Good Practices in the Prevention, Control, and Surveillance of Noncommunicable Diseases (NCDs)

The Ministry of Health led the regulatory review that led to the creation of the Cancer Prevention and Control Network and the Navigation Program for People Diagnosed with Cancer, based on Law 14,758/2023. The exercise consisted of establishing an updated operational framework, coordinating health system stakeholders through inter-institutional workshops. As a result, three national decrees were published, formalizing the implementation of the policy, the network, and the program, which advances toward comprehensive and coordinated cancer care within the Unified Health System.

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The Ministry of Health, in partnership with PAHO and local authorities, implemented a pilot project in Pernambuco to improve cervical cancer prevention through an organized screening system and HPV PCR testing. In addition, school vaccination against HPV was promoted. More than 21,000 tests were conducted, and over 25,000 vaccine doses were administered in schools. This practice strengthens comprehensive care and can be replicated in other regions to advance toward the elimination of cervical cancer.

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The Brazilian Ministry of Health promoted the expansion of access to oncological radiation therapy through the implementation of PER-SUS, which includes the acquisition of equipment, infrastructure improvements, and technology transfer. The initiative enabled the installation of 67 linear accelerators, the construction of 49 new treatment areas, the development of a national equipment factory, and the establishment of a regional training center. This strategy reduced inequalities in access to oncological treatments, strengthened local capacities, and improved coverage in regions with limited supply.

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The Ministry of Health implemented self-testing for HPV as an innovation in cervical cancer screening, with a focus on equity and access in communities that pioneered Universal Primary Care. The practice improved coverage, acceptability, and follow-up of positive cases, empowering women and transgender people through self-care strategies, traceability, and community engagement.

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The Ministry of Health adapted the WHO's 90-70-90 strategy, prioritizing primary care with HPV vaccination, screening with highly accurate tests, and timely treatment. The care network was strengthened, with 100% of health units offering the test, 19 laboratories, and 75 treatment centers. The strategy achieved 68% screening coverage and 72% treatment coverage, and reduced cervical cancer mortality from 11.1 in 2017 to 7.2 in 2023. (Categories 1, 3, 4)

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The Ministry of Health of the Province of Jujuy implemented a health strategy for adults with morbid obesity (BMI ≥ 40), focusing on a comprehensive, interdisciplinary, and group approach. Coordinated by the Department of Nutrition, the strategy includes adapted physical activities, psychological support, non-weight-centered nutritional education, and comprehensive health workshops. It is structured in two phases: an initial phase of intensive support and a maintenance phase with regular follow-up. Results include improvements in mobility, muscle tone, biochemical parameters, quality of life, self-esteem, and social ties. The strategy has 11 groups in the province, is replicable, and has generated decentralized care networks. Its sustainability is based on existing resources, ongoing training, and political support, with the potential for expansion to other age groups and obesity levels. (Categories 1, 2)

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The Maternity and Gynecology Institute of Tucumán introduced prescription forms using pictograms to improve comprehension of medical instructions among populations with low literacy, Indigenous communities, and older adults. The strategy improved treatment adherence and reduced medication administration errors. Graphic symbols were included in personalized calendars with stickers for daily tracking. The practice improved communication between health teams and patients and showed good results in terms of acceptability, low cost, and scalability across the health system.

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The Ministry of Health of Tucumán Province implemented a mobile clinic (trailer) to provide integrated care services for people with noncommunicable diseases (NCDs) in geographically hard-to-reach areas. In 2024, the trailer visited 49 localities and provided 3,811 medical consultations, mostly to people over 50 years old. It also performed more than 2,600 laboratory tests, including low- and high-complexity tests for NCD follow-up (diabetes, hypertension, obesity, pulmonary diseases). The model delivers multidisciplinary care with physicians, nutritionists, biochemists, and community health agents, and includes community outreach and specialist referrals. The strategy enhances accessibility, continuity, and quality of care, and demonstrates high efficiency, sustainability, and replicability as a mobile solution for integrated NCD management in rural and peri-urban settings. (Categories 1, 2, and 4)

