Abstract
The forthcoming United Nations General Assembly High-Level Meeting on noncommunicable diseases and mental health offers a crucial opportunity to advance global health governance. This editorial argues that while the draft declaration represents a vital step forward, its potential to address global mental health needs is complicated by several paradoxes that merit careful consideration. First, its targets for financing and access may not fully reflect the ambition needed to overcome systemic underinvestment. Second, the “integration paradox” champions a cohesive approach while setting different types of targets for mental health and NCDs. Finally, an implementation paradox is evident in the ongoing focus on individual behavior rather than on the upstream social and commercial determinants of health. Using Slovenia’s experience as a national case study, we illustrate how these global challenges can complicate efforts to translate high-level commitments into national reality. We conclude that for the UN Political Declaration to be truly transformative, it must inspire a shift from cautious frameworks to more ambitious financing, authentic integration, and the political courage to prioritise population needs over siloed institutional legacies.