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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]
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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BackgroundSiu-Paredes, F., Rude, N., Rouached, I., Rat, C., Mahalli, R., El‐Hage, W., Rozas, K., & Denis, F. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182312413 · Cited by 2
“This demonstrates the complexity of constructing tools to assess global health, which refer to measures that give a broad view of health, not referring to specific problems, such as cancer, diabetes, dental problems, or mental disorders; this tool focused on global measures of perceived physical and mental health [34].”
BackgroundA new model for estimating in-hospital mortality in patients with pulmonary embolism: PATHOS score
Alışkan, H., & Kılıç, M. (2023) · Anatolian Current Medical Journal · doi:10.38053/acmj.1306731 · Cited by 2
The Changing World of Global Health
Raviglione, M. C., Pablos-Méndez, A., & Villa, S. (2023) · Sustainable development goals series · doi:10.1007/978-3-031-33851-9_2 · Cited by 2
Understanding the Concept of Health Inequality
Bibi, E., Mubashir, A. S., Ghori, A. K., & Bibi, A. (2023) · IntechOpen eBooks · doi:10.5772/intechopen.1003038 · Cited by 4
Effect of ozone gas on viral kinetics and liver histopathology in hepatitis C patients
Sadek, A., Hady, A. M. A. E., Hammam, O. A., Abdel-Hady, A. A., Wafy, W., Zaki, M. E., & Youness, E. R. (2024) · Journal of Complementary and Integrative Medicine · doi:10.1515/jcim-2023-0239 · Cited by 2
Azmat, S. K., Thom, E., Arshad, M., Hamza, H. B., Aabroo, A., Balal, A., Awan, M. A., Rifaq, F., Hemachandra, N. N., & Uzma, Q. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1293278 · Cited by 2
Revisiting swimming against tide; inequalities in child malnutrition in Nepal
Siddiqui, M. Z., Illiyan, A., Akram, V., & Nigar, K. (2024) · Discover Global Society · doi:10.1007/s44282-024-00047-7 · Cited by 2
“As a result, when the overall health status of a population improves, it benefits the richer individuals disproportionately more, which exacerbates health inequalities [24, 35–41].”
Massuda, A., Fernández, M., Kemper, E. S., Paschoalotto, M. A. C., & Tapia, R. (2024) · Revista de Administração Pública · doi:10.1590/0034-761220230391 · Cited by 2
Massuda, A., Fernández, M., Kemper, E. S., Paschoalotto, M. A. C., & Tapia, R. (2024) · Revista de Administração Pública · doi:10.1590/0034-761220230391x · Cited by 2
Effective Health Aid: Evidence from Gavi’s Vaccine Program
Shastry, G. K., & Tortorice, D. L. (2025) · American Economic Journal Economic Policy · doi:10.1257/pol.20230036 · Cited by 2
Telemedicina en países en desarrollo y cooperación
Rossetti, A. F., Suero, M. J. C., Elvira, Á. S., Corbella, T. R., Miceli, F. G. D. Q., & Muñoz, M. G. (2025) · Atención Primaria · doi:10.1016/j.aprim.2025.103226 · Cited by 4
Born Too Soon: Accelerating change to 2030 and beyond
Lawn, J. E., Khosla, R., Reid, A., Langlois, É. V., Kinney, M. V., Gupta, G. K., Mollel, D., Jacobsson, B., Bizri, M. E., Gruending, A., et al. (2025) · Reproductive Health · doi:10.1186/s12978-025-02035-9 · Cited by 3
“For 74 high-burden countries, every US$ 1 spent on key interventions for RMNCH is estimated to lead to a return of between US$ 9 to US$ 20 in economic and social benefits as a result of lower morbidity and mortality between 2015-2035 [52].”
Morbid Symptoms, Organic Crises, and Enclosures of the Commons
Gill, S. R., Bakker, I., & Wamsley, D. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108692137.019 · Cited by 2
London, A. J. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197534830.003.0005 · Cited by 2
Global Leadership Practices for Planetary Health
Krause, W. (2023) · Springer eBooks · doi:10.1007/978-3-030-75831-8_53-1 · Cited by 2
Binagwaho, A., Nutt, C. T., Mugwaneza, P., Wagner, C. M., & Nsanzimana, S. (2014) · PLoS Medicine · doi:10.1371/journal.pmed.1001719 · Cited by 2
Self-citationMensah, G. A. (2016) · Global Heart · doi:10.1016/j.gheart.2016.01.005 · Cited by 2
Knowledge for a Sustainable World
Halvorsen, T., Ibsen, H., & M'kumbuzi, V. R. P. (2015) · African Minds eBooks · doi:10.47622/9781928331049 · Cited by 2
Developing Capacity in Nutrition
Fanzo, J., & Graziose, M. M. (2017) · Springer eBooks · doi:10.1007/978-3-319-43739-2_4 · Cited by 2
la Cruz, Y. C. D., & Robinson, S. (2017) · The Linacre Quarterly · doi:10.1080/00243639.2016.1274631 · Cited by 2
The Economic Case for Surgical Care in Low-Resource Settings
Raykar, N. P., Mukhopadhyay, S., Halbach, J. L., Cossa, M., Saluja, S., Lin, Y., Shrime, M. G., Meara, J. G., & Bickler, S. W. (2017) · Springer eBooks · doi:10.1007/978-3-319-49482-1_3 · Cited by 2
BRICS health and tuberculosis control collaborations during an era of global health
Dirlikov, E. (2015) · Medicine Anthropology Theory · doi:10.17157/mat.2.1.176 · Cited by 2
“Tuberculosis is positioned as a challenge to health in BRICS, the control of which has been determined to not only be the most cost-effective public health intervention (Lancet 2014), but also to positively impact national GDP (World Bank 1993; Jamison et al. 2013).”