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The Comprehensive Obesity Care Program of SIPROSA (Tucumán, Argentina) implemented an interinstitutional coordination strategy to improve detection, referral, and follow-up of adults with morbid (BMI ≥ 40) and extreme (BMI ≥ 50) obesity. Through the Chronic Disease Trailer, 2,399 individuals were identified and attended to, 55% of whom had obesity and 19% morbid obesity. Patients were referred according to their condition to specialized centers (CEPTA) or primary care centers. A protected appointment system, active monitoring, and territorial coordination were established. The model reduced access barriers and improved linkage to the health system. Challenges included geographic, economic, and stigma-related obstacles, highlighting the need for hybrid strategies and telehealth. The practice is replicable in other provinces and contexts with mobile services and primary-specialized care coordination. (Category 1)

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The Ministry of Health launched a free public clinic for uninsured individuals, integrating the HEARTS initiative in the Americas with a standardized treatment protocol. The practice improved blood pressure control from 25% to 62% in two years, expanded access to free antihypertensive medications, and even attracted insured individuals, offering a replicable model for predominantly private health systems.

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PAHO, in coordination with the Ministry of Health and local partners, developed a specific noncommunicable disease (NCD) module within the Essential Conditions Assessment (ECA) tool for implementation in the Bolivian Chaco. This best practice allowed for the assessment of health service conditions in vulnerable Indigenous areas, identifying gaps in access to screening, medications, and care. Forty-five local professionals were trained, and the tool was applied in 16 facilities, revealing that only 51–53% of essential conditions were met. The initiative provided key evidence to guide local policies and promote the integration of NCDs into primary care.

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The Oruro Departmental Health Service implemented HEARTS in 20 primary health centers, with support from PAHO, to improve the diagnosis, treatment, and control of hypertension. The practice strengthened the capacity of healthcare personnel through self-training, standardization of blood pressure monitoring, and the use of information systems such as SOAPS. A scientific committee was established, and innovative equipment adapted for precise measurements was introduced, enabling local prevalence estimates and improved quality of care for the first time.

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In 2023, the Porto Alegre Municipal Health Department implemented the "Take Care of Your Heart" program to prevent deaths from cardiovascular disease through early diagnosis and ongoing monitoring of people with hypertension and diabetes. The strategy included community-based actions, teleconsultations, risk stratification using digital tools, and training for local leaders. The practice led to improved diagnosis, treatment adherence, and equity in access to services, combining technological innovation and community participation.

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The Ministry of Health implemented a national policy that guarantees timely diagnosis, comprehensive treatment, and financial protection for people with type 2 diabetes. The strategy included screening, essential medications, self-care education, and clinical follow-up, with free access for members of the public health system and limited co-payments for private providers. This policy strengthened equity in access, improved disease control, and reduced complications, establishing itself as a replicable and sustainable model.

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The Costa Rican Ministry of Health, through the Limón Health Authority, implemented a strategy to prevent and control diabetes, hypertension, obesity, and mental health in the workplace. The strategy consisted of advising public and private institutions on the development of health plans, conducting screenings, awarding prizes to outstanding organizations, and providing ongoing follow-up. This strategy reached more than 3,800 people directly or through educational initiatives, with 12 institutions receiving awards. The inter-institutional coordination and comprehensive focus on employee well-being are notable.

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The Ministry of Health of Jujuy Province implemented a health strategy for adults with morbid obesity (BMI ≥ 40), focused on an integrated, interdisciplinary, and group-based approach. Coordinated by the Nutrition Department, the strategy includes tailored physical activities, psychological support, non-weight-centered nutrition education, and holistic health workshops. It is structured in two phases: an initial phase of intensive support and a maintenance phase with regular follow-up. Outcomes include improvements in mobility, muscle tone, biochemical markers, quality of life, self-esteem, and social connections. The strategy includes 11 active groups across the province, is replicable, and has fostered decentralized care networks. Its sustainability is based on existing resources, continuous training, and political support, with potential for expansion to other age groups and obesity levels. (Categories 1, 2)

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The Brazilian Ministry of Health, in collaboration with the Federal University of Espírito Santo, carried out a pioneering study to monitor sodium and potassium intake in children and adolescents aged 6 to 17. From this study, low-cost predictive equations were developed that can be applied in schools to estimate salt consumption. The study assessed nutritional status and cardiovascular and renal health in 318 students and generated key evidence to strengthen risk factor surveillance in early life. Based on findings, health promotion actions were initiated, and technical recommendations were integrated into public policies on school nutrition and sodium reduction.

