Initiatives to improve access to good-quality essential health-care services and to safe, effective, good-quality and affordable essential medicines and vaccines for the prevention and control of non-communicable diseases have not been scaled up in the majority of developing countries. Political commitments have often not been translated into concrete action. Serious constraints driven by economic and trade promotion interests are impeding the implementation by many Governments of some of the “best buys” and other recommended interventions for the prevention and control of non-communicable diseases, including the taxation of tobacco, alcohol and sugar-sweetened beverages and policies to reduce the impact on children of the marketing of foods and non-alcoholic beverages high in saturated fats, trans-fatty acids, free sugars or salt. There is also a visible gap in respect of each country’s policy space and leadership to establish and implement policies for the prevention and control of non-communicable diseases.