People with non-communicable diseases (NCDs) are particularly vulnerable to health service disruptions resulting from conflicts, natural disasters, and major disease outbreaks. The 2018 Political Declaration of the 3rd UN High-Level Meeting of the General Assembly on the Prevention and Control of NCDs called for the strengthening of health system resilience to withstand emergencies due to all hazards. Since this declaration, substantial progress has been made by countries and implementing organisations in the development of policies that reduce risk to people with NCDs, as well as the integration of NCDs in emergency preparedness and response measures. However, the increasing frequency of conflicts and natural disasters and the financing shortfall for NCDs have slowed progress. This Personal View describes key developments and lessons learned since the 2018 UN Political Declaration with regard to NCDs across the emergency management cycle, and highlights the current operational and policy challenges. We propose three areas of focus for further development, together with detailed actions for improving NCD care in emergencies.