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The Chilean Ministry of Health, along with local authorities and intersectoral actors, piloted the Active School Transport (TAE) Guide in five municipalities, promoting guided walking routes to and from schools. The initiative aimed to increase daily physical activity, improve road safety, reduce sedentary behavior, and strengthen community engagement around active school environments. 54% of participants adopted active transport daily, and school safety perceptions improved significantly. A flexible, replicable model was developed, featuring safe routes, signage, trained monitors, and continuous monitoring. The program delivered environmental, social, and educational benefits, and strengthened collaboration among health, education, and local governments. Its participatory and intersectoral approach, along with proven impact, positions it as a scalable strategy for promoting child health and sustainable mobility in the region. (Category 2)

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The Purranque CESFAM implemented a comprehensive smoking cessation program for the adult population with support from the Osorno Health Service. This best practice is based on a multidisciplinary approach with medical and psychological evaluations and group sessions, including remote follow-up. In 2024, 12 people entered the program, of whom 3 achieved complete cessation. The experience stands out for its replicability and sustainability, adapting to local contexts with the commitment of the health team and community outreach activities.

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The city of Pasto implemented a culturally and community-based communication strategy to promote healthy lifestyles. Through workshops, campaigns, and intergenerational gatherings, the initiative addressed nutrition, physical activity, oral health, and tobacco/alcohol prevention. The campaign “Care for the Forest Within You” promoted smoke-free spaces, and “See-Life in Moderation” focused on responsible alcohol use. Dance was used as a cross-cutting tool for physical activity, reaching over 800 people. Social mapping and empowerment processes involved 34 organizations, strengthening local health capacities.

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The Cauca Health Secretariat implemented an intersectoral strategy in rural areas to promote physical activity, healthy eating, and self-care through a primary care model. Tools such as the SIGAPS platform were developed to identify risks, train community leaders, and form physical activity groups. This practice benefited thousands of people, strengthened community leadership, and generated evidence of the positive impact on physical and mental health.

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Multisectoral coordination for alcohol control. The Ministry of Health and Social Protection led this national best practice, which focused on creating a space for technical and political dialogue to strengthen public policy on alcohol. The strategy included disease burden analysis, evidence generation, regulatory proposals on taxes, and communication campaigns. Its innovation lies in coordinating public institutions, civil society, and academia under a permanent platform, focusing on public health and rights. This experience placed the issue on the national agenda and proposed concrete tools for its regulation, with high potential for scalability.

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Since 2012, the Medellín Mayor's Office, through its Secretariat for Social Inclusion and Family, has implemented the "Implementation of Actions in Food and Nutrition Education" (IAEAN) project, primarily targeting students in over 430 district schools. The strategy promotes healthy eating habits through participatory educational sessions, didactic tools, and technical assistance to integrate food and nutrition topics into school curricula. Annually, the program reaches over 50,000 students, teachers, and families. Innovations include epidemiological surveillance of the intervention's effects and the empowerment of student leaders as peer educators. The project is institutionalized, publicly funded, and shows high adaptability, with strong potential for regional replication in health promotion and NCD prevention through education. (Categories 2 and 3)

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Colombia’s National Cancer Institute designed a strategy to enhance public officials’ capacities to identify and manage tobacco industry interference in public health policies. Through a national seminar-workshop and methodological tools, 35 officials, congress members, and civil society representatives were trained on applying Article 5.3 of the FCTC. The initiative institutionalized mechanisms to control conflicts of interest, promoted transparent governance, and rejected undue partnerships with the industry. Its innovative and participatory approach has strengthened tobacco control governance in Colombia and can be adapted to other settings.

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The Costa Rican Ministry of Health, through the Limón Health Authority, implemented a strategy to prevent and control diabetes, hypertension, obesity, and mental health in the workplace. The strategy consisted of advising public and private institutions on the development of health plans, conducting screenings, awarding prizes to outstanding organizations, and providing ongoing follow-up. This strategy reached more than 3,800 people directly or through educational initiatives, with 12 institutions receiving awards. The inter-institutional coordination and comprehensive focus on employee well-being are notable. (Categories 1 and 2)

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The National Council of Sport, Physical Education and Recreation (CONADER), with technical support from PAHO, implemented a national strategy to strengthen NCD prevention through the certification of municipalities that promote active, safe, and inclusive environments. The initiative combines healthy urbanism, social participation, and intersectoral action to foster physical activity, social cohesion, and the use of public spaces. As of March 2025, 33 municipalities had enrolled and four had submitted comprehensive action plans. The strategy included the development of a technical manual, progress indicators, and a tiered certification route (bronze, silver, gold), achieving concrete advances such as bike lanes, ecological parks, and inclusive activities like parent-child fitness programs. The model has demonstrated high replicability, sustainability, and adaptability to diverse contexts, contributing to risk factor reduction and alignment with PAHO's Strategic Plan and the SDGs.

