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Discontinued operations (Details 2) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Statement [line items]      
Interest income $ 91 $ 245 $ 292
Impairment charges and fair value gains on financial assets, net 335 38 (6)
Additions to restructuring provisions (354) (492) (521)
Discontinued operations      
Statement [line items]      
Interest income     2
Additions to restructuring provisions     (13)
Equity-based compensation of Novartis equity plans   (9) (93)
Property, plant and equipment [member]      
Statement [line items]      
Depreciation and amortisation expense (1,318) (1,345) (1,482)
Impairment loss (reversal of impairment loss) recognised in profit or loss (440) (202) (301)
Property, plant and equipment [member] | Discontinued operations      
Statement [line items]      
Depreciation and amortisation expense   (42) (235)
Impairment loss (reversal of impairment loss) recognised in profit or loss     (3)
Right-of-use assets [member]      
Statement [line items]      
Depreciation and amortisation expense (330) (305)  
Right-of-use assets [member] | Discontinued operations      
Statement [line items]      
Depreciation and amortisation expense   (9)  
Intangible assets and goodwill [member]      
Statement [line items]      
Depreciation and amortisation expense (3,462) (2,836) (2,587)
Impairment loss (reversal of impairment loss) recognised in profit or loss $ (914) (1,138) (841)
Intangible assets and goodwill [member] | Discontinued operations      
Statement [line items]      
Depreciation and amortisation expense   $ (174) (1,052)
Impairment loss (reversal of impairment loss) recognised in profit or loss     $ (391)