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Post-employment benefits for associates (Details 3) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Amounts recognized in the consolidated balance sheet [abstract]    
Prepaid benefit cost $ 202 $ 148
Pension plans    
Defined benefit plan, change in net liability [roll forward]    
Net liability at beginning of period (3,321) (3,409)
Current service cost (372) (336)
Net interest expense (58) (77)
Administrative expenses (24) (24)
Past service cost and settlements 117 (25)
Remeasurements 21 (126)
Currency translation effects (190) 21
Novartis Group contributions 464 420
Effect of acquisitions, divestments or transfers 11 (10)
Change in limitation on recognition of fund surplus (incl. exchange rate differences) 16 7
Net liability at end of period (3,336) (3,321)
Amounts recognized in the consolidated balance sheet [abstract]    
Prepaid benefit cost 202 148
Accrued benefit liability (3,538) (3,469)
Other post-employment benefit plans    
Defined benefit plan, change in net liability [roll forward]    
Net liability at beginning of period (612) (954)
Current service cost (11) (13)
Net interest expense (16) (26)
Past service cost and settlements (1) 0
Remeasurements 109 (35)
Currency translation effects 7 0
Novartis Group contributions   74
Novartis Group contributions (20)  
Effect of acquisitions, divestments or transfers 1 (3)
Net liability at end of period (543) (612)
Amounts recognized in the consolidated balance sheet [abstract]    
Accrued benefit liability (543) (612)
Discontinued operations [member] | Pension plans    
Defined benefit plan, change in net liability [roll forward]    
Net liability at beginning of period 0 238
Net liability at end of period   0
Discontinued operations [member] | Other post-employment benefit plans    
Defined benefit plan, change in net liability [roll forward]    
Net liability at beginning of period $ 0 345
Net liability at end of period   $ 0