Galea Gauden, Ekberg Allison, Ciobanu Angela, Corbex Marilys, Farrington Jill, Ferreira-Bores Carina, Kokole Daša, Losada María Lasierra, Neufeld Maria, Rakovac Ivo, Tsoy Elena, Wickramasinghe Kremlin, Williams Julianne, McKee Martin, Stuckler David
WHO Regional Office for Europe, Copenhagen, Denmark.
Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, UK.
Lancet Reg Health Eur. 2025 Mar 24;52:101281. doi: 10.1016/j.lanepe.2025.101281. eCollection 2025 May.
Despite their established effectiveness, uptake of the WHO best buys for tackling non-communicable diseases (NCDs) has been uneven and disappointing. Here we introduce the "quick buys", an evidence-based set of cost-effective interventions with measurable public health impacts within five years. We reviewed 49 interventions previously established as cost-effective (<$I20,000 per disability-adjusted life-year averted) to identify the earliest possible detectable effect on high-level population health targets. Using a strict evidence hierarchy, including Cochrane and systematic reviews, we estimated the effects of each intervention against global targets agreed upon by countries. Quick buys were defined as those interventions that could exhibit measurable effects within 5 years, aligning with average electoral cycles in across the WHO European Region. Of the 49 interventions, 25 qualified as quick buys, including those relating to tobacco (n = 5), alcohol (n = 4), unhealthy diet (n = 3), physical inactivity (n = 1), cardiovascular disease (n = 3), diabetes (n = 4), chronic respiratory disease (n = 1), and cancer (n = 4). These findings not only offer guidance to policymakers deciding on interventions that align with short-term political cycles but also have the potential to accelerate progress to global health targets, particularly the 2030 Sustainable Development Goal of reducing premature NCD mortality by one-third.
尽管世界卫生组织(WHO)推荐的应对非传染性疾病(NCDs)的最佳措施已证实有效,但这些措施的采用情况参差不齐,令人失望。在此,我们介绍“快速采购”措施,这是一套基于证据的具有成本效益的干预措施,有望在五年内产生可衡量的公共卫生影响。我们回顾了49项先前已确定具有成本效益的干预措施(每避免一个伤残调整生命年成本低于120,000美元),以确定对高层次人群健康目标最早可能检测到的影响。我们使用严格的证据等级体系,包括Cochrane系统评价和系统性综述,评估了每项干预措施对各国商定的全球目标的影响。“快速采购”措施定义为那些能够在5年内展现出可衡量效果的干预措施,这与WHO欧洲区域的平均选举周期一致。在这49项干预措施中,有25项符合“快速采购”标准,包括与烟草(n = 5)、酒精(n = 4)、不健康饮食(n = 3)、身体活动不足(n = 1)、心血管疾病(n = 3)、糖尿病(n = 4)、慢性呼吸道疾病(n = 1)和癌症(n = 4)相关的措施。这些发现不仅为决策者在选择符合短期政治周期的干预措施时提供了指导,还有可能加速实现全球健康目标,特别是到2030年将非传染性疾病过早死亡率降低三分之一的可持续发展目标。