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Global health 2035: a world converging within a generation
Open accessAbstract
countries can be reduced by 2035 through inexpensive population-based and clinical interventions.Fiscal policies are an especially promising lever for reducing this burden. Opportunities:• National governments can curb NCDs and raise signifi cant revenue by heavily taxing tobacco and other harmful substances, and they can redirect fi nances towards NCD control by reducing subsidies on items such as fossil fuels.Investment in strengthening health systems to deliver packages of costeff ective clinical interventions for NCDs and injuries is another important national opportunity.• International action should focus on provision of technical assistance on fi scal policies, regional cooperation on tobacco, and funding of population, policy, and implementation research on scaling-up of interventions for NCDs and injuries.Progressive universalism, a pathway to universal health coverage (UHC), is an effi cient way to achieve health and fi nancial protectionThe Commission endorses two pro-poor pathways to achieving UHC within a generation.In the fi rst, publicly fi nanced insurance would cover essential health-care interventions to achieve convergence and tackle NCDs and injuries.This pathway would directly benefi t the poor because they are disproportionately aff ected by these problems.The second pathway provides a larger benefi t package, funded through a range of fi nancing mechanisms, with poor people exempted from payments.Opportunities:• For national governments, progressive universalism would yield high health gains per dollar spent and poor people would gain the most in terms of health and fi nancial protection.• The international community can best support countries to implement progressive universal health coverage by fi nancing population, policy, and imple mentation research, such as on the mechanics of designing and implementing evolution of the benefi ts package as the resource envelope for public fi nance grows.Our report points to the possibility of achieving dramatic gains in global health by 2035 through a grand con vergence around infectious, child, and maternal mortality; major reductions in the incidence and consequences of NCDs and injuries; and the promise of universal health coverage.Good reasons exist to be optimistic about seeing the global health landscape utterly transformed in this way within our lifetimes.For the background papers see http://globalhealth2035.org Panel 2: Social and intersectoral determinants and consequences of better healthThree key WHO publications have advanced our understanding of these relations: • The 1999 World Health Report (WHR), the fi rst WHR issued by WHO Director General Gro Harlem Brundtland, estimated that half of the health improvements between 1960 and 1990 in low-income and middle-income countries were from changes in two social determinants: income and education.7 The report noted that these determinants aff ect health through consequences such as poor nutrition, sanitation, and other risk factors for ill health.Nevertheless, WHR 1999 argued that the health community could have the greatest eff ect on health by focusing on the health sector, including health systems strengthening, rather than by taking action outside this sector.• The 2001 report of the Commission on Macroeconomics and Health, chaired by Jeff rey Sachs, emphasised the importance of investment not only in the health sector but also in education, water, sanitation, and agriculture, to reduce poverty.8 By quantifying both the substantial economic consequences of better health and the costs of achieving it, the report had a hugely important role in informed advocacy for the health sector.• The Commission on Social Determinants of Health, chaired by Michael Marmot, was established by WHO in 2005 to lay out evidence for how to promote health equity through sound social and economic policies and to foster a global movement towards its achievement.9 The Commission made three broad recommendations: improve daily conditions; take "far-reaching and systematic action" to improve the distribution of resources to ensure "fair fi nancing, corporate social responsibility, gender equity and better governance"; and improve data collection for better measurement of health inequities and monitor the eff ect of interventions in improving these inequities.
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“Furthermore, studies show that for every dollar spent on key health services, the direct and indirect benefits would exceed costs by a factor of between 9 and 20, further showing the benefits that arise from investing in health.3”
From The legal determinants of health: harnessing the power of law for global health and sustainable development (2019) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Law can be used to implement fair, evidence-based health interventions, and can be a powerful tool for global health.3”
From The legal determinants of health: harnessing the power of law for global health and sustainable development (2019) · cites this paper as [3]
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“(ii) they have common underlying causes, such as dangerous pathogens, unhealthy behaviours, or unsafe environments;”
From The legal determinants of health: harnessing the power of law for global health and sustainable development (2019) · cites this paper as [3]
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“(iv) they require a coordinated, multi-sectoral global response.”
