PHSSR Policy Roadmaps for Acting Early on NCDs Synthesis Report 2025

89 Acting early on NCDs The Partnership for Health System Sustainability and Resilience9 Medicines and technologies Modern NCD management increasingly depends on sophisticated diagnostics, innovative therapeutics, and digital health technologies that enable precision medicine and remote care. Access to these innovations can dramatically alter disease trajectories: targeted cancer therapies, continuous glucose monitoring, advanced imaging, and AI-assisted diagnosis offer unprecedented opportunities for early intervention and personalised treatment. Yet the pathway from innovation to patient access remains complex and inequitable. This chapter examines how health systems adopt and deploy technologies for NCDs, covering diagnostic infrastructure, pharmaceutical access and reimbursement, digital health implementation, and research capacity. It analyses both physical technologies and digital innovations, established interventions and emerging capabilities, and the persistent challenge of ensuring equitable access to innovations that could transform NCD outcomes. Access to diagnostics The importance of medical imaging infrastructure for NCD management has gained international recognition, as reflected in the World Health Assembly’s 2025 resolution on strengthening medical imaging capacity (WHO, 2025h). The resolution emphasises that medical imaging is vital for diagnosis and treatment of numerous non-communicable diseases, and highlights the need to improve equitable access to safe and effective medical imaging globally, particularly for early detection, diagnosis, treatment, and monitoring of NCDs. However, access patterns reveal systematic disparities both between and within countries. Greece’s position as 5th among OECD countries for imaging equipment availability (CT, MRI, and PET scanners per capita) (OECD, 2023a and Italy’s above-OECD-average diagnostic capacity demonstrates substantial capital investment in diagnostic infrastructure. However, the translation of this diagnostic capacity into improved patient outcomes remains uncertain, as equipment availability alone does not ensure appropriate utilisation, timely access, or integration with treatment pathways. Geographic disparities in diagnostic technology access compound national challenges. Japan shows three-fold variations in imaging equipment availability between prefectures, with rural areas systematically lacking access to advanced diagnostics (MHLW, 2016). These substantial disparities in access to services forces patients to travel to urban centres for diagnostic procedures. This geographic inequality creates cascading delays through the care pathway, as initial diagnosis, staging, and treatment monitoring all require separate long-distance journeys. Poland’s concentration of MRI and CT scanners in major urban centres leaves most rural populations underserved. The concentration in Warsaw, Kraków, and Gdańsk creates a diagnostic desert in rural voivodeships, where patients may wait months for imaging that would be available within days in urban centres. Equipment ageing and renewal present growing challenges that threaten to erode current diagnostic capacity. Italy reports that 37.3% of its diagnostic equipment exceeds 10 years in age, including 74% of gamma cameras and 44% of MRI units, raising concerns about reliability, image quality, and maintenance costs. Older equipment produces lower quality images that may miss early-stage disease, requires more frequent maintenance causing service interruptions, and consumes more