Advances in basic healthcare during the past few decades, such as wider availability of medicines and vaccines and improvements in medical procedures, have reduced disease, improved overall health outcomes, and extended longevity for large numbers of people globally. During the next two decades, however, several health challenges are likely to persist and expand, in part because of population growth, urbanization, and antimicrobial resistance.

Stalled Progress on Combating Infectious Disease

International progress against tuberculosis and malaria has stalled in recent years. From 2015-19, the number of cases of drug-resistant tuberculosis worldwide increased, and malaria cases declined just 2 percent, compared to 27 percent in the preceding 15 years, in part because of the leveling of international investments. Looking forward, longstanding, emerging, and reemerging infectious diseases will continue to endanger individuals and communities. The incidence of new pandemics also is likely to grow due to increased risk of new animal pathogens infecting humans and factors that enable spread, such as human mobility and population density.

Growing Antimicrobial Resistance

Resistance to antibiotic treatment is rising globally, due in part to overuse and misuse of antibiotics in livestock and antimicrobials in human medicine. Drug-resistant infections cause more than half a million deaths annually, and the cumulative economic cost could reach $100 trillion between 2020 and 2050 because of productivity loss and the high cost of extended hospital stays or treatment.

Rising Levels of Noncommunicable Disease

Noncommunicable diseases now cause the majority of deaths worldwide—principally because of diabetes, cardiovascular disease, cancer, and chronic respiratory conditions such as asthma. Health experts project that by 2040, noncommunicable diseases could cause 80 percent of deaths in low-income countries, up from 25 percent in 1990, due in part to longer life expectancies but also to poor nutrition, pollution, and tobacco use. In many countries, health systems are not adequately equipped to respond to this shift, which could increase human suffering. Periods of economic slowdown exacerbate those risks by straining public health systems and putting downward pressure on foreign assistance and private health investments.

Increasing Strains on Mental Health, Especially Among Youth

Mental health and substance abuse disorders increased 13 percent during the past decade, principally because of increases in population and life expectancy but also because of the disproportionate prevalence of mental illness among adolescents. Currently, between 10 and 20 percent of children and adolescents globally suffer from mental health disorders, and suicide is the third leading cause of death among people between 15 and 19 years old.

Health experts project that the economic cost of mental illness worldwide could exceed $16 trillion during the next 20 years, with much of the economic burden resulting from lost income and productivity as a result of chronic disability and premature death. Preliminary research suggests that because of the pandemic, people in every region will experience increased rates of mental distress caused by economic losses and social isolation stress disorder.

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