As the world prepares for the 2024 World Health Summit, a new report from the Lancet Commission on 'Investing in Health' has outlined an ambitious goal to cut the global probability of premature deaths by half by 2050. The report, authored by an international team from leading institutions including Harvard University’s School of Public Health, the World Health Organization (WHO), and the Public Health Foundation of India, proposes a strategy they have termed '50-by-50.'
According to the report, seven of the world’s 30 most populous countries, including Bangladesh, Ethiopia, Iran, and Turkiye, are already on track to meet this challenging objective. These nations have shown significant progress in addressing public health issues, setting an example for others to follow. The global initiative is spearheaded by a diverse team of researchers from leading institutions such as Harvard University's School of Public Health, the WHO, and the Public Health Foundation of India (PHFI), New Delhi.
A Bold Vision: 50-by-50
The commission’s report highlights that, as of 2019, the average person born that year had a 31 percent chance of dying before reaching the age of 70. This figure, stark as it is, underscores the need for immediate and sustained interventions across healthcare systems. "If the 50-by-50 goal is achieved globally, a child born in 2050 could expect to have only a 15 per cent chance of dying before reaching the age of 70," the report stated. This projection marks a monumental shift in global health prospects, offering hope for substantial reductions in premature mortality worldwide.
The Lancet Commission's authors pointed out that the gains made by the seven countries currently leading the charge toward meeting the 50-by-50 goal could be replicated by others if they prioritize providing universal health coverage. The report suggests that early action and consistent policy implementation are key factors in their success.
Universal Health Coverage: A Key to Success
Universal health coverage (UHC) is seen as a critical factor in reducing early deaths. By ensuring that healthcare is accessible, affordable, and of high quality, nations can dramatically reduce mortality rates. The authors emphasize that UHC is the most powerful tool for cutting the risk of premature death, particularly when combined with focused interventions targeting key health conditions. They noted that countries making progress toward UHC tend to experience significant reductions in deaths from both infectious and non-communicable diseases.
Tobacco control policies, for instance, play a significant role in lowering mortality rates. The report identifies tobacco taxation and regulation as the "most important policy that governments can adopt" to prevent premature deaths. Given the well-documented link between tobacco use and deadly conditions such as cancer and heart disease, the commission stresses that even modest progress in tobacco control could save millions of lives over the next few decades. "Tobacco-related deaths remain one of the largest avoidable causes of early death, and the capacity of governments to implement tobacco policy is well-established," the authors explained.
A Broader View on Public Health
Beyond tobacco, other lifestyle-related factors contribute to the high global death toll, particularly those associated with diet and nutrition. A study led by Harvard University, published in the British Medical Journal in April 2023, found that sugary drinks are linked to an increased risk of early death and heart disease, particularly among individuals with type 2 diabetes. The Lancet report urges governments to implement fiscal policies, including taxing sugary drinks and unhealthy foods, as a means of reducing mortality rates.
"Fiscal policies such as taxing unhealthy food and beverages, as well as eliminating fossil fuel subsidies, not only promote health directly but also create revenue streams that can be reinvested into health services," the report states. These policies could also address the dual issues of poor health and environmental degradation, offering a comprehensive approach to global public health.
Learning from the Best
One of the most pressing concerns outlined in the report is the exceptionally high death risk from pandemics, which was underscored by the COVID-19 crisis. The commission lauded countries such as China and Japan for their strong national public health responses, including early action, isolation, quarantine measures, and financial support for those affected. These countries effectively curbed pandemic-related deaths, providing a model for others to emulate. "The success of these nations can be attributed to their rigorous implementation of public health fundamentals," the authors explained.
This success emphasizes the need for robust public health infrastructure and a proactive approach to pandemic preparedness. As the world becomes increasingly interconnected, the risk of pandemics looms large, making it essential for nations to invest in public health systems that can respond quickly and effectively to emerging threats.
Tackling 15 Priority Health Conditions
To meet the 50-by-50 goal, the Lancet report proposes a targeted approach, focusing on 15 priority health conditions. These include eight infectious and maternal health conditions, such as tuberculosis and maternal mortality, and seven non-communicable diseases and injury-related conditions, including cardiovascular disease and road traffic accidents.
The report suggests that scaling up investments in these areas could yield significant reductions in premature deaths. "Our analyses have shown that a decline in deaths due to these 15 conditions was key to the gains in life expectancy between 2000 and 2019," the authors wrote. However, the report also highlighted the ongoing challenge of making these interventions accessible to millions of people who currently lack the necessary healthcare services.
One of the main obstacles to achieving the 50-by-50 goal is the lack of focus on high-priority steps needed for universal health coverage. The authors stress that providing access to healthcare for these 15 conditions could be a "game changer" in reducing early mortality, but only if governments make these interventions a priority.
The Economic Argument for Investment
The Lancet Commission report makes a compelling economic argument for investing in health. "Our analyses have shown that the economic value of achievable mortality declines is high and is often a substantial fraction of the value of gains from economic growth itself," the report states. In other words, reducing premature deaths not only improves quality of life but also boosts economic productivity by keeping people healthier for longer.
To achieve the 50-by-50 goal, the authors call for an interim milestone: a 30 per cent reduction in the probability of premature death by 2035. They emphasize that the most efficient route to achieving these targets is to focus resources on a narrow set of conditions and scale up financing to develop and deploy new health technologies. By doing so, governments can achieve both significant health improvements and long-term economic benefits.
A Global Call to Action
The Lancet report serves as a global call to action, urging governments, international organizations, and public health experts to work together toward the shared goal of reducing premature mortality. With strong political will and targeted investments, the 50-by-50 goal can become a reality, offering hope for millions of people around the world.
The authors conclude, "The 50-by-50 goal, with an interim milestone of a 30 per cent reduction in the probability of premature death by 2035, remains within reach." The world now stands at a crucial juncture where decisions made today will shape the future of global health, potentially saving millions of lives in the decades to come.