From The legal determinants of health: harnessing the power of law for global health and sustainable development (2019) · cites this paper as [3]
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“(iii) they are exacerbated by inequities linked to the socio-economic determinants of health;”
From The legal determinants of health: harnessing the power of law for global health and sustainable development (2019) · cites this paper as [3]
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“Global health hazards nowadays share four important features: (i) health hazards are not bound by borders, ranging from infectious diseases, to non-communicable diseases, and injuries;”
From The legal determinants of health: harnessing the power of law for global health and sustainable development (2019) · cites this paper as [3]
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“Despite considerable progress, the burden of infectious diseases remains unacceptably high, particularly in low-income and middle-income countries, and among poor and rural populations.3”
From The legal determinants of health: harnessing the power of law for global health and sustainable development (2019) · cites this paper as [3]
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“On a broader scale, we are in the midst of a process some are calling “the third global health transition” [31] or “a grand convergence” [32]—emerging from a demographic transition (from higher to lower death and birth rates) into an epidemiologic transition (from a high burden of maternal and child conditions and communicable diseases to noncommunicable diseases [NCDs]).”
From Community health workers at the dawn of a new era: 11. CHWs leading the way to “Health for All” (2021) · cites this paper as [32]
In the citing paper
“In a grand convergence, mortality from infections and maternal conditions could, in countries that chose to do so, be brought down to levels that would allow their life expectancies to converge toward that of the ‘frontier’ country (the best-performing country).”
From Global health 2050: the path to halving premature death by mid-century (2024) · cites this paper as [2]
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“It found that from about 1850 onwards, life expectancy in the best performing countries increased steadily at a rate of about 2.5 years of life expectancy every decade until the time GH2035 was published.”
From Global health 2050: the path to halving premature death by mid-century (2024) · cites this paper as [2]
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“This value was almost half as large as the value of increases in income levels during this period.”
From Global health 2050: the path to halving premature death by mid-century (2024) · cites this paper as [2]
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“In South Asia, for example, it estimated that the value of mortality decline in 2000–2011 was about 2.9% of average national income per year.”
From Global health 2050: the path to halving premature death by mid-century (2024) · cites this paper as [2]
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“GH2035 provided estimates of the value, relative to their income levels, of the mortality declines experienced by countries.2”
From Global health 2050: the path to halving premature death by mid-century (2024) · cites this paper as [2]
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Neelsen, S., & O’Donnell, O. (2016) · Health Economics · doi:10.1002/hec.3492 · Cited by 34
Turner, H. C., Hori, Y., Revill, P. A., Rattanavipapong, W., Arai, K., Nonvignon, J., Jit, M., & Teerawattananon, Y. (2023) · BMJ Global Health · doi:10.1136/bmjgh-2023-012798 · Cited by 33
“‡ The frameworks by Arksey and O’Malley (6) and Levac and colleagues (7) and the JBI guidance (4, 5) refer to the process of data extraction in a scoping review as data charting.”
BackgroundSander, L. D., Newell, K., Ssebbowa, P., Serwadda, D., Quinn, T. C., Gray, R. H., Wawer, M. J., Mondo, G., & Reynolds, S. J. (2014) · Tropical Medicine & International Health · doi:10.1111/tmi.12443 · Cited by 33
“Most mortality in sub-Saharan Africa (SSA) is currently due to communicable diseases, but WHO estimates that by 2030 non-communicable diseases (NCDs) will be the most common causes of death (Alwan et al. 2010; Jamison et al. 2013).”
