UN weakens draft declaration on non-communicable diseases

With the United Nations General Assembly scheduled for September just weeks away, a new draft political declaration is causing serious concern among public health stakeholders. This text, intended to strengthen the fight against noncommunicable diseases (NCDs), has been significantly weakened compared to previous versions. Key measures based on sound scientific data, such as taxing sugary drinks and requiring graphic warnings on cigarette packages, have been removed from the final draft.

This setback, which public health experts say came under pressure from the industries concerned, risks compromising essential advances in the prevention of cancer, diabetes, cardiovascular and respiratory diseases and obesity.

A global text emptied of its fiscal substance

The political declaration to be adopted by the United Nations General Assembly in September is intended to be a benchmark text to guide policies for the prevention of non-communicable diseases, which are responsible for more than 43 million deaths each year, including 18 million before the age of 70. Cancers, cardiovascular diseases, diabetes, and respiratory diseases now represent the leading cause of preventable mortality worldwide, particularly in low- and middle-income countries. These diseases place a strain on health systems, putting them at risk in many countries. Therefore, a strong collective commitment is deemed essential to change this trajectory.

The initial draft, published in May 2025, appeared to address this requirement by proposing specific and proven measures. In particular, it recommended increasing taxes on tobacco, alcohol, and sugary drinks, in line with the recommendations of the World Health Organization. The effectiveness of these tax policies is widely documented: they both reduce the consumption of harmful products and free up additional resources to finance public health. For example, the WHO estimates that a 50% increase in the prices of tobacco products, sugary drinks, and alcohol by 2035, integrated into its " 3 by 2035 ", could generate up to $1 trillion in revenue to strengthen health systems worldwide.

However, the revised version of the draft, unveiled in early August, marks a clear step backward. All mention of sugary drinks has disappeared from the text, despite their proven role in the global obesity and diabetes epidemic. As for tax recommendations on tobacco and alcohol, they now appear only in the form of a much vaguer invitation, inviting certain states to "consider" increasing their taxes. This semantic shift, which transforms a firm direction into a mere suggestion, profoundly weakens the scope of the collective commitment. For many experts, it illustrates the difficulty of putting public health before the economic and commercial interests linked to these industries.

Concern of experts, civil society and the weight of industries

Faced with these setbacks, many voices are being raised. The Alliance Against Noncommunicable Diseases, which brings together several international organizations committed to the fight against NCDs, has denounced the text as too weak to address the scale of the global health crisis. Safura Abdool Karim, a South African public health lawyer, regrets that a project supposed to embody an ambitious collective vision has turned into a "minimalist set of commitments." For NGOs, such a document risks proving ineffective when, on the contrary, it should strengthen national prevention policies.

This weakness also reflects, according to several public health actors, the pressure exerted by the sugar, alcohol and tobacco industries. If the organizations questioned by The Examination[1] have not provided direct evidence of influence in this specific process, the media outlet points out that these sectors have already led active campaigns in the past to curb public health measures.

As part of this investigation, The Examination requested comments from the major tobacco manufacturers (British American Tobacco, Japan Tobacco International, Imperial Brands, and Philip Morris International), as well as organizations representing these industries: the International Tobacco Growers Association, the International Food and Beverage Alliance for the food industry, and the International Alliance for Responsible Drinking for the alcohol sector. None of these actors responded to requests for clarification. For civil society, this silence illustrates a recurring strategy: minimizing their role while exerting decisive influence behind the scenes on the direction of international public health policies.

With the General Assembly set to vote in September, civil society and public health stakeholders are calling on states to reinvigorate the text's ambition, in order to align the political declaration with global health challenges and objectives. They point out that effective measures are known and that it is up to them to defend the public interest.

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[1] Ashley Okwuosa, Draft UN declaration rolls back proposed restrictions on sugary drinks, tobacco, The Examination, published August 14, 2025, accessed August 19, 2025