How countries can act on WHO kidney resolution

A new Lancet paper outlines how countries can turn World Health Organisation kidney health commitments into action

A new health policy paper published in The Lancet offers practical guidance to help countries implement the World Health Organisation’s (WHO) kidney health resolution and strengthen prevention, early detection, and kidney care worldwide, as the burden of kidney diseases continues to rise.

Chronic kidney disease (CKD) affects 850 million people worldwide and places a disproportionate burden on low-income and middle-income countries where access to timely diagnosis, treatment, and life-sustaining kidney replacement therapy (KRT) is restricted.

In May 2025, the WHO’s 78th World Health Assembly adopted a resolution on kidney health that called on all Member States to integrate kidney care into national strategies; enhance prevention, early detection, and timely management; strengthen primary care; expand access to KRT; and enhance capacity for measuring burden, progress, and return on investment. Capitalising on the opportunities created by the resolution will depend on governance, political commitment, and accountability, along with technical tools, appropriate funding, and mechanisms to measure progress.

As countries begin translating the WHO’s global commitments into national policies and health system planning, the need to move from resolution to action has become increasingly urgent, according to the International Society of Nephrology (ISN), a global professional association dedicated to advancing kidney health worldwide since 1960 through education, grants, research, and advocacy.

Thus The Lancet paper, ‘Implementing the commitments of the World Health Assembly kidney health resolution: A key opportunity to improve health for millions’, authored by an international group of experts, addresses this gap by outlining a step-by-step framework to put the resolution into practice.

The document offers a practical framework to help governments and partners operationalise the commitments from the resolution and political declaration, drawing on lessons from other non-communicable disease programmes, and on countries’ experiences with kidney health policy.

ISN President Dr Marcello Tonelli said: “The adoption of the WHO kidney health resolution was a historic milestone, but resolutions alone do not save lives. Meaningful progress will depend on how Member States implement these commitments within their own health systems. This paper is designed to support that process by providing a practical approach to help countries identify priorities and advance kidney health in a measurable way.”

The paper highlights a phased and integrated approach, starting with governance mechanisms, national focal points, and situational assessment to help countries identify gaps and define areas for action. The authors stress that expanding equitable kidney care, from prevention and early detection through to KRT, will depend on financing, workforce capacity, and robust systems to measure outcomes and ensure accountability.

“Kidney disease is both a driver and a consequence of health inequities,” said Dr Robert Kalyesubula, co-author of the paper and a member of the ISN executive committee. “In many parts of the world, people with kidney disease are still diagnosed too late or cannot access the treatment they need. Expanding access to early detection and timely care, especially in LMICs [low- and middle-income countries], is one of the most important steps we can take to reduce preventable deaths and health inequities.”

The authors emphasise that kidney care should be embedded within primary healthcare, non-communicable disease (NCD) strategies, and universal health coverage, building on existing programmes for diabetes, hypertension, and other NCDs rather than creating parallel systems. They also call for sustained political commitment to ensure that global promises translate into improved outcomes and equity.

“This is a pivotal moment for kidney health globally,” said Prof Aminu Bello, co-chair of the ISN-Global Kidney Health Atlas Core Group and a co-author of the paper. “The WHO resolution created a unique opportunity and this paper helps show how countries can take the next steps to deliver real, measurable change for patients.”

Because advanced CKD is a leading cause of catastrophic health expenditures, countries should include tests and treatments needed for early detection and timely treatment in universal healthcare packages, the paper says. If newer treatments such as SGLT2 inhibitors are not initially included, transparent health technology assessment processes could be used to reconsider this decision at regular intervals, it suggests. Decisions about benefits and reimbursement should be linked to relevant enablers and supported by appropriate resources.

A concise panel of core key performance indicators should be agreed, embedded in national health management information systems, and reported overall and disaggregated by key characteristics (see panel).

Reference

Tonelli M, Kalyesubula R, Tungsanga S, Francis A, Gill J, Lou-Meda R, et al. Implementing the commitments of the World Health Assembly kidney health resolution: A key opportunity to improve health for millions. Lancet. 2026 May 19:S0140-6736(26)00755-5