Global Health Strategy for 2025–2028 (Part Five)

At the same time, the burden of noncommunicable diseases (NCDs)—primarily cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes—continues to rise. These diseases kill 41 million people annually, accounting for 74% of all deaths and the vast majority of premature mortality worldwide, with the greatest impact in low- and middle-income countries.

With the increasing burden of NCDs, rare diseases, multimorbidity, and longer life expectancy, the number of people living with disability has reached 1.3 billion, or one in six people globally.

More than 2 billion people live with conditions that would benefit from rehabilitation services.

The burden of Alzheimer’s disease and other dementias is rising.

Mental health disorders are also increasing: nearly 1 billion people live with such conditions, and rates of depression and anxiety are rising rapidly, especially among young people. Almost 700,000 people die by suicide each year.

Despite effective interventions and modest progress in program areas, violence and injuries still claim over 4 million lives annually. Nearly 30% of these deaths are due to road traffic injuries. One in two children experiences violence each year, and one in three women has experienced intimate partner violence at least once in her life.

The enormous potential for investment in disease prevention and health promotion—which could reduce the global disease burden by 50%—remains unrealized: 8 million deaths yearly are due to tobacco; 7 million are linked to air pollution; 8 million to unhealthy diets; 3 million to harmful alcohol use; and 2 million to environmental chemicals.

Up to 50 million people are injured in road traffic accidents annually. Rates of unhealthy behaviors among youth are rising, and 80% of adolescents do not get enough physical activity.

There are 3 million new hepatitis infections each year, and 1 million sexually transmitted infections occur daily.

Encouragingly, the number of people needing care for one or more of the 20 neglected tropical diseases has dropped by 25% since 2010, to 1.65 billion.

However, maintaining infectious disease control goals and progressing toward elimination and eradication remains difficult, as polio and lymphatic filariasis transmission continues.

Despite more than 170 countries having national action plans, antimicrobial resistance remains widespread and alarming.

Pandemic-prone viral and bacterial diseases—such as measles, cholera, meningitis, diphtheria, dengue, and yellow fever—continue to cause major health impacts and severely disrupt essential health services.

Foodborne diseases continue to impose a substantial burden on global health.

Moreover, high-risk emerging and re-emerging infectious threats—including vector-borne and zoonotic diseases such as coronaviruses, Ebola, Zika, and avian influenza—are increasing.

The human–animal–environment interface is under severe pressure, with inadequate investment in biosafety and risk-reduction measures, insufficient diagnostic and risk assessment capabilities in both human and veterinary sectors, and suboptimal rapid-response and containment capacities.

The COVID-19 pandemic exposed the fragility of health systems worldwide. Over 90% of countries reported disruption to essential health services, and routine vaccination coverage declined for the first time in three decades; 20 million children missed vaccine doses in 2022 alone.

School closures had devastating effects on nutrition, child protection, mental health, and psychosocial services.

Similar disruptions occurred in essential surgeries; services for women, newborns, children, and adolescents; and nearly all disease-specific services, both infectious and noncommunicable, as well as mental health care.

The pandemic also highlighted inequities in access to safe, effective, quality-assured, and affordable health products, especially in low- and middle-income countries.

Health systems continue to suffer from the “scars” of COVID-19, particularly in the health and care workforce, which is projected to face a shortage of 10 million workers by 2030 if current trends persist.

An estimated 1 billion people receive care from facilities without electricity or with unreliable power supply, and 1.7 billion rely on facilities lacking basic water services.

Central government health spending—which had risen by 25% during the pandemic—fell sharply in 2022, leaving health systems with flat or declining budgets while grappling with backlogs of disrupted services.

Health system capacities are further strained by migration, increasing natural and humanitarian crises, and rising, unacceptable attacks on health workers and facilities, disproportionately affecting women in the workforce.

Health and well-being are inextricably linked to progress on Sustainable Development Goals, health determinants, and risk factors.

Lack of progress toward gender equality—and failure to prioritize it—has broad negative consequences for:

• the health and well-being of women and girls
• health systems’ ability to ensure access to sexual and reproductive health services
• empowerment of women in the health and care sector.

Unhealthy diets and malnutrition now account for nearly one-third of the global disease burden.

A staggering 1 billion people worldwide are living with obesity, contributing to a wide range of NCDs and mental health disorders.

Limited progress in reducing child stunting and wasting is threatened by the complex transition to sustainable food systems, conflicts, and rising food insecurity: 735 million people face chronic hunger and 333 million faced acute food insecurity in 2023.

Despite progress under SDG 6, 2.2 billion people still lack safely managed drinking water and 3.5 billion lack safely managed sanitation.

Moreover, despite limited improvements in air quality, 2.3 billion people still rely on polluting fuels and technologies for cooking, while 99% of the world’s population lives in areas where air pollution exceeds WHO limits.