BackgroundPalliative Care and Pain Control
Krakauer, E. L., Kwete, X. J., Verguet, S., Arreola‐Ornelas, H., Bhadelia, A., Mendez, O., Rodriguez, N. M., Ali, Z. V., Allende‐Pérez, S., Cleary, J. F., et al. (2017) · World Bank, Washington, DC eBooks · doi:10.1596/978-1-4648-0527-1_ch12 · Cited by 33
Self-citationChang, A. Y., Bolongaita, S., Cao, B., Castro, M. C., Karlsson, O., Mao, W., Norheim, O. F., Ogbuoji, O., & Jamison, D. T. T. (2025) · The Lancet · doi:10.1016/s0140-6736(25)00902-x · Cited by 32
Self-citationBalwicki, Ł., Stokłosa, M., Balwicka-Szczyrba, M., & Tomczak, W. (2015) · Tobacco Control · doi:10.1136/tobaccocontrol-2015-052582 · Cited by 32
Bourgeois, D. M., Phantumvanit, P., Llodrá, J. C., Horn, V., Carlile, M. J., & Eiselé, J.-L. (2014) · International Dental Journal · doi:10.1111/idj.12126 · Cited by 36
Boyle, C. F., Levin, C., Hatefi, A., Madriz, S., & Santos, N. (2015) · PLoS ONE · doi:10.1371/journal.pone.0140092 · Cited by 30
“…for Women’s and Children’s Health (WCH) [12] and also extends the analysis doi:10.1371/journal.pone.0140092.g001 PLOS ONE | DOI:10.1371/journal.pone.0140092 October 9, 2015 3 / 20 presented in Jamison et al (2013) to estimate the investment required for grand convergence, as described above.”
BackgroundInfluentialErgo, A., Htoo, T. S., Badiani-Magnusson, R., & Royono, R. (2018) · Health Policy and Planning · doi:10.1093/heapol/czy110 · Cited by 32
“Fourth, the importance of adopting a pro-poor path to UHC—a principle referred to as ‘progressive universalism’ (Gwatkin and Ergo, 2011)—is now widely recognized (Jamison et al., 2013; WHO, 2014; Cotlear et al., 2015; Bump et al., 2016).”
BackgroundDiffusion Source Inference for Large-Scale Complex Networks Based on Network Percolation
Liu, Y., Wang, X., Wang, X., Wang, Z., & Kurths, J. (2023) · IEEE Transactions on Neural Networks and Learning Systems · doi:10.1109/tnnls.2023.3321767 · Cited by 32
Watkins, D., Lubinga, S. J., Mayosi, B. M., & Babigumira, J. B. (2016) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0004860 · Cited by 32
“These findings contrast with previous studies and make a strong case that rheumatic heart disease prevention could be a high-priority intervention in Africa.”
MethodInfluentialWilson, D., Taaffe, J. E., Fraser‐Hurt, N., & Görgens, M. (2014) · African Journal of AIDS Research · doi:10.2989/16085906.2014.943254 · Cited by 31
“An observation study in discordant couples in China showed only 26% lower HIV incidence, and this protection was only maintained in transfusion or sexually infected groups, not in those acquiring HIV through injecting drug use (Jia et al. 2013).”
BackgroundResultValuing health as development: going beyond gross domestic product
Fan, V. Y., Bloom, D. E., Ogbuoji, O., Klaus Prettner, A., & Yamey, G. (2018) · BMJ · doi:10.1136/bmj.k4371 · Cited by 31
Self-citationThe Effects of Two Influential Early Childhood Interventions on Health and Healthy Behaviors
Conti, G., Heckman, J. J., & Pinto, R. R. (2015) · National Bureau of Economic Research · doi:10.3386/w21454 · Cited by 31
A Global Biomedical R&D Fund and Mechanism for Innovations of Public Health Importance
Balasegaram, M., Bréchot, C., Farrar, J., Heymann, D., Ganguly, N. K., Khor, M., Lévy, Y., Matsoso, P., Minghui, R., Pécoul, B., et al. (2015) · PLoS Medicine · doi:10.1371/journal.pmed.1001831 · Cited by 30
“Both the CEWG and the Lancet Commission on Investing in Health have called for a doubling of global health R&D funding to US$6 billion annually for infections of poverty [2,6].”
