The blood-pressure target all WHO members endorsed calls for a 25% cut by 2025 — or at least holding the line. We read every economy's data: 35 went the wrong way — and 16 of them are in the Western Pacific.

In May 2013, the 66th World Health Assembly adopted the Global Action Plan for the Prevention and Control of Non-communicable Diseases 2013–2020, setting nine voluntary global targets against a 2010 baseline. Target 6: a 25% relative reduction in the prevalence of raised blood pressure — or its containment according to national circumstances — by 2025. The WHO tracks this through BP_04: an age-standardized modeled estimate, derived from national surveys through a Bayesian pooling model, of the share of adults aged 30 to 79 with blood pressure at or above 140/90 mmHg. Every figure below comes from that series, retrieved from the WHO Global Health Observatory on 2026-09-14. Per-economy percentage changes are relative changes computed from the unrounded WHO values, so they may differ slightly from a direct subtraction of the rounded rates shown. At the global level, the estimate stood at 28.59% in 2010 and 26.24% in 2019 — the latest published year — a fall of 8.2%. Reaching the 25% target requires the global rate to reach 21.44% by 2025. At the 2010–2019 pace extended linearly over 15 years, the projected 2025 figure is approximately 24.68%, a 13.7% reduction — roughly half the target. ^mmodeled Among all 195 economies in WHO's dataset with data for both 2010 and 2019: 35 (18%) recorded higher prevalence in 2019 than in 2010. Twelve had already achieved a 25% or greater cut by 2019. Thirty-one (16%) are on a pace, if continued, to meet the threshold by 2025. ^mmodeled The median economy recorded a −8.7% change. Regional totals cited below — such as 29 Western Pacific and 47 African economies — likewise count only economies with prevalence data for both 2010 and 2019 in each WHO region.

The following is analysis, not fact. The 35 economies with rising prevalence reveal a sharp regional divide in the data. Sixteen of 29 Western Pacific economies — 55% of the region — recorded increases from 2010 to 2019. At the other end of the table: not one of the 47 African economies in the dataset recorded an increase over the same period, despite several starting from among the highest absolute rates in the world. In the Western Pacific, the rises are concentrated in Pacific Island economies and Indonesia. Kiribati climbed from 32.0% to 39.5% (+23.7%). Tonga: 34.0% to 39.2% (+15.3%). Indonesia, the most populous of the region's rising economies: 34.3% to 38.5% (+12.2%). Tuvalu began the decade at 42.3% — already among the region's highest — and reached 47.4%. South Korea, at −25.0%, is the only Western Pacific economy to have reached or nearly reached the target. Singapore came close at −23.9%. Two high-income economies outside the Pacific also appear in the wrong column: the United States moved from 15.4% to 16.6% (+7.6%) and Australia from 20.3% to 21.7% (+6.8%). Iran is among the clearest global success stories: its rate fell from 27.0% to 19.9% (−26.4%), clearing the target ahead of the deadline. Among the steepest cuts in the data: Luxembourg at −30.4%, Mauritius (−29.8%), Costa Rica (−28.6%), and Switzerland (−28.4%). The twelve economies that had already cleared the bar by 2019 span five WHO regions and three income levels — Iran at upper-middle income and Malawi at low income (−25.2%) among them. ^sspeculative

The target's 'or containment' qualifier matters: the 2013 action plan explicitly allows countries to argue that stabilizing prevalence is appropriate given national circumstances, and the plan carries no enforcement mechanism for either version. The 2019 data predates COVID-19, and lockdown-era disruptions to routine care and changes in diet and physical activity may have altered the trends this piece projects forward. Africa's uniformly negative changes — several of them fractional, with Cameroon at −1.96% — raise a methodological question: for countries with limited survey coverage, the WHO pooling model may impose a regional downward slope that available surveys could not strongly distinguish from zero change ^sspeculative. For the United States, domestic NHANES surveillance shows improved hypertension control rates over the same period, suggesting that better case-detection of previously untreated patients may account for some of the rise in measured prevalence ^sspeculative.

From the WHO Western Pacific Regional Office's vantage, the island-economy data is consistent with a trajectory the office has documented since the 2000s: rapid urbanization and the shift to imported processed foods in small Pacific economies have outrun the infrastructure to measure and treat cardiovascular risk. From the African region: the consistent declines across all 47 economies are consistent with a decade of expanded primary-care reach — though the smallest changes sit close enough to flat that continued measurement will matter more than the direction alone. [speculative — our reading of each regional office's framing]