More than a dozen interconnected threats pose significant risks to global health and wellbeing through the rest of the 21st century, including the potential for human extinction, according to a new commission of 35 leaders from various industries. Their findings, published in the journal The Lancet, identify 17 catastrophic threats that demand targeted action from world leaders to avoid worst-case scenarios.
Using data from the Institute for Health Metrics and Evaluation's Global Burden of Disease study, the commission forecast the total years of good health that could be lost due to sickness, disability, or premature mortality. The threats include health conditions and behaviors such as obesity, high blood pressure, smoking, and mental health issues, as well as economic conditions, environmental change, technology, and conflict. If current trends continue, these threats could collectively account for tens of billions of years of lost health.
«The striking finding is not only the scale of these threats, but that humanity still has the agency to act,» said Dr. Christopher Murray, co-chair of the commission and director of the University of Washington's Institute for Health Metrics and Evaluation. «Across all 17 catastrophic threats, the decisions made by leaders today will shape the health and wellbeing of the next generation. But delaying action will only serve to shift and increase the costs into the future.»
Two threats pose a risk of extinction, the commission found: nuclear conflict and the malicious use of artificial intelligence. The report notes that various forecasters showed wide divergence in estimating the risk of AI-related catastrophe. The potential for healthy years of life lost due to malicious AI is about 10.4 billion years worldwide by 2100, roughly the same as some other risks including naturally occurring pandemics and obesity. However, because no malicious AI event of truly global magnitude has yet occurred, those estimates remain theoretical.
By contrast, the risks posed by obesity are based on more empirical data. Overweight and obesity are increasing in every country, and estimates suggest the global rate could reach 60% of adults and a third of children by 2050. Obesity is linked to dozens of other poor health outcomes, particularly associated with increased caloric intake and decreased physical activity, and the commission forecasts a major global impact from this cluster of behavioral risks.
The commission's goal is not to rank threats but to catalyse international, regional, and national actions to protect and strengthen the future of health and humanity, according to a related editorial in The Lancet. «Recent global events show us just how quickly stability can give way to crisis, and how costly it is to respond only after disaster strikes,» said Dr. Natalia Kanem, former executive director of the United Nations Population Fund and co-chair of the commission. «The global threats to health risk amplifying existing inequalities, with the greatest burden falling on the most vulnerable communities. Yet the future is not inevitable.»
Trust is key to meaningful intervention, according to the report. The commissioners describe trust as a stabilizing force that enables societies to anticipate, mitigate, and adapt, while distrust can increase potential harm. Along with trust, seven other factors will shape how societies respond to future threats, including collaborative global leadership, resilient food systems, and efforts to foster more equitable societies.
«Public health is full of examples in which potential threats were known, and protection plans were in place, yet effective action failed,» the report says. «Achieving meaningful progress will require not only technical solutions but also robust societal and institutional foundations that foster collaboration and accountability.»
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