By Shobha Shukla
At the 80th United Nations General Assembly (UNGA) High-Level Meeting on Non-Communicable Diseases (NCDs) and Mental Health, most nations were ready to adopt a political declaration by consensus. However, the United States broke ranks and opposed key elements, effectively stalling the process. This move could push the draft declaration to a divisive vote in early October, rather than a unanimous endorsement.
A Pattern of Resistance
UNGA high-level meetings have historically produced consensus-based agreements on health, such as those on tuberculosis (2018), antimicrobial resistance (2024), and the Sustainable Development Goals (2015). Debate and disagreement are healthy, but when a single country’s stance undermines scientific evidence and human rights, it raises serious concerns. Critics argue the U.S. position reflects a broader pattern of protecting corporate interests at the expense of public health.
Corporate Interests Versus Public Health
Robert Kennedy Jr., representing the U.S. government, objected to taxing unhealthy products. Yet overwhelming evidence shows that higher taxes on tobacco, alcohol, and sugary beverages save lives by reducing consumption and generating revenue for health programs. The U.S., however, is home to powerful corporations—from tobacco giant Philip Morris International to beverage giants Coca-Cola and Pepsi—that profit from unhealthy products linked to millions of preventable deaths.
These industries also intersect with global crises. Fast food and sugary drinks fuel obesity and diabetes, while fossil fuel corporations drive climate change, which worsens health inequalities. Advocates argue that people, not profits, must come first, calling on governments to “#MakeBigTobaccoPay” and “#KickPollutersOut.”
The Gender and Rights Debate
Kennedy Jr. also rejected references to “gender ideology” and the recognition of safe abortion as a right. While the draft declaration does not explicitly mention abortion, it does call for integrating NCD prevention into sexual and reproductive health programs and adopting a gender perspective in health policy.
Global health experts stress that gender equality and the right to health are inseparable human rights. Dr. Tlaleng Mofokeng, UN Special Rapporteur on the Right to Health, recently reiterated that gender mainstreaming—including recognition of diverse gender identities—is essential to achieving the Sustainable Development Goals.
NCDs and Mental Health: The Global Burden
NCDs are the world’s leading killers, causing more than 70% of global deaths—around 43 million annually, including 18 million premature deaths. Cardiovascular diseases, cancers, diabetes, and chronic respiratory illnesses dominate this toll. These conditions are largely preventable through reducing risk factors such as tobacco use, unhealthy diets, alcohol consumption, and physical inactivity.
The draft declaration also highlights the burden of mental health conditions, which affect nearly 1 billion people worldwide. Disorders like anxiety, depression, and psychosis often overlap with neurological conditions and substance use, compounding disability and economic loss.
Trade Versus Health
Tobacco remains the most pressing preventable threat, killing over 8 million people each year. Yet the U.S. has not ratified the World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC), the first global public health treaty signed by 183 countries. The FCTC recommends higher tobacco taxes, plain packaging, advertising bans, and strict regulation of emerging nicotine products.
Most countries support such measures, but the U.S. continues to resist, prioritizing trade and industry interests. Advocates warn this undermines global progress on both NCDs and mental health, especially in low- and middle-income countries where tobacco-related deaths are rising.
A Call for Human Rights and Equity
The draft declaration recognizes that NCDs and mental health are not only health issues but also threats to economic growth, security, and human capital. Long-term illness fuels poverty cycles and undermines sustainable development. Governments worldwide, except for a handful led by the U.S., support bold action including taxation of harmful products, gender mainstreaming, and stronger regulation.
As the UN prepares for upcoming summits on climate change and tobacco control, civil society voices are urging leaders to prioritize human rights—especially the right to health and gender equality—over corporate lobbying. The question remains: will the global community uphold equity and evidence-based health policies, or will powerful interests derail consensus once again?
– CNS