Dismantling structural inequities in global prevention of childhood and adolescent non-communicable diseases

Abstract

Non-communicable diseases (NCDs) account for a growing proportion of morbidity and disability among children and adolescents worldwide. Contemporary NCD preventive strategies are predominantly adult-centric, resulting in delayed prevention and widening inequities, particularly in low- and middle-income countries. This neglect reflects a deeper structural and ethical failure, sustained by fragmented financing, siloed governance, commercial determinants of health, and short-term political priorities. Drawing on life-course theory, systems thinking, and principles of global health justice, childhood and adolescent NCD neglect can be understood as a systematic gap in long-term health governance that undermines human capital formation and entrenches socioeconomic disadvantage. A policy reorientation that positions early-life NCD prevention as a strategic investment in sustainable development is required. Priority reforms include embedding paediatric NCD services within universal health coverage, strengthening age-disaggregated surveillance systems, institutionalising intersectoral governance mechanisms, and establishing global accountability frameworks. Protecting children and adolescents from preventable NCDs constitutes not only a public health necessity but a moral, economic, and political imperative.