96 Acting early on NCDs The Partnership for Health System Sustainability and Resilience■ Build interoperable digital health infrastructure with robust governance Establish mandatory open interoperability standards that enable care coordination, addressing the current reality where countries with near-universal EMR adoption cannot share data between providers or regions. Create frameworks for health data secondary use that balance privacy protection with research needs, including provisions for trusted research environments and clear guidance on AI applications. Governance structures need authority to enforce standards and resolve the stakeholder disputes that have delayed progress in some countries for decades. ■ Reform clinical trial and innovation infrastructure Address the barriers causing countries to lose competitive position in global research despite strong infrastructure. This includes unified ethics approval processes to replace fragmented regional systems, streamlined administrative requirements, and investment in clinical trial networks with sustainable funding. Develop real-world evidence capabilities leveraging electronic health records, and improve patient recruitment through accessible information rather than technical language that excludes participants. ■ Bridge the digital divide for older adults with NCDs Ensure digital health solutions accommodate older adults, addressing evidence that half of citizens over 70 in some countries cannot use digital devices and most chronic patients over 70 lack autonomy with digital tools. This requires mandatory accessibility standards for health interfaces, support services including helplines and in-person assistance, and maintained non-digital alternatives to access healthcare. Digital literacy training should be integrated with chronic disease management programmes, recognising that the populations most affected by NCDs face systematic barriers to digital adoption.

PHSSR Policy Roadmaps for Acting Early on NCDs Synthesis Report 2025