Turning the WHO Kidney Disease Resolution Into Action, With Marcello Tonelli, MD

Chronic kidney disease (CKD) affects an estimated 850 million people worldwide, yet it has long been absent from the highest levels of the global noncommunicable disease (NCD) agenda. Despite its strong associations with diabetes, hypertension, and cardiovascular disease, kidney disease has historically received less policy attention and fewer health system resources than these related conditions, leaving major gaps in early detection, access to treatment, and kidney replacement therapies, particularly in low- and middle-income countries.

That changed in May 2025, when WHO member states voted to adopt a kidney health resolution at the 78th World Health Assembly. The resolution, titled "Reducing the burden of noncommunicable diseases through the promotion of kidney health and strengthening prevention and control of kidney disease," marks the first time kidney health has been formally prioritized within the WHO NCD framework. The measure calls on member states to develop national strategic plans, strengthen early detection and primary care integration, scale up kidney replacement therapies, improve procurement systems, build kidney care workforces, and establish monitoring and evaluation frameworks to track progress and ensure accountability.

"Today is a turning point for kidney health, thanks to Guatemala's leadership and the growing awareness among Member States of how widespread and serious kidney disease really is," Marcello Tonelli, MD, a nephrologist and professor of medicine at the University of Calgary, founding director of the World Health Organization Collaborating Centre on Prevention and Control of Chronic Kidney Disease, and president of the International Society of Nephrology (ISN), said in a press release. "It's inspiring to see so many groups — including those focused on diabetes and heart health — came together in support, showing just how central kidney care is to the fight against chronic diseases."

Tonelli, who helped lead ISN's years-long advocacy effort behind the resolution, has emphasized that implementation will require coordinated investment across clinical, policy, procurement, and workforce sectors in every country.

In the following interview, Tonelli discusses what the WHO resolution means for frontline clinicians, how meaningful adoption will look different across health systems, and where clinicians can have the greatest impact in the years ahead.

Q: What is the significance of the WHO resolution on kidney health?

Tonelli: The resolution is important because it calls attention to the fact that kidney disease is common, preventable, deadly and treatable. So it's on the policy agenda. It's mentioned up there with the other important NCDs for the first time, like hypertension, diabetes and cardiovascular disease. So it's important because we know from experience that if you can mobilize efforts behind resolution, drive implementation, you can get action that benefits millions of people.

Q: Do any of the core priorities outlined in the resolution stick out to you as having the greatest population-level impact?

Tonelli: As a clinician, the first things that pop out are an emphasis on early detection and an emphasis on integrating kidney care in primary care. So those are going to be important. We can't deliver care for 850 million people. As nephrologists, we need to work with our colleagues in primary care and other specialties. So clinically speaking, those are the things that jump out. But as someone who's interested in health policy, it's often the more boring, less clinical. Those are the those are the opportunities that really excite me, getting countries unified behind a plan, a big picture strategic plan that looks at their situation in their country. What are the barriers? What are the gaps? What are the opportunities, the big picture, and then focusing in on the country's priorities. So I think that together with a focus on the other parts, like procurement, boy, no one's excited by procurement, but it's really important having a good system for procurement, having a good system for developing workforce, this is going to take decades, but we have an opportunity to get started where things were with the things that matter most.

Q: What does meaningful adoption look like?

Tonelli: Well, for me, meaningful adoption will look different for each country, each country starting in a different place. Each country has different parties, so I think that's the first thing. Overall, we need to strengthen efforts at early detection, timely treatment of people with kidney disease. We need to scale up kidney replacement, dialysis, and transplantation on a pace that makes sense for each country. So those are key issues. Also, because this is going to take decades to achieve, we need to build the systems for monitoring and evaluation so we can hold countries to account, and also we can show countries where they're doing well.

Q: How can frontline clinicians engage with or support these efforts?

Tonelli: The first thing that clinicians think about are their ability to to move the needle on clinical care. And that for sure, is important. We need technical expertise, clinical expertise in every country but physicians and nephrologists are usually leaders in their home communities. They have weight with the public and with policymakers. They can galvanize interest behind kidney disease. That's what we need. We need we need everyone speaking out through the channels that they have home and at work about the about the about the importance of kidney disease and integrating it in the global health agenda.

Q: Where do you see the greatest opportunities to drive real progress in the next few years?

Tonelli: Clinically speaking, the biggest opportunities are going to be with, in my opinion, with early detection and timely treatment. We have so many great new drugs. There are so many people that don't have access to them, finding the people, getting them on the right therapies, and keeping them on therapies for years. We can make a big impact that way. Again, though, we're going to have to put the systems in place that make that possible, which is going to take a lot of time and a lot of effort, and working with people who are not clinical experts, people with expertise in it, procurement, workforce, development, education and training, it's going to be a team effort.

Editors’ note: Tonelli reports no relevant disclosures.

Reference: ISN. Historic win for kidney health as WHO adopts global resolution. May 23, 2025. Accessed April 2, 2026. https://www.theisn.org/blog/2025/05/23/historic-win-for-kidney-health-as-who-adopts-global-resolution/