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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”
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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]
In the citing paper
“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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“In summary, we recognise that the control of NCDs should be targeted by a multifaceted approach including spreading knowledge to the society and health professionals, making policies and promoting various health interventions (Jamison et al. 2013).”
BackgroundTerzioğlu, F. (2020) · Turkish Journal of Pediatric Disease · doi:10.12956/tchd.733123 · Cited by 8
“Sağlığın geliştirilmesine, hastalık ve rahatsızlıkların önlenmesine yatırım yapılması; kişilerin sağlıksız duruma geçmeleri ile sağlık sistemi üzerinde yaratacakları talebi ortadan kaldırarak ve sağlıklı ve üretken kalan vatandaşların topluma yapacakları ekonomik katkı ile pozitif bir etki yaratabilir (16,19).”
Ayushman Bharat and Universal Health Coverage in India: Is our approach ethical?
Bhaduri, S. D. (2021) · Indian Journal of Medical Ethics · doi:10.20529/ijme.2021.016 · Cited by 8
A low‐cost field ventilator: An urgent global need
Nachiappan, N., Koo, J. M., Chockalingam, N., & Scott, T. E. (2021) · Health Science Reports · doi:10.1002/hsr2.349 · Cited by 8
“the initial financial outlay by a factor of 9 to 20 over the 2015 to 2035 period.(4) The value of ventilators for both short and longer-term use in low middle-income countries (LMICs) is clear.”
BackgroundTransitioning to Good Health and Well-Being
Flahault, A. (2022) · MDPI eBooks · doi:10.3390/books978-3-03897-865-7 · Cited by 8
Aligning global health policy and research with sustainable development: A strategic market approach
Haenssgen, M. J. (2023) · Sustainable Development · doi:10.1002/sd.2762 · Cited by 9
Investing in health: progress but hard choices remain
Chan, M. (2013) · The Lancet · doi:10.1016/s0140-6736(13)62336-3 · Cited by 8
A grand convergence in mortality is possible: comment on Global Health 2035
Norheim, O. F. (2014) · International Journal of Health Policy and Management · doi:10.15171/ijhpm.2014.01 · Cited by 8
“This pathway would directly benefit the poor, because they are disproportionately affected by these problems” (8).”
InfluentialThe economics of global health: an assessment
Farlow, A. W. K. (2016) · Oxford Review of Economic Policy · doi:10.1093/oxrep/grw002 · Cited by 8
Investing in Health Innovation: A Cornerstone to Achieving Global Health Convergence
Yamey, G., & Morel, C. M. (2016) · PLoS Biology · doi:10.1371/journal.pbio.1002389 · Cited by 8
Self-citationDad, L., Royce, T. J., Morris, Z. S., Moran, M. S., Pawlicki, T. A., Khuntia, D., Hardenbergh, P. H., Cummings, B., Mayr, N. A., & Hu, K. S. (2016) · Seminars in Radiation Oncology · doi:10.1016/j.semradonc.2016.11.002 · Cited by 8
What drivers will influence global immunizations in the era of grand convergence in global health?
Levine, O. S. (2016) · Vaccine · doi:10.1016/j.vaccine.2016.09.071 · Cited by 8
“Recent projections from an international consortium of health scientists and economists forecast that with a concerted effort to scale up existing interventions and develop new ones we could see a ‘grand convergence’ in public health (GCIPH) by 2035 [1].”
BackgroundMaternal mortality and women’s political participation
Bhalotra, S. R., Clarke, D., Gomes, J., & Venkataramani, A. S. (2018) · Working Paper Series · doi:10.35188/unu-wider/2018/500-8 · Cited by 8
Jing, J., Du, Z., Wen, Z., Jiang, B., & He, B. (2018) · Journal of Cellular Physiology · doi:10.1002/jcp.27904 · Cited by 8
“Thromboembolism is a serious threat to life and health and is the most common cause of the three major cardiovascular disorders: ischemic heart disease (acute coronary syndrome), stroke, and venous thromboembolism (Ceyhan, Andie, & Akay, 2017; Hunter & Fineberg, 2014; Jamison et al., 2013).”
