Global Health 2050: A Roadmap to Halve Premature Death

The "Global Health 2050" report offers not only a diagnosis but also a clear, evidence-based roadmap with measurable goals, strengthening health systems through cost-effective interventions, ensuring sustainable financing, and preparing the world for future health threats.

For decades, global efforts to improve health have yielded uneven results. While in many countries life expectancy has increased significantly, millions of people continue to die before the age of 70 from preventable diseases and treatable conditions. In light of this situation, an ambitious report from The Lancet Commission on Investing in Health proposes a new goal: to reduce by 50% the probability of premature death worldwide by the year 2050. This plan, known as “50 for 50,” could mark a turning point in global health, provided it translates into concrete public policies, sustained investment, and international cooperation.

The report “Global Health 2050” (GH2050), recently published in Salud Pública de México, emerges as the third installment in a series of historical assessments driven by The Lancet since 1993. That first call to “invest in health,” aimed at finance ministers and international donors, emphasized the economic value of implementing cost-effective interventions. Two decades later, in 2013, a new report proposed the concept of a “grand convergence” in health by 2035. Now, GH2050 resumes that legacy and presents a more realistic yet equally urgent vision: to drastically reduce premature mortality through key interventions in 15 priority conditions and a decisive strengthening of health systems.

The report focuses on a concrete metric: the probability of premature death (PPD), defined as the probability of dying before the age of 70 based on age-specific rates. In 2019, that probability was 31% globally. Achieving a 50% reduction would mean that a person born in 2050 would have only a 15% chance of dying before age 70. Is this feasible? The authors argue that it is, and they support this claim with historical data and demographic projections.

Between 1970 and 2019, global PPD fell from 56% to 31%. In regions such as the North Atlantic—including Western Europe and Canada—the current figure is only 15%. Countries such as Bangladesh, China, and Vietnam have managed to halve their PPD in less than 31 years, showing that the “50 for 50” target is achievable. Even in sub-Saharan Africa, the region with the highest burden of premature mortality, progress since 2000 has been notable, especially following the partial containment of HIV/AIDS. However, the path is full of obstacles, many of them recent.

The COVID-19 pandemic meant a dramatic setback. Between January 2020 and May 2023, 23 million excess deaths were recorded globally, most directly attributable to the virus. The impact was even more devastating in countries with weak health systems or without equitable access to vaccines. Other global challenges compound this: wars, geopolitical tensions, climate change, inflation, and external debts that limit many countries’ fiscal capacity to invest in health. In this context, GH2050 is not just a technical call, but a political act.

The cornerstone of the plan is to address 15 health conditions identified as priorities. Eight of them are infectious or maternal: neonatal conditions, respiratory infections, diarrheal diseases, HIV/AIDS, tuberculosis, malaria, vaccine-preventable diseases, and maternal causes. The other seven are noncommunicable diseases and injuries: cardiovascular diseases, cancers linked to infections or tobacco, diabetes, traffic accidents, and suicide. These 15 conditions explain up to 86% of the difference in life expectancy between countries with high and low health performance.

An analysis presented in the report shows that between 2000 and 2019, global life expectancy increased by 6.2 years, and about 86% of that gain was due to reductions in mortality from these priority conditions. In sub-Saharan Africa, the increase was 9.5 years, of which 8.7 were due to fewer deaths from infectious and maternal conditions. In India, these same conditions accounted for 6.9 of the 8.1 years gained in life expectancy. This reinforces the argument that focusing on these 15 conditions is a smart and urgent investment.

However, tackling these conditions is not enough if health systems remain fragmented, underfunded, or lacking response capacity. Therefore, the report proposes a modular approach to health systems strengthening (HSS). This model suggests grouping cost-effective interventions into 19 modules—for example, maternal care, cardiovascular diseases, or mental health—and planning their implementation based on national priorities and available resources. Thus, instead of applying a one-size-fits-all approach, each country could tailor its interventions according to context, capacity, and local needs.

This modular approach also enables evidence-based decisions about where to allocate additional resources. For example, investing in combined treatments for diabetes and cardiovascular diseases may be more cost-effective than addressing them separately. In addition, the aim is for these interventions to be prepaid and guaranteed for the entire population, which implies a strong fiscal commitment from governments.

Financing, without a doubt, is a central issue. The report warns that the costs of maintaining and innovating in health will rise due to population aging, technological development, and wage pressure in the sector. Added to this is the global competition for healthcare professionals, who often migrate from low-income countries to nations with greater economic opportunities, leaving critical workforce gaps. To face this reality, it is proposed to strengthen training systems, align them with local needs, and improve working conditions for health personnel.

Likewise, the importance of intersectoral policies is emphasized. Many determinants of health—such as access to drinking water, education, air quality, or tobacco regulation—do not depend exclusively on the health sector. Therefore, coordination between governments, multilateral organizations, civil society, and the private sector is required to comprehensively address the factors that affect health and premature mortality.

Finally, GH2050 issues a clear call to prepare for future pandemics. Based on risk analysis, it is estimated that an average of 2.5 million people could die each year from new pandemics if prevention mechanisms, rapid response, and equitable distribution of medical supplies are not implemented. This is no small point, as the COVID-19 experience showed that lack of preparedness and global cooperation can have catastrophic consequences.

In summary, the “Global Health 2050” report not only offers a diagnosis but also a clear roadmap, based on evidence and with measurable goals. It proposes focusing on 15 key conditions, strengthening health systems through cost-effective interventions, ensuring sustainable financing, and preparing the world for future health threats. But above all, it reminds us that investing in health is not an expense, but a powerful tool to improve human well-being, reduce inequality, and build a fairer and more resilient future.

The challenge is enormous, but the benefits are unquestionable. Halving premature death is not just a technical goal; it is an ethical imperative.

Reference of the original article:

Jamison, D. T., Summers, L. H., Chang, A. Y., Karlsson, O., Mao, W., Norheim, O. F., Ogbuoji, O., Schäferhoff, M., Watkins, D., & Yamey, G. (2025). Salud global 2050: el camino para reducir a la mitad la muerte prematura. Salud Pública De México, 67(3 (may-jun), 301-322. https://doi.org/10.21149/16963 

https://saludpublica.mx/index.php/spm/article/view/16963