However, these advances carry the risk of serious social consequences due to access gaps, heightened inequalities, misinformation and disinformation, exclusion, and unemployment. Social media has contributed to polarization and politicization, while the rapid and widespread adoption of artificial intelligence highlights the need for coordinated governance to harness its potential while ensuring necessary safeguards.

The persistent and increasing number of crises and emergencies further complicates these long-term trends and efforts to ensure that no one is left behind. The COVID-19 pandemic has inflicted a devastating toll on human lives, with enormous consequences for global health and well-being—particularly among vulnerable and marginalized populations—alongside severe economic and social disruptions.

Health systems continue to recover slowly, and economic uncertainty persists, with slowing growth, rising debt, persistent inflation, and shrinking fiscal space—factors that broadly affect social-sector spending.

New and large-scale conflicts have emerged, with immediate consequences for civilian populations. In 2023, a record 340 million people worldwide required humanitarian assistance.

The frequency and impact of natural disasters are increasing, with climate change becoming a major driver. Countries are facing more complex, frequent, and prolonged emergencies than at any other time in recorded history, with rising vulnerabilities and converging threats that compound and amplify risks.

Overall, these trends and shocks contribute to social instability and heightened stress and anxiety levels, particularly among adolescents and young people.

Stagnant wages, rising income inequality, and growing youth unemployment are eroding trust in public institutions and leadership.

An unacceptable toll on human health and well-being

The combination of long-term trends, acute and protracted crises, and the interactions among them has created an especially challenging environment for countries to maintain and improve the health and well-being of their populations. This is evident in the poor progress toward most Sustainable Development Goals and the declining rate of improvement in healthy life expectancy (HALE)—a composite measure of mortality and morbidity.

Since the launch of the SDGs, the rate of HALE increase has fallen by 40%, from 0.3 years annually during the Millennium Development Goal era (2000–2015) to 0.19 years between 2015 and 2019, and is projected to decline further to 0.1 years by 2050. Even before COVID-19, urgent action was needed to put the world back on track toward health-related SDGs and to create safe and healthy environments so everyone, everywhere, could enjoy healthier lives.

WHO estimates that fewer than 15% of health-related SDG targets are on track. While the pandemic severely disrupted planned health activities between 2020 and 2023, progress since 2019 has been made toward WHO’s triple-billion targets:
– 1.26 billion more people enjoying better health and well-being;
– 477 million more people receiving essential health services without financial hardship;
– 690 million more people better protected from health emergencies.

However, the pace of progress remains insufficient to meet the 2030 targets.

In 2023—midway to the SDG deadline—more than half of the world’s population lacked access to essential health services, while one in every four people faced financial hardship or catastrophic health spending. Although 30% of countries have made progress on these two dimensions of Universal Health Coverage (UHC), overall progress has stalled, and catastrophic out-of-pocket health expenditures have actually increased.

Of particular concern is that, globally, there has been virtually no progress in reducing maternal mortality since 2015, with nearly 300,000 women dying each year during pregnancy or childbirth.

Progress in reducing child mortality has slowed: 5 million children still die every year before reaching age five, with newborns accounting for nearly half of those deaths.

Despite increased exclusive breastfeeding over the past decade, maternal and child malnutrition causes 4 million deaths annually. Nearly half of all child deaths are now associated with malnutrition, partly driven by rising food insecurity and famine.

By 2030, 25% of the world’s population—including 85% of the global poor—will live in countries affected by fragility, conflict, or vulnerability, where most maternal and child deaths occur and where 75% of high-impact epidemic diseases originate.