Globally, almost 70% of all deaths are due to noncommunicable diseases such as stroke, cancer, diabetes, heart and chronic lung diseases.

Of these, many premature deaths can be prevented or delayed through a multisectoral approach to reducing key risks, which are tobacco use, lack of physical activity, unhealthy diets, obesity, harmful use of alcohol and violence and injuries.

Health promotion faced considerable challenges during the biennium, as countries continued to reorient scarce resources towards the COVID-19 emergency response in 2021, resulting in slower progress in some policy areas and regions. Nevertheless, the overall direction of change has remained positive for many risk factor areas – such as healthy diets, tobacco control and physical activity, and the progressive momentum for health promotion has been strengthened.

Marked progress was seen in tobacco control, with an increase in the number of countries on track to meet the target of a 30% reduction in tobacco use (2010–2025) from 32 to 60. Half of the countries (98) and more than half of the world population (4.4 billion) are now covered by at least two demand-reduction best-practice tobacco control measures at the highest level of achievement. Overall, tobacco use is on a downward trajectory in 150 countries, and the number of tobacco users has decreased by 69 million since 2020. Projections show, however, that the world will achieve only a 24% reduction in tobacco use by 2025, unless additional action is taken to accelerate the trend. Today, tobacco control is also a component of COVID-19 recovery, in part due to highlighting by WHO of the link between tobacco use, noncommunicable diseases and severe COVID-19.

Significant progress was also seen in the elimination of industrially produced trans fats, toxic chemicals found in many processed foods, including packaged foods and cooking oils, which prematurely kill hundreds of thousands of people every year from heart disease. Mandatory policies prohibiting the use of industrially produced trans fats are now in effect for 3.2 billion people in 58 countries; of these, 40 countries have best-practice policies (including Brazil, Peru, Singapore, Turkey and the United Kingdom and European Union countries in 2021), as reported recently. WHO’s REPLACE action package is a guide for countries in becoming trans fat-free by the end of 2023.

During the biennium, national policies on food systems for promoting healthy diets were published, adopted or came into force in 34 countries, resulting in new or stronger measures for nutrition labelling, food reformulation, marketing restrictions, public food procurement and taxes on sugar-sweetened beverages. More countries in the Americas and Europe now have front-of-pack labelling, a cost–effective means for consumers to make healthier food choices, with Argentina, Brazil, Colombia, Luxembourg, Uruguay and Venezuela having adopted this measure. WHO is supporting China, Kenya, India and the United Republic of Tanzania in developing such systems and Indonesia in developing a policy for taxing sugar-sweetened beverages. WHO advocated for health to be central to food systems transformation and led the work on Shifting to sustainable and healthy consumption patterns as the United Nations agency for the United Nations Food Systems Summit in September 2021.