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Transplantation extends and improves lives, but the shortage of organs is one of the main factors limiting the number of transplants in Italy, as well as in other countries. This study investigated the awareness about organ donation and the socio-demographic factors associated with donation will in a general population.

In 2019, a survey was carried out by computer-assisted web interviewing. A questionnaire was sent via e-mail to 39,360 individuals (i.e. students, administrative and teaching staff of the University of Milano-Bicocca, Italy). The response rate was 10.6% and 4,191 weighted cases were used in the analysis.

This study showed a strong, positive attitude towards donation: over 96% of respondents stated to be keen on organ donation. Of the respondents, 40.8% considered themselves informed on medical procedures involving organ donation, and only 15.8% thought to have sufficient legal information. Overall, only 17.7% of respondents thought that the information available was sufficient to make informed decisions. According to the respondents, ethical and religious implications were the main reasons (30% of answers) that limited the level of information. Just 57.9% of respondents had already recorded their willingness to donate. Among them, renewal of the identity card was the most common motivation (55.8%) and the main motivation reported for lack of expression of donation will was the lack of opportunity or time (61.5%).

A positive attitude towards donation demands a wide public education programme and opportunities to declare one's will to donate to increase the population of potential organ donors.

As the coronavirus disease 2019 (COVID-19) continues to spread across countries, it is becoming increasingly clear that the presence of pre-existing noncommunicable diseases (NCDs) dramatically increases the risk of aggravation in persons who contract the virus. The neglect in managing NCDs during emergencies may result in fatal consequences for individuals living with comorbidities. This paper aims to highlight the need for a paradigm shift in the governance of public health emergencies to simultaneously address NCD and noncommunicable disease (CD) pandemics while taking into account the needs of high-risk populations, underlying etiological factors, and the social, economic, and environmental determinants that are relevant for both CDs and NCDs.

The paper reviews the available global frameworks for pandemic preparedness to highlight the governance challenges of addressing the dual agenda of NCDs and CDs during a public health emergency. It proposes key strategies to strengthen multilevel governance in support of countries to better prepare for public health emergencies through the engagement of a wide range of stakeholders across sectors.

Addressing both CD and NCD pandemics during public health emergencies requires (1) a new framework that unites the narratives and overcomes service and system fragmentations; (2) a multisectoral and multistakeholder governance mechanism empowered and resourced to include stakeholders across sectors and (3) a prioritized research agenda to understand the political economy of pandemics, the role played by different political systems and actors and implementation challenges, and to identify combined strategies to address the converging agendas of CDs and NCDs.

The article is based on the review of available published evidence.

The uptake of the strategies proposed will better prepare countries to respond to NCD and CD pandemics during public health emergencies.

The article is the first of its kind addressing the governance challenges of the dual pandemic of NCDs and CDs in emergencies.