Postgrowth and Human Wellbeing
Büchs, M., & Koch, M. (2017) · Springer eBooks · doi:10.1007/978-3-319-59903-8_5 · Cited by 2
Engmann, C., & Batra, M. (2018) · Elsevier eBooks · doi:10.1016/b978-0-323-40139-5.00004-8 · Cited by 2
Renouf, T. S., Doyle, M., Pollard, M. A., Bankovic, T., & Dubrowski, A. (2018) · Cureus · doi:10.7759/cureus.2850 · Cited by 2
Therapy of Cancer and Retroviral Diseases
Williams, C. K. O. (2018) · Springer eBooks · doi:10.1007/978-3-319-99362-1_2 · Cited by 2
Valuing Protection against Health-Related Financial Risks
Skinner, J., Chalkidou, K., & Jamison, D. T. T. (2019) · Journal of Benefit-Cost Analysis · doi:10.1017/bca.2018.30 · Cited by 2
“1 In valuing the benefits of health insurance, most analyses, not surprisingly, focus primarily on its beneficial impact on health (Jamison et al., 2013; Robinson et al., 2019 a , b ).”
BackgroundSelf-citationGyedu, A., Stewart, B. T., Gaskill, C. E., Salia, E. L., Wadie, R., Donkor, P., & Mock, C. (2019) · World Journal of Surgery · doi:10.1007/s00268-019-04963-7 · Cited by 2
The Idea of Universal Basic Income
Gentilini, U., Grosh, M., & Yemtsov, R. (2019) · World Bank, Washington, DC eBooks · doi:10.1596/978-1-4648-1458-7_ch1 · Cited by 2
Mukara, K. B., & Kyamanywa, P. (2019) · Rwanda Journal of Medicine and Health Sciences · doi:10.4314/rjmhs.v2i1.8 · Cited by 2
“Emphasis is placed on investing in stronger health systems and policies capable of meeting the main health challenges faced by these countries; that is, infections; reproductive-maternal-neonatal and child health; NCDs and injuries.[37] All service delivery avenues within a health system will need to be supported in t…”
BackgroundPhilosophy of sustainable development: understanding public health
Sahoo, A. K., Behera, H. C., & Behura, A. K. (2021) · Environment Development and Sustainability · doi:10.1007/s10668-021-01945-5 · Cited by 2
“The challenges of “tackling the social and inter-sectoral determinants of health” (Jamison et al., 2013) have been eluded as the policies are sectoral in nature.”
BackgroundA Non-Paternalistic Model of Research Ethics and Oversight
London, A. J. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197534830.003.0007 · Cited by 2
Challenging the Global Extractive Order
Schrecker, T., Birn, A., & Aguilera, M. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108692137.020 · Cited by 2
Корж, Ю. В., Олєйнікова, Н. В., Beketova, M., Кубарєва, І. В., Korobova, E. S., Sevriukov, O. V., & Афанасенко, О. В. (2022) · ScienceRise Pharmaceutical Science · doi:10.15587/2519-4852.2022.255840 · Cited by 2
Costa, S. D. (2023) · Health Economics · doi:10.1002/hec.4654 · Cited by 3
Monlezun, D. J. (2023) · Elsevier eBooks · doi:10.1016/b978-0-443-18906-7.00001-5 · Cited by 2
Effects of the energy transition on China’s economic sustainability
Wei, W., & Wang, Z. (2023) · Environment Development and Sustainability · doi:10.1007/s10668-023-04115-x · Cited by 2
“The energy transition can change the depreciation rate of natural capital (IEA & IRENA, 2017), positively stimulate the growth of human capital (Apergis et al., 2018; Jamison et al., 2013), and reduce the negative impact of energy use on environmental degradation (IEA, 2019; IEA & IRENA, 2017).”
Implementation Science in the Global Context
Geng, E. H., Moshabela, M., & Alonge, O. (2023) · doi:10.1093/oso/9780197660690.003.0026 · Cited by 2
Holst, J. (2019) · BMJ Global Health · doi:10.1136/bmjgh-2019-001404 · Cited by 2
“Protecting citizens from social risks, however, is not a mere economic cost factor but a state obligation and the foundation of individual and economic development and social welfare.(17) In the case of illness, unemployment and disability, people must be able to rely on effective social protection systems.”
BackgroundVaccine Innovation and Global Sustainability
Possas, C. D. A., Martins, R. D. M., & Homma, A. (2020) · Oxford University Press eBooks · doi:10.1093/oso/9780190949501.003.0011 · Cited by 2
Big Data Platform Selection at a Hospital: A Rembrandt System Application
Singh, S., Verma, R., & Koul, S. (2020) · Advances in intelligent systems and computing · doi:10.1007/978-981-15-6067-5_16 · Cited by 2
The Medical Clinic of Proximity: Business Controversies and Medical Challenges
Mihoreanu, L. (2020) · Palgrave studies in cross-disciplinary business research, in association with EuroMed Academy of Business · doi:10.1007/978-3-030-45831-7_3 · Cited by 2
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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