PHSSR Policy Roadmaps for Acting Early on NCDs Synthesis Report 2025

87 Acting early on NCDs The Partnership for Health System Sustainability and ResilienceEqually concerning is that no country reports systematic demand-side efforts to enable patient self- management at scale, which could help reduce pressure on the healthcare workforce. This absence is particularly striking given that most NCD management occurs outside clinical encounters. Patients making daily decisions about medication, diet, exercise, and symptom monitoring, yet health systems invest minimally in supporting these capabilities. Digital health tools have potential to promote patient self-management, but require integration into care models and payment systems to promote their implementation by healthcare staff that current structures resist. Based on the evidence examined, countries should consider the following approaches: ■ Develop comprehensive workforce planning models linked to NCD burden projections Countries need long-term workforce strategies that genuinely reflect future population health needs rather than perpetuating historical patterns. This requires modelling demographic transitions and disease trends whilst considering how new care models and prevention investments might reduce traditional workforce demands. Such planning must integrate all health professions rather than treating each in isolation, with continuous monitoring systems that track whether workforce development aligns with evolving population needs. ■ Implement multi-component policies to address geographic and specialty maldistribution Countries should create compelling reasons for practice in underserved areas through combinations of financial incentives, career development opportunities, and infrastructure support that makes rural practice genuinely attractive. This might include service obligations for publicly-funded education, rotational models that maintain urban connections, or regulatory approaches that limit further concentration in oversupplied areas. ■ Expand professional roles and scopes of practice to optimise skill-mix and promote evidence-based task shifting Meeting growing NCD demands requires mobilising the full potential of all health professions. This means creating new roles specifically designed for chronic disease prevention and management whilst enabling existing professions to work at the full extent of their capabilities. Pharmacists and nurses, for instance, could manage stable chronic conditions within appropriate frameworks, but this requires aligned regulatory, legal, and payment systems that support rather than obstruct such practice changes, as well as a supportive professional culture. ■ Reform professional education with mandatory NCD competencies Health professional education must shift from its traditional acute care focus to prepare graduates for the reality of chronic disease management. This means embedding prevention, behaviour change, and multimorbidity management throughout curricula whilst ensuring different professions learn to work together through interprofessional education. Digital health capabilities should become core competencies, with continuing professional development ensuring these skills remain current throughout careers. ■ Create sustainable career pathways that value prevention and primary care The persistent shortage of primary care and prevention specialists reflects systemic undervaluation of these fields. Creating sustainable careers requires addressing income disparities with specialists whilst providing intellectual stimulation through research opportunities and academic positions. Infrastructure support that reduces administrative burden is essential, as is ensuring prevention activities are properly resourced within job plans rather than squeezed into already overwhelming workloads.