Ahead of the 4th UN High-Level Meeting on Non-Communicable Diseases (NCDs) in September 2025, representatives of the global neurology community, under the OneNeurology Partnership, have come together to publish a position paper that calls for inclusion of neurology as a distinct pillar within the NCD response. 

Neurological conditions are the leading cause of disability and the second leading cause of death worldwide. Yet they remain overlooked in global NCD responses. The 2025 UN High-Level Meeting is a chance to change that. 

This meeting arrives at a critical inflection point for global health. Progress on NCDs has been uneven and insufficient: as of 2023, only 19 countries are on track to meet Sustainable Development Goal target 3.4 on NCD mortality reduction​. Meanwhile, new challenges and insights have emerged since the last HLM in 2018. Notably, neurological conditions – long under-recognised in global NCD discussions – have been spotlighted by recent data as a leading cause of global morbidity and mortality​. The World Health Organization’s adoption of the Intersectoral Global Action Plan (IGAP) on Epilepsy and Other Neurological Disorders in 2022 signalled a turning point, affirming that neurological health is integral to the NCD agenda. 

However, current political commitments do not yet fully reflect this reality. The 2018 Political Declaration on NCDs did include an important clause recognising that “mental disorders and other mental health conditions, as well as neurological disorders, contribute to the global burden of NCDs”​. This was a significant achievement – effectively broadening the NCD focus from the traditional four diseases (cardiovascular diseases, cancers, chronic respiratory diseases, diabetes) to a “five-by-five” framework that adds a fifth category of conditions (mental and neurological) and a fifth risk factor (air pollution)​. Yet, in practice, implementation has remained 4×4-dominated: many countries’ NCD strategies still omit neurological disorders, and funding and initiatives for NCDs typically prioritize the original four disease groups. Moreover, the uneven implementation of even the original 4×4 framework has consequences for brain health, as unmanaged risk factors like hypertension, diabetes, and alcohol use contribute to rising rates of stroke, dementia, and other neurological disorders. Preventive care for NCDs such as diabetes, hypertension, and hypercholesterolemia — which are major risk factors for stroke and vascular dementia — remains insufficient in many countries. Strengthening these efforts would not only improve cardiovascular outcomes but also significantly reduce the burden of neurological conditions. 

Mental health has started to gain dedicated attention (e.g. the 2020 WHO Mental Health Action Plan extension and the inclusion of mental health in UHC discussions), but neurological conditions are often conflated with or overshadowed by mental health. The OneNeurology Partnership – a collective of global organisations from patient advocates and clinicians to researchers and professional societies – is advocating for the 2025 HLM to explicitly address this gap. The Partnership calls on Member States to make neurological conditions a clear priority in the Political Declaration and ensuing actions, distinct from but complementing mental health efforts.