BackgroundBriggs, A. M., Jordan, J. E., Kopansky-Giles, D. R., Sharma, S., MARCH, L. M., Schneider, C. H., Mishrra, S., Young, J. J., & Slater, H. (2021) · Global Health Research and Policy · doi:10.1186/s41256-021-00201-7 · Cited by 30
Factors influencing publication of scientific articles derived from masters theses in public health
Hollmann, M., Borrell, C., Garín, O., Fernández, E., & Alonso, J. (2015) · International Journal of Public Health · doi:10.1007/s00038-015-0664-0 · Cited by 35
Alkire, B. C., Bergmark, R. W., Chambers, K. J., Lin, D. T., Deschler, D. G., Cheney, M. L., & Meara, J. G. (2016) · Head & Neck · doi:10.1002/hed.24430 · Cited by 30
“Educational initiatives have been shown to be effective in India at reducing tobacco use,(30) but heavy taxation of tobacco products has been repeatedly shown to be the best opportunity to combat not only head and neck cancer, but noncommunicable disease in general.(14) The human papillomavirus (HPV) vaccine could pla…”
BackgroundMethodFiorillo, A., Luciano, M., Pompili, M., & Sartorius, N. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00434 · Cited by 30
Time for even greater ambition in global health
Kim, J. Y. (2013) · The Lancet · doi:10.1016/s0140-6736(13)62374-0 · Cited by 29
Global distribution of research efforts, disease burden, and impact of US public funding withdrawal
Schmallenbach, L., Bley, M., Bärnighausen, T., Sugimoto, C. R., Lerchenmüller, C., & Lerchenmueller, M. (2025) · Nature Medicine · doi:10.1038/s41591-025-03923-0 · Cited by 33
“This uncertainty underscores the importance of a procedurally just approach to distributing research efforts, one that responds to current and future health challenges and promotes alignment between research activity and disease burden over time 38–40 .”
Valuing vaccines using value of statistical life measures
Laxminarayan, R., Jamison, D. T. T., Krupnick, A., & Norheim, O. F. (2014) · Vaccine · doi:10.1016/j.vaccine.2014.07.003 · Cited by 29
Self-citationBali, S., & Taaffe, J. E. (2017) · Journal of Public Health Policy · doi:10.1057/s41271-016-0058-4 · Cited by 29
“The Lancet Global Health 2035 initiative advocates for global health investments to be used as tools to improve economies along with resilience and economic sustainability of countries in the face of health emergencies.(20) Investing in synergistic alignment of objectives of GHSA and SDGs can take advantage of a windo…”
BackgroundThe DIY Digital Medical Centre
Timmis, K. N., & Timmis, K. N. (2017) · Microbial Biotechnology · doi:10.1111/1751-7915.12817 · Cited by 29
“…coordinated exploitation of new healthcare technologies, the significance of which in improving health outcomes has been documented (inter alia by Jamison et al., 2013), and of microbial biotechnology (see some examples of highly relevant research and innovations in this issue), are in our…”
BackgroundInfluential2018 must be the year for action against NCDs
Horton, R. C., & Sargent, J. (2018) · The Lancet · doi:10.1016/s0140-6736(18)30674-3 · Cited by 29
Self-citationNjiro, B. J., Ndumwa, H. P., Msenga, C. J., Kawala, T., Matola, E., Mhonda, J., Corbin, H., Ubuguyu, O., & Likindikoki, S. L. (2021) · General Psychiatry · doi:10.1136/gpsych-2020-100448 · Cited by 29
Returns on Investment in the Continuum of Care for Reproductive, Maternal, Newborn, and Child Health
Stenberg, K., Sweeny, K., Axelson, H., Temmerman, M., & Sheehan, P. J. (2016) · World Bank, Washington, DC eBooks · doi:10.1596/978-1-4648-0348-2_ch16 · Cited by 29
How might global health master deadly sins and strive for greater virtues?
