Improved health care, lifestyle changes and changing demography mean that more people are living longer and often with chronic diseases that cannot currently be cured. Advances in health care that support longer life are to be celebrated, but health care systems cannot cope with the increasing incidence and cost of chronic diseases. Across low-, medium- and high-income countries, 50–80% of the health budget is spent on chronic diseases. Without intervention, this will continue to rise, as risk factors such as tobacco use, unhealthy diet and lack of physical activity remain prevalent. Chronic diseases cause 86% of deaths across the 53 Member States in the WHO European Region. Countries have set up interventions to reduce the social, health and financial effects of chronic diseases. However, when used in isolation, these interventions may have limited long-term impact, especially given the need to tackle inequality in health and problems with transferring initiatives across the varied contexts of the Region. Chronic disease management is a systematic approach for coordinating health care interventions and communication at the individual, organizational, regional or national level. Evidence indicates that coordinated approaches are more effective than single or uncoordinated interventions, but the best strategies for integrating interventions across different providers, regions and funding systems remain uncertain.