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The Ministry of Health developed an online course to train professionals in promoting healthy habits, targeting people with NCDs. The course includes theoretical content and a video clinical case to apply what has been learned, followed by an assessment. Thanks to its practical and accessible approach, it attracted the participation of more than 10,000 professionals across the country, with a completion rate of 78%. Its online format facilitates scalability and replication in various contexts.

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The National Commission on Mental Health and Addictions (CONASAMA), with support from PAHO, implemented a reform to the General Law for Tobacco Control to expand protection from exposure to tobacco smoke and emissions from new products. The measure established criteria for declaring 100% smoke- and emission-free spaces (ELHTE) in public and private areas, workplaces, public transport, and educational institutions. A national protocol was developed, and staff in all 32 states received training. Between 2015 and 2023, exposure significantly decreased in public buildings (-41.5%), restaurants (-39.5%), public transport (-39.6%), and universities (-21%). Despite challenges from tobacco industry interference, this policy has proven highly effective, sustainable, and replicable, in alignment with WHO FCTC Article 8 and the MPOWER package, positioning Mexico as a regional leader in smoke-free environments. (Category 2)

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The Honorary Commission for Cardiovascular Health, together with the Ministry of Education and Culture and the National Public Education Administration, has organized this competition for children and adolescents for 20 years, as part of Heart Week. The event promotes cardiovascular prevention and healthy lifestyles through creative educational projects developed in schools. The active participation of students, teachers, and communities has generated a national impact, promoting health education from an early age and facilitating its replication in different contexts.

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Uruguay’s Ministry of Public Health, through its National Tobacco Control Program, launched the “The Colors of Harm” campaign to raise awareness among children and youth about the risks of electronic cigarettes (ENDS). Using a creative, evidence-based digital strategy, the campaign countered the myth of ENDS being harmless, highlighting their health and environmental impact. It reached over 1.5 million people with more than 16 million impressions via TikTok, Instagram, YouTube, and Google Ads. The campaign was cost-effective, highly replicable, and designed to counter the tobacco industry’s marketing tactics.

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Since 2016, the Honorary Commission for Cardiovascular Health of Uruguay has run an annual competition awarding outdoor gym equipment to institutions with innovative proposals to promote physical activity in specific communities. The initiative encourages the creation of active spaces, interinstitutional networking, and the inclusion of diverse populations (schools, prisons, health centers, social organizations). Over 9 years, 134 proposals were received and 98 equipment sets awarded to 14 winning institutions. The initiative includes sustainability, universal accessibility, and community ownership criteria and uses digital tools like QR codes and guides. Its low operating cost and participatory design make it highly replicable and adaptable to different territorial contexts. (Category 2)

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PAHO, in coordination with the Ministry of Health and local partners, developed a specific noncommunicable disease (NCD) module within the Essential Conditions Assessment (ECA) tool for implementation in the Bolivian Chaco. This best practice allowed for the evaluation of health service conditions in vulnerable Indigenous areas, identifying gaps in access to screening, medications, and care. Forty-five local professionals were trained, and the tool was applied in 16 facilities, revealing that only 51–53% of essential conditions were met. The initiative provided key evidence to guide local policies and promote the integration of NCDs into primary care (Categories 3 and 1).

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The Ministry of Health defined the standard dose of an alcoholic beverage (10g of pure alcohol) and annual per capita consumption as official units to improve alcohol surveillance. This practice strengthened national monitoring with comparable data, promoted educational campaigns, and provided evidence for public policies. It also included a validated technical note and the annual publication of indicators on the official SDG dashboard, contributing to reducing the risks of alcohol consumption among the population.

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The Ministry of Health, together with public universities, developed the ICI-DANT (National Institute of Health) to evaluate and improve the institutional capacity for NCD surveillance in all states and capital cities across the country. The initiative identified critical gaps in human resources, infrastructure, and intersectoral coordination, and proposed measures to strengthen SUS governance. The participation of local stakeholders and the development of a robust index facilitated evidence-based decision-making and the planning of more effective public policies.