BackgroundH, D. B. M. P., Jha, R., Bhawalkar, M., & Berman, P. (2019) · International Journal of Health Policy and Management · doi:10.15171/ijhpm.2019.06 · Cited by 8
“15 Although the Commission more generally highlights the improvements that follow from investments in health, the Commission specifically emphasizes the substantial benefits that arise from investing in primary healthcare.”
InfluentialA scoping review of methods for assessment of sex differentials in early childhood mortality
Costa, J. C., & Victora, C. G. (2021) · BMC Pediatrics · doi:10.1186/s12887-021-02503-8 · Cited by 8
“The reference populations include: life table models from multiple high-income geographies [12, 95, 105, 138]; survey data from LMICs [18, 77, 136], official statistics gathered by the United Nations [93, 153], estimates published by other authors [42], and multiple sources including census, surveys, vital registratio…”
BackgroundResultInfluentialCosts of hospitalization in preterm infants: impact of antenatal steroid therapy
Ogata, J. F. M., Fonseca, M. C. M., Miyoshi, M. H., de Almeida, M. F. B., & Guinsburg, R. (2016) · Jornal de Pediatria (Versão em Português) · doi:10.1016/j.jpedp.2015.06.001 · Cited by 8
Benefit-Cost Analysis in Disease Control Priorities, Third Edition
Chang, A. Y., Horton, S., & Jamison, D. T. T. (2017) · World Bank, Washington, DC eBooks · doi:10.1596/978-1-4648-0527-1_ch9 · Cited by 8
Self-citationYamey, G., Fewer, S., & Beyeler, N. (2015) · International Journal of Health Policy and Management · doi:10.15171/ijhpm.2015.143 · Cited by 8
Self-citationChiriboga, D. E., Buss, P. M., Birn, A., Garay, J., Muntaner, C., & Nervi, L. (2014) · The Lancet · doi:10.1016/s0140-6736(14)60473-6 · Cited by 8
International Perspectives on Resource Allocation
Benatar, S. R., & Ashcroft, R. E. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-803678-5.00380-5 · Cited by 8
Towards universal social protection
Rim, J.-Y., & Tassot, C. (2019) · OECD development policy papers · doi:10.1787/bae641e2-en · Cited by 8
Priority Health Conditions and Global Life Expectancy Disparities
Karlsson, O., Chang, A. Y., Norheim, O. F., Mao, W., Bolongaita, S., & Jamison, D. T. T. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.12198 · Cited by 9
Self-citationGender, Intra-Household Discrimination and Cash Transfer Schemes: The Case of Indian Punjab
Singh, N. (2019) · Economies · doi:10.3390/economies7030075 · Cited by 7
“5 female deaths for every 100 male deaths (Jamison et al. 2013).”
Guerra, S., Roope, L. S. J., & Tsiachristas, A. (2024) · Health Policy and Planning · doi:10.1093/heapol/czae002 · Cited by 7
“The ‘Global Health 2035’ report from the Lancet Commission on Investing in Health endorses two pro-poor approaches towards UHC (Jamison et al ., 2013).”
BackgroundAIDS and global health: the path to sustainable development
Lo, S., & Horton, R. C. (2015) · The Lancet · doi:10.1016/s0140-6736(15)61040-6 · Cited by 7
Self-citationFitchett, J. R. A., Li, J. F., & Atun, R. A. (2015) · International Health · doi:10.1093/inthealth/ihv067 · Cited by 7
Consequences of a changing US strategy in the global HIV investment landscape
McGillen, J. B., Sharp, A. R., Honermann, B., Millett, G. A., Collins, C. M., & Hallett, T. B. (2017) · AIDS · doi:10.1097/qad.0000000000001669 · Cited by 7
“Most substantive are the ongoing Populationbased HIV Impact Assessments Project, which in 2016 reported decreasing HIV incidence in three PEPFARrecipient countries [10], and a Lancet commission that estimated the costs of several global health investment scenarios [11].”
