They identify 15 key health threats causing premature deaths around the world

A new report from The Lancet, presented at the World Health Summit in Berlin, identifies 15 key health threats causing premature deaths around the world, including smoking as the main cause.

The Global Health 2050 (GH2050) report, produced by The Lancet Commission on Investing in Health (CIH), offers a roadmap for countries at all income levels to achieve dramatic improvements in human well-being by mid-century

The “50 by 50” goal, a 50% reduction in the probability of premature death, by 2050, (death before age 70), can be achieved by focusing on these 15 priority conditions, eight related to infectious diseases and health maternal and seven related to non-communicable diseases and injuries, as can be seen from the document.

The report, according to its authors, comes at a time when global health faces many obstacles: geopolitical tensions, current and new conflicts, increasingly evident climate change, slower progress towards universal health coverage, costs health care challenges and the ever-present risk of pandemics.

The GH2050 recommends public financing of essential medicines aimed at the 15 threats, in the form of diseases, that cause premature mortality. It also proposes mobilizing international financing and joint procurement efforts, similar to the strategies used by GAVI, PEPFAR and the Global Fund, to reduce costs for both patients and governments.

Core set of interventions

GH2050 reiterates the CIH’s initial recommendations that national governments maintain their focus on publicly funding a core set of interventions and making them available to all, starting with the best value for money interventions targeting the 15 priority conditions.

It groups these interventions into 19 modules, including one on childhood immunization and another on prevention and low-cost, widely available treatments for cardiovascular diseases. In the authors’ view, adoption of this focused approach should also address major morbidities, such as psychiatric illnesses, that are not yet covered by interventions to reduce mortality.

It also proposes a new tool, modular cost-effectiveness analysis, to help planners design health benefit packages. As proposed, the tool can be used in a two-step process: technical cost-effectiveness analysis to evaluate how best to achieve the specific objectives of the module (for example, reductions in infant mortality or cardiovascular mortality) and evaluation compensation policy when investing in expanding module coverage.

“Dramatic reductions in mortality and morbidity can be achieved by focusing on 15 priority diseases,” Dr. Angela Chang of the University of Southern Denmark and lead author of the report said on a panel at the World Health Summit on Tuesday in Berlin. “Doubling down on past health investments, focusing resources on a narrow set of diseases, increasing funding and developing new technologies can continue to have enormous impact despite obstacles.”

New risk of pandemics

Background research conducted for the GH2050 report points to a high mortality risk from pandemics. The GH2050 estimates that there is a greater than 20% probability in the next 10 years of a pandemic that kills at least 25 million people, a magnitude similar to that of the COVID-19 pandemic. Expressing this risk another way, on average, there would be 2.5 million pandemic-related deaths per year (with no deaths in most years). Of these deaths, 1.6 million would be expected to be from a flu pandemic and 0.9 million from a coronavirus pandemic. To put the average of 2.5 million deaths per year into context, that is about the same number of deaths that occur annually from HIV/AIDS, tuberculosis and malaria combined and far greater than the number of annual climate change deaths projected even in very pessimistic scenarios in the coming decades.

In the next pandemic, basic public health principles will help avoid mortality while awaiting vaccine development and distribution. These basic principles include rapid response, isolation of infected people, quarantine of people potentially exposed to infection, and social and financial support for people who isolate or quarantine.