Purpose: As the coronavirus disease 2019 (COVID-19) continues to spread across countries, it is becoming increasingly clear that the presence of pre-existing noncommunicable diseases (NCDs) dramatically increases the risk of aggravation in persons who contract the virus. The neglect in managing NCDs during emergencies may result in fatal consequences for individuals living with comorbidities. This paper aims to highlight the need for a paradigm shift in the governance of public health emergencies to simultaneously address NCD and noncommunicable disease (CD) pandemics while taking into account the needs of high-risk populations, underlying etiological factors, and the social, economic, and environmental determinants that are relevant for both CDs and NCDs.Design/methodology/approach: The paper reviews the available global frameworks for pandemic preparedness to highlight the governance challenges of addressing the dual agenda of NCDs and CDs during a public health emergency. It proposes key strategies to strengthen multilevel governance in support of countries to better prepare for public health emergencies through the engagement of a wide range of stakeholders across sectors.Findings: Addressing both CD and NCD pandemics during public health emergencies requires (1) a new framework that unites the narratives and overcomes service and system fragmentations; (2) a multisectoral and multistakeholder governance mechanism empowered and resourced to include stakeholders across sectors and (3) a prioritized research agenda to understand the political economy of pandemics, the role played by different political systems and actors and implementation challenges, and to identify combined strategies to address the converging agendas of CDs and NCDs.Research limitations/implications: The article is based on the review of available published evidence.Practical implications: The uptake of the strategies proposed will better prepare countries to respond to NCD and CD pandemics during public health emergencies.Originality/value: The article is the first of its kind addressing the governance challenges of the dual pandemic of NCDs and CDs in emergencies.

Introduction: Cancer care in humanitarian settings is very challenging, and patients may face significant barriers to accessing the care they need. This study explored access to advanced diagnostic and treatment services for children with cancer in humanitarian settings, taking Gaza as a case study. Methods: The study was based on 51 key informant interviews and two focus group discussions with close relatives of children with cancer, healthcare providers and Ministry of Health officials between November 2021 and January 2022. We also analysed referral data for paediatric oncology care outside Gaza in 2021. Results: Among the structural barriers to cancer care are complex and lengthy referral mechanisms, along with an unclear permit system. These challenges contribute to significant delays in both diagnosis and the initiation of treatment. The referral pathway involves multiple administrative and logistical steps to secure approval for treatment outside Gaza. It begins with a physician-initiated referral, approval of the Ministry of Health Service Purchasing Unit, and concludes with exit permit requests for the child and a companion, which must be approved by the Israeli Gaza Coordination and Liaison Administration. Analysis of 2021 referral data reveals that 25% of children with cancer experienced permit delays of over 1 month, and 8% died while waiting for an exit permit. Conclusions: The urgent need to scale up cancer care in Gaza is critical, particularly for children who face severe challenges due to ongoing conflict, the Israeli blockade since 2006 and the closure of the only paediatric oncology department. Immediate, coordinated national and global efforts are essential to overcome political, medical and financial barriers. Improving health outcomes and survival for children with cancer in Gaza requires addressing the root causes of late diagnosis, as well as the complex referral and unclear permit processes that delay timely access to specialised care.

Cancer is one of the leading causes of global morbidity and mortality and one of the most challenging global health conditions, impacting the lives of millions every year. The Eastern Mediterranean Region (EMR) is not on track to achieve the sustainable development goal (SDG) target 3.4 which aims to reduce premature mortality (i.e., before the age of 70 years) for non-communicable diseases (NCDs), including cancer, by a third by year 2030; instead, it is projected that the EMR will experience the least progress towards achieving this target. This review therefore highlights the importance of context-specific cancer management, with a focus on nutritional, lifestyle and supportive care, in the EMR. A comprehensive literature search was conducted using electronic databases, including PubMed, Scopus and Google Scholar, as well as the Academy of Nutrition and Dietetics and key oncology institutes. Nutritional and lifestyle management is a fundamental aspect of cancer care which should be context-specific, achievable and individualized to minimize symptoms and side effects, while maximizing benefits and better addressing the needs of the patients with cancer. A multidisciplinary approach that integrates medical, nutritional, psychological and palliative care is essential to address this growing issue effectively. Cancer care and management requires coordinated efforts from policymakers, healthcare providers and communities to implement evidence-based interventions and promote cancer awareness.

Non-communicable diseases (NCDs) are a leading health and development challenge worldwide. Since 2015, WHO and the United Nations Development Programme have provided support to governments to develop national NCD investment cases to describe the socioeconomic dimensions of NCDs. To assess the impact of the investment cases, semistructured interviews and a structured process for gathering written feedback were conducted between July and October 2022 with key informants in 13 countries who had developed a national NCD investment case between 2015 and 2020. Investment cases describe: (1) the social and economic costs of NCDs, including their distribution and projections over time; (2) priority areas for scaled up action; (3) the cost and returns from investing in WHO-recommended measures to prevent and manage NCDs; and (4) the political dimensions of NCD responses. While no country had implemented all the recommendations set out in their investment case reports, actions and policy changes attributable to the investment cases were identified, across (1) governance; (2) financing; and (3) health service access and delivery. The pathways of these changes included: (1) stronger collaboration across government ministries and partners; (2) advocacy for NCD prevention and control; (3) grounding efforts in nationally owned data and evidence; (4) developing mutually embraced ‘language’ across health and finance; and (5) elevating the priority accorded to NCDs, by framing action as an investment rather than a cost. The assessment also identified barriers to progress on the investment case implementation, including the influence of some private sector entities on sectors other than health, the impact of the COVID-19 pandemic, and changes in senior political and technical government officials. The results suggest that national NCD investment cases can significantly contribute to catalysing the prevention and control of NCDs through strengthening governance, financing, and health service access and delivery.

Cervical cancer remains a significant public health challenge in the WHO Eastern Mediterranean Region (EMR), with significant implications for women’s health and sustainable development. Despite being largely preventable, the EMR reported high prevalence of new cases and deaths in 2022. The burden is expected to increase by 2050. Primary healthcare (PHC) offers a cost-effective platform for delivering essential health services, such as human papilloma virus vaccination and early detection and referral programmes, which are crucial for reducing cervical cancer incidence and mortality. The paper discusses the role of PHC in cervical cancer interventions, showcasing successful examples from EMR countries and examining barriers like resource constraints, sociocultural factors and systemic inefficiencies. It also proposes solutions, such as enhancing infrastructure and human resources, fostering public–private partnerships and adopting innovative screening methods. By addressing these gaps and leveraging PHC’s potential, EMR countries can improve cervical cancer outcomes and promote health equity for girls and women across the region.