BackgroundMigrant health is global health
Kumar, B., Siem, H., Haavardsson, I., & Winkler, A. S. (2017) · Tidsskrift for Den norske legeforening · doi:10.4045/tidsskr.17.0656 · Cited by 7
Jason, H. (2018) · Medical Teacher · doi:10.1080/0142159x.2018.1425383 · Cited by 7
“That theme, of individuals and organized groups calling for constructive changes while observing that not enough was happening, has not gone away (Cooke et al. 2010; Frenk et al. 2010; Skochelak 2010; Jamison et al. 2013).”
BackgroundC-Reactive Protein and Fatty Acids
Norde, M. M., Oki, É., & Rogero, M. M. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-811297-7.00009-3 · Cited by 7
Koon, A. D., Conrad, A., Naimoli, J. F., Saxena, S., Connor, C., & Rodríguez, D. (2019) · Global Public Health · doi:10.1080/17441692.2019.1622758 · Cited by 7
“Critically thinking about how USAID funded projects may elevate health systems in this way could not be more timely (Jamison et al., 2013).”
BackgroundNguyen, T. T., Sweeny, K., Tran, T. D., Luchters, S. M. F., Hipgrave, D. B., Hanieh, S., Tran, T., Tran, H., Biggs, B., & Fisher, J. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-031721 · Cited by 7
Road to family planning and RMNCHN related SDGs: Tracing the role of public health spending in India
Goli, S., Moradhvaj, James, K. S., Singh, D., & Srinivasan, V. (2020) · Global Public Health · doi:10.1080/17441692.2020.1809692 · Cited by 7
Bonnechère, B., Samadoulougou, S., Cissé, K., Tassembédo, S., Kouanda, S., & Kirakoya‐Samadoulougou, F. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-058005 · Cited by 9
“Low and mid-income countries are facing the emergence of non-communicable diseases (NCDs) [5].”
BackgroundPopulation health in a global society: Preparing nurses for the future
Walton, A., Nikpour, J. A., & Randolph, S. D. (2022) · Public Health Nursing · doi:10.1111/phn.13081 · Cited by 7
HOW TO MEASURE THE ECONOMIC IMPACT OF VECTOR‐BORNE DISEASES AT COUNTRY LEVEL
Basili, M., & Belloc, F. (2014) · Journal of Economic Surveys · doi:10.1111/joes.12075 · Cited by 8
“With a main focus on empirical issues, the recent Report of the Lancet Commission on International Health (Jamison et al., 2013) provides some interesting suggestions for research improvements, that are worth a mention here.”
Population and climate change: who will the grand convergence leave behind?
Campbell, M. M., Casterline, J. B., Castillo, F., Graves, A., Hall, T. L., May, J. F., Perlman, D., Potts, M., Speidel, J. J., Walsh, J., et al. (2014) · The Lancet Global Health · doi:10.1016/s2214-109x(14)70021-x · Cited by 7
Can Economic Performance Predict Pediatric Surgical Capacity in Sub‐Saharan Africa?
Okoye, M. T., Nguyen, E. T., Kushner, A. L., Ameh, E. A., & Nwomeh, B. C. (2016) · World Journal of Surgery · doi:10.1007/s00268-016-3410-8 · Cited by 7
Out of Africa: Insights from a prospective pediatric surgery database
Bickler, S. W. (2017) · Journal of Pediatric Surgery · doi:10.1016/j.jpedsurg.2017.10.009 · Cited by 7
Geriatric Trends Facing Nursing with the Growing Aging
Harris, J. (2019) · Critical Care Nursing Clinics of North America · doi:10.1016/j.cnc.2019.02.007 · Cited by 7
Brunet‐Jailly, J. (2018) · Cairn.info · doi:10.3917/afco.265.0123 · Cited by 7
White, M. C., Leather, A. J. M., Sevdalis, N., & Healey, A. (2020) · Annals of Surgery · doi:10.1097/sla.0000000000004498 · Cited by 7
Abdallah, C., Coady, D. P., Gupta, S., & Hanedar, E. (2015) · IMF Working Paper · doi:10.2139/ssrn.2653605 · Cited by 7
Self-citation
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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