A Silent Drain on Growth: Why NCDs and Mental Illness Demand Urgent Investment

A UNDP-led review of national investment cases across 60+ countries shows that noncommunicable diseases and mental health conditions quietly drain economies through lost productivity, costing countries up to 4–10% of GDP each year. The evidence is clear: investing early in prevention, primary care, and mental health delivers high economic returns, protects households from poverty, and is far cheaper than paying for late-stage illness.

Heart disease, cancer, diabetes, chronic lung disease, and mental health conditions rarely dominate headlines, yet they are quietly reshaping the global economy. Together, these noncommunicable diseases (NCDs) now cause most deaths and disability worldwide. According to a major new assessment led by the United Nations Development Programme (UNDP), alongside the World Health Organization, the UN Inter-Agency Task Force on NCDs, the WHO Framework Convention on Tobacco Control Secretariat, and partners across governments, academia, and civil society, the economic damage caused by neglecting these conditions rivals that of major financial shocks.

The burden falls hardest on low- and middle-income countries, where more than 80 percent of premature NCD deaths occur. Mental health conditions affect over one billion people globally, yet public spending on mental health remains stuck at around two percent of health budgets. Despite their scale, these diseases have long been treated as unavoidable costs rather than preventable threats.

The true cost of doing nothing

Over the past decade, more than 60 countries have developed national “investment cases” to measure what NCDs and mental health actually cost their economies. The findings are stark. On average, NCDs alone drain about 4.4 percent of national GDP each year, rising to nearly 10 percent in some countries. Tobacco use typically accounts for around two percent of GDP annually, while air pollution and mental health conditions add further losses.

Most of this damage does not come from hospital bills. It comes from lost productivity, people dying too young, missing work, or struggling to function at full capacity. Mental health is especially costly in this respect, with around 90 percent of its economic impact linked to lost productivity rather than healthcare spending. In effect, countries are paying a hidden tax every year for failing to prevent disease early.

Why prevention pays off

The report overturns the idea that prevention is expensive or slow to deliver benefits. Across countries, investment cases show that prevention and early treatment are among the smartest investments governments can make. Tobacco taxes, smoke-free laws, salt reduction, alcohol control, physical activity promotion, cleaner cooking fuels, and better air quality all deliver strong economic returns at relatively low cost.

In many cases, the total cost of implementing prevention measures over 15 years is far lower than the economic losses countries suffer in just one year of inaction. Some tobacco control policies generate returns many times greater than their cost. Early detection and treatment of heart disease, diabetes, hypertension, and mental health conditions also save lives while reducing the need for expensive hospital care later. The message is simple: paying early costs far less than paying late.

More than money: fairness and protection

The benefits of prevention go beyond economics. When disease is avoided, families are protected from catastrophic health expenses that can push them into poverty. This matters most for low-income households, women, and vulnerable groups, who often carry the greatest burden of care and lost income.

Health taxes on tobacco, alcohol, and sugary drinks stand out as powerful tools. They reduce harmful consumption, especially among poorer populations, while generating revenue that governments can reinvest in healthcare, education, or social protection. Mental health investments also strengthen people’s ability to learn, work, and participate in society, improving social cohesion and dignity in ways that are hard to quantify but deeply felt.

Politics, not evidence, is the real barrier

If the economic case is so strong, why has progress been slow? The report’s answer is clear: evidence alone does not drive reform, politics does. In many countries, NCDs and mental health appear in strategies and speeches but disappear when budgets are written. Health ministries often lack the power to coordinate across government, while powerful commercial interests, from tobacco and alcohol to ultra-processed food and fossil fuels, work to weaken regulation.

Where political leadership is strong, investment cases have helped unlock change. Countries report stronger laws, higher health taxes, increased budgets, better coordination across ministries, and wider access to services through primary care and universal health coverage. No country has done everything, but most say investment cases accelerated reforms that had long been stalled.

The conclusion is hard to ignore. Treating health as a cost has proven far more expensive than treating it as an investment. In an era of economic uncertainty, climate shocks, and ageing populations, preventing NCDs and improving mental health is not just good public health, it is essential for economic resilience and shared prosperity.