Staying positive can be a challenge, and being over-optimistic can be counterproductive and exhausting. But in this blog written for the Global Week of Action on NCDs, Katy Cooper (chair of the UK Working Group on NCDs) sets out our recent engagement with the UK government, making the case that it is absolutely essential to remain actively engaged in the spaces where changes to global health are happening, if NCDs are to be better integrated into health services worldwide.
Every September, the NCD Alliance (of which the UKWG is an active member) holds its Global Week for Action. I expect it feels to everyone reading this like much more than a year since the last one, which was held around the time of 2025’s UN High-level Meeting on NCDs and Mental Health in New York. In the intervening time, global health has come under further unprecedented pressure, with millions of people facing the repercussions of cuts of development assistance for health (DAH). Where national health systems have been outsourcing care to programmes funded by donors, rather than integrating it into mainstream services, the disappearance of donor funding too often means the breakdown of care. And even though NCDs have traditionally had only a tiny fraction of DAH, this pot is now shrinking further.
There is now widespread recognition that root-and-branch reform of the ‘global health architecture’ is urgently required, based on actual need, on vastly improved integration of services, and on far deeper community involvement.
It can be hard to see any positives at all. But we have to keep pushing for change. This is a crucial moment that could impact NCDs’ place in the global health architecture for years to come. Many UKWG members are following the processes around the reshaping of global health, including through HearCSO, an organisation focused on bringing in the views of civil society.
We are fortunate in the UK of having the support of Action for Global Health, which has been an invaluable conduit to colleagues in the government in Westminster, particularly within the Foreign, Commonwealth and Development Office and the Department of Health and Social Care. In 2025, the UKWG had a flurry of regular meetings with government officials ahead of the High-level Meeting. The frequency of these meetings has slowed – not least because of dramatic restructuring of the FCDO in London, combined with multiple competing priorities for civil servants – but we continue to meet, share views, and make the case for NCDs being at the heart of international development.
The changes to the government may also be a fresh window through which there is a chink of light. Andy Burnham is the first PM to have previously been a health secretary, and his new international development minister, Kirsty McNeill, came to politics from a senior role with Save the Children – so both have highly relevant past experience. The UKWG wrote to Minister McNeill on her appointment, setting out exactly why NCDs matter, and calling for strong UK engagement – not least in the Third International Dialogue on Sustainable Financing for NCDs and Mental Health, which has recently been postponed to February 2027 (ostensibly to provide the government of the Philippines, which is hosting the event, with more time to develop the meeting and outputs).*
In another positive move, Ruth Lawson (the UK’s Deputy Permanent Representative in Global Health in Geneva) has a seat at the WHO ‘Joint Process Task Force’ on global health architecture reform. The UKWG and NCD Alliance have written to congratulate her and to reinforce the need to include NCDs as part of any new, integrated approach to global health – and we hope to meet. The UK has, in the past, taken its role seriously in this kind of negotiation – not least in the run-up to the Sustainable Development Goals, over a quarter-century ago, with the then-PM David Cameron acting as one of three co-chairs of the High-Level Panel of Eminent Persons on the Post-2015 Development Agenda.
So, although global health has undoubtedly taken many steps back (at incalculable human cost), we must focus on again taking a step forward, and then another step, and then another. And the UK government can – with support from civil society, and with low- and middle-income countries firmly at the helm – help this to happen.
* Alas, the Minister’s reply (received just as this blog was about to be published) does not mention NCDs or acknowledge health at all, simply stressing instead a ‘partnership approach’ to international development more broadly.
UK Working Group on NCDs 