Panter‐Brick, C., Eggerman, M., & Tomlinson, M. (2014) · Global Health Action · doi:10.3402/gha.v7.23411 · Cited by 28
“For instance, the Global Health 2035 framework (35) provides a new investment framework to achieve dramatic health gains within the timeline of just one generation.”
BackgroundImproving quality is necessary to building a TB-free world: Lancet Commission on Tuberculosis
Reid, M. J. A., & Goosby, E. (2020) · Journal of Clinical Tuberculosis and Other Mycobacterial Diseases · doi:10.1016/j.jctube.2020.100156 · Cited by 28
Incorporating a structural approach to reducing the burden of non-communicable diseases
Yang, J. S., Mamudu, H., & John, R. M. (2018) · Globalization and Health · doi:10.1186/s12992-018-0380-7 · Cited by 28
Bringing Global Access to Radiation Therapy: Time for a Change in Approach
Jaffray, D. A., & Gospodarowicz, M. K. (2014) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2014.05.019 · Cited by 28
“The nature of investment in healthcare in the world is changing (12).”
BackgroundPantzerhielm, L., Holzscheiter, A., & Bahr, T. (2020) · Review of International Studies · doi:10.1017/s0260210520000145 · Cited by 27
Politics and Universal Health Coverage — The Post-2015 Global Health Agenda
Gupta, V., Kerry, V. B., Goosby, E., & Yates, R. (2015) · New England Journal of Medicine · doi:10.1056/nejmp1508807 · Cited by 27
Bärnighausen, T., Bloom, D. E., & Humair, S. (2016) · PLoS ONE · doi:10.1371/journal.pone.0163960 · Cited by 27
Lisk, F., & Šehović, A. B. (2019) · Fudan Journal of the Humanities and Social Sciences · doi:10.1007/s40647-018-00250-2 · Cited by 31
Global Common Goods for Health: Towards a New Framework for Global Financing
Soucat, A. L. B., & Kickbusch, I. (2020) · Global Policy · doi:10.1111/1758-5899.12875 · Cited by 26
“The 2013 report of the Lancet Commission on Investing in Health included similar recommendations but added the need to increase investments in global functions, including R&D and stockpiles of critical drugs and materials (Jamison et al., 2013).”
BackgroundSelf-citationGlobal Advisory Panel on the Future of Nursing (GAPFON) and Global Health
Klopper, H. C., & Hill, M. (2014) · Journal of Nursing Scholarship · doi:10.1111/jnu.12118 · Cited by 27
“As with other healthcare professionals, nurses believe in and support the idea that an investment in health results in an enormous payoff, and that in our collective lifetimes, a grand convergence in health is within reach (Jamison et al., 2013).”
BackgroundLessons from Health Transformation in Turkey: Leadership and Challenges
Akdağ, R. (2015) · Health Systems & Reform · doi:10.1080/23288604.2014.956017 · Cited by 27
“”(3) Successful examples suggest that achieving or getting close to UHC may be realistic for all countries in the world.(4) However, this generalization requires a strong emphasis on ‘context and receptivity of change’.”
BackgroundZhou, J., Song, Y., Ying, J., Zhang, C., Wu, J., Shan, S., Zha, J., Zhou, L., Xiao, W., & Song, P. (2025) · EClinicalMedicine · doi:10.1016/j.eclinm.2025.103121 · Cited by 29
“Regarding NRSIs, the detailed results of the assessment of risk of bias are presented in the Appendix pp 38 – 39.”
InfluentialGlobal health education in Swedish medical schools
Ehn, S., Agardh, A., Holmer, H., Krantz, G., & Hagander, L. E. (2015) · Scandinavian Journal of Public Health · doi:10.1177/1403494815591720 · Cited by 26
“The concept of global health includes factors that may not have been traditionally emphasised in clinical education, such as global disparities of disease, social and economic determinants of health and health system strengthening [4,14,15].”
