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Noncommunicable diseases (NCDs) are the number one killer in Thailand. The four main NCDs — cancer, cardiovascular diseases, diabetes and chronic obstructive pulmonary disease (COPD) — claim 400 000 lives annually or more than 1000 lives every day, and are responsible for 74% of all deaths in the country. Premature deaths and reduced or lost productivity when employees cannot fully function in (“presenteeism”) or leave the workplace (absenteeism) because they have an NCD are known to result in an economic burden, but exact numbers were not available. This report provides evidence that Thailand would benefit from investing in four policy intervention packages that reduce exposure to behavioural risk factors (tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity) and in key clinical interventions for the four most prevalent NCDs. The findings show that investment in NCDs is a matter of urgency and will ensure significant social and economic returns. Investment of THB 211 billion in implementation of the five suggested intervention packages will save 310 000 lives and generate THB 430 billion in benefits for the national economy in the next 15 years. Beyond the principal risk factors for NCDs, the document also discusses other issues that affect health and sustainable development in Thailand, including air pollution. The packages of policies and clinical interventions proposed represent critical initial actions to reverse the NCD epidemic in Thailand. Responsibility for these actions, and the benefits that accrue, go beyond the health sector to have direct and indirect impacts on achievement of all the SDGs, and affect society as a whole.