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The Ministry of Health, together with the Albert Einstein Hospital, developed a digital platform to integrate and visualize indicators from national surveys on chronic diseases. This tool unifies databases such as Vigitel and PeNSE, allowing managers, researchers, and civil society to access timely information for decision-making. The solution promotes transparency, open access, and user-centered design, facilitating the formulation of evidence-based public policies.

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The Municipal Health Secretariat implemented a population registry using data from eight information systems to identify and monitor diabetes cases. This practice integrated data on consultations, hospitalizations, medications, and mortality, allowing for the identification of more than 73,000 people with diabetes, representing 5.5% of the local population. The initiative strengthens health surveillance, improves public policy planning, and offers a replicable model for other territories.

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The Ministry of Health of Tucumán, through the Virtual Hospital, implemented a smoking cessation strategy based on telemedicine, integrated into primary and specialized care services. The program offers free professional follow-up by video calls, telephone, and app, including pharmacological and psychosocial interventions. Between 2021 and 2023, more than 2,400 active patients were registered, with cessation rates of 32% after three months. Access channels were expanded with telephone lines, referrals from health centers and online appointments, especially benefiting rural and vulnerable populations. The initiative strengthened installed capacity and reduced geographical barriers, and has been replicated in other public services in the province. (Categories 2 and 4)

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The Tucumán Ministry of Health developed a telemedicine network for cardiovascular emergency care, using videoconferencing and real-time data transmission from low-complexity centers. The practice articulated protocols, training, and prehospital cardiology coordination to optimize diagnosis and treatment times, especially in acute heart attacks. It resolved 50% of cases at the primary care level, reduced prehospital mortality, and improved equity and efficiency in the use of health system resources. (Categories 4 and 1)

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The Ministry of Health, through its Digital Health Secretariat, led the digital transformation of the SUS (National Health System) to expand access to care in vulnerable and indigenous communities. This practice implemented telediagnosis in dermatology, cardiology, and ophthalmology; remote consultations in 42 specialties; and distance learning programs. Waiting times for diagnoses were reduced, the use of specialists was optimized, and the system's costs and carbon footprint were reduced, strengthening equitable access to specialized healthcare. (Categories 4 and 1)

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The Telehealth Center of the Federal University of Minas Gerais implemented an integrated digital health strategy in primary care in ten low-income municipalities in the Jequitinhonha and Mucuri Valleys. The practice included a clinical support system, teleconsultations, educational messages, ongoing training, and remote monitoring. It improved blood pressure and glucose control, anthropometric indicators, and physical function, demonstrating high potential for scalability to other regions of the country (Categories 4 and 1).

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The Chilean Ministry of Health implemented an innovative strategy for early detection of diabetic retinopathy in primary care, incorporating artificial intelligence (AI) through the Digital Hospital's DART system. Medical technologists perform retinographies that are classified by AI, and ophthalmologists review images with abnormalities. This practice improved diagnostic efficiency and strengthened primary care, although its coverage is limited to 132 municipalities. The experience is replicable and sustainable thanks to the legal framework (GES) and ongoing staff training.

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UNOPS Guatemala developed KANOXïK, a data intelligence-based digital tool for the early identification of chronic kidney disease based on clinical and georeferencing data from IGSS patients. By applying glomerular filtration rate equations to more than 3 million creatinine tests, it allowed for the estimation of the hidden burden of kidney disease, the definition of priority care areas, and the generation of alerts for early care. The open-source and replicable tool improves equity in access and supports evidence-based decisions. (Categories 4 and 3)

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The National Institute of Psychiatry developed and implemented the intervention "¿Qué pasa si te pasas?" (QPSTP), a mobile application aimed at high school students to prevent alcohol, tobacco, and other drug use. Based on WHO’s Life Skills model and Bandura's Social Learning Theory, the intervention enhances risk perception and promotes skills such as decision-making, peer resistance, and assertive communication. A quasi-experimental design with pre- and post-tests showed significant increases in knowledge of substance use effects and in risk perception. The intervention is low-cost, replicable, and easily adaptable to school settings with basic technological resources. It includes a web version and interactive content such as comics and quizzes. Its implementation is supported by training for health and education professionals, and its social return on investment is currently being assessed, demonstrating strong scalability and sustainability potential. (Categories 2 and 4)

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