Benefit-Cost Analysis for Selected Surgical Interventions in Low- and Middle-Income Countries
Alkire, B. C., Vincent, J. R., & Meara, J. G. (2015) · World Bank, Washington, DC eBooks · doi:10.1596/978-1-4648-0346-8_ch21 · Cited by 26
Pradhan, E., Suzuki, E. M., Martínez, S., Schäferhoff, M., & Jamison, D. T. T. (2017) · World Bank, Washington, DC eBooks · doi:10.1596/978-1-4648-0423-6_ch30 · Cited by 26
Self-citationLe maroc à l'horizon 2040: Investir dans le capital immatériel pour accélérer l’émergence économique
Chauffour, J.-P. (2017) · World Bank, Washington, DC eBooks · doi:10.1596/978-1-4648-1078-7 · Cited by 26
Patenaude, B., Semali, I. A., Killewo, J., & Bärnighausen, T. (2019) · Value in Health Regional Issues · doi:10.1016/j.vhri.2019.07.009 · Cited by 26
García, J. I., Allué‐Guardia, A., Tampi, R. P., Restrepo, B. I., & Torrelles, J. B. (2021) · Current Epidemiology Reports · doi:10.1007/s40471-021-00269-2 · Cited by 29
“1 TB synergies with potential drivers for TB expansion under known TB social determinants 35 Curr Epidemiol Rep (2021) 8:33–45”
Background
Metadata
- Authors
- Jamison, D. T., Summers, L. H., Alleyne, G., Arrow, K. J., Berkley, S., Binagwaho, A., Bustreo, F., Evans, D., Feachem, R. G. A., Frenk, J., Ghosh, G., Goldie, S. J., Guo, Y., Gupta, S., Horton, R., Kruk, M. E., Mahmoud, A., Mohohlo, L. K., Ncube, M., Pablos-Mendez, A., Reddy, K. S., Saxenian, H., Soucat, A., Ulltveit-Moe, K. H., & Yamey, G.
- Affiliations
- University of Washington (US)
- Harvard University (US)
- University of the West Indies (JM)
- Stanford University (US)
- Gavi (CH)
- World Health Organization (CH)
- University of California, San Francisco (US)
- Gates Foundation (US)
- Peking University (CN)
- International Monetary Fund (US)
- Columbia University (US)
- Princeton University (US)
- African Development Bank Group (CI)
- Public Health Foundation of India (IN)
- Results for Development Institute (US)
- Corresponding author
- Yamey, Gavin
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2013-12
- Volume
- 382
- Issue
- 9908
- Pages
- 1898-1955
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W4320288076
- Cited by
- 1,220
- References
- 174
- Citations by year
- 2026: 47 · 2025: 62 · 2024: 49 · 2023: 53 · 2022: 72 · 2021: 121 · 2020: 101 · 2019: 112 · 2018: 106 · 2017: 125 · 2016: 129 · 2015: 141 · 2014: 95 · 2013: 6
- FWCI
- 215.66
- Type
- journal article
- Language
- en
- Update notices
- erratum (2014-01-18)
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- The Lancet (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Funders
- Bill and Melinda Gates Foundation
- World Bank Group
- Harvard University
- University of Washington
- Harvard Global Health Institute
- Department for International Development
- Direktoratet for Utviklingssamarbeid
- University of California, San Francisco
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Reforms
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Global Health Care Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Public Health Policies and Epidemiology
- Keywords
- global health, non-communicable diseases, injuries, universal health coverage, fiscal policy, tobacco taxation, fossil fuel subsidies, health system strengthening, health care financing, social determinants of health, health equity, financial protection, population-level interventions, child mortality, maternal mortality, infectious disease mortality
- MeSH terms
- Delivery of Health Care, Developing Countries, Health Expenditures, Humans, International Cooperation, Global Health, Universal Health Insurance
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