, decision- making may reflect political priorities or stakeholder influence rather than epidemiological need. This creates a vicious cycle where prevention remains underfunded because its benefits cannot be demonstrated, whilst demonstration requires investments in evaluation infrastructure that seem unjustifiable without proven benefits. Stakeholder engagement and inclusivity Whilst robust data systems and evidence mechanisms provide the technical foundation for governance, the legitimacy and effectiveness of NCD policies ultimately depend on meaningful engagement with those affected by and implementing these policies. Japan’s expert evaluation committees provide a model for systematic multi-stakeholder engagement, with formal representation protocols ensuring that medical expertise, patient experience, and implementation capacity all contribute to decision-making processes (MHLW, 2024l). These committees include mandatory representation from patient organisations, creating