If there’s one thing the COVID-19 pandemic taught us, it’s that the world isn’t always as prepared for a crisis as we might think.
Now, in a sweeping international assessment published in The Lancet, a team of dozens of scientific experts has cataloged the dangers of 17 major global health threats faced by humanity this century – and preparedness is a key theme of their findings.
While it’s a sobering review, the key message is that the dangers of global catastrophes can be mitigated and managed, but only if society takes action now.
“The striking finding is not only the scale of these threats, but that humanity still has the agency to act,” says physician and health economist Christopher JL Murray from the University of Washington, the co-chair of The Lancet Commission on 21st Century Global Threats to Health.
“Across all 17 catastrophic threats, the decisions made by leaders today will shape the health and well-being of the next generation.”
In their study, the researchers used modeling to estimate how much death and disability could potentially be avoided for each threat between 2025 and 2100, measured in disability-adjusted life-years (DALYs).
“The estimates highlight how much health loss could be avoided in each area,” Murray says.
“Some are already imposing substantial health burdens today, while others carry a real danger if they materialize.”
Of the most dangerous threats, the researchers say two in particular deserve special attention, rating them as carrying “extinction potential” for humanity between now and 2100, despite their ultimately low probability.
“These were malicious AI, including using AI to create new bioweapons, and nuclear conflict with nuclear famine,” the researchers explain in their report, noting that other potentially extinction-level dangers, such as asteroid strikes or supervolcano eruptions, were discounted due to their very low probability of occurring this century.
Another possible event with hypothesized extinction potential for humanity – the creation of ‘mirror life’ – was similarly left out because it has not yet been developed, and despite the theoretical dangers to human health, it’s too early to quantify them.
After the special cases of malicious AI and nuclear conflict, the researchers identified 15 major catastrophic risks, each associated with more than 1 billion potentially avoidable DALYs between now and 2100.
“For reference, 1 billion DALYs is equivalent to two COVID-19 pandemics,” the researchers write, “showing that these are critical threats for governments and the global community to address.”
Among this category, the researchers identified: air pollution, antimicrobial resistance, childhood malnutrition, climate change, the collapse of international aid funding for health, conventional armed conflict, high alcohol use, high blood pressure, income inequality, low educational attainment, naturally occurring pandemics, obesity, poor mental health, smoking, and unhealthy aging.
Of these, the threat with the largest potentially avoidable burden was obesity (including the health effects of high BMI, poor diet, and low physical activity), with an estimated 23.1 billion DALYs – corresponding to about 46 COVID-19 pandemics – being the difference between the best- and worst-case scenarios by 2100.
After obesity, the largest potentially avoidable health burdens were low educational attainment and income inequality, with higher rates of education projected to reduce the burden of disease both by improving people’s health and slowing population growth.
Under the researchers’ baseline forecast, the total global burden of disease and injury between 2025 and 2100 amounts to an estimated 246 billion DALYs – equivalent to roughly 500 COVID-19 pandemics.
Such is the scale of the issues at stake – but it’s important to note that, since the burden of each threat was calculated individually, the total burdens can’t be added together like that, as it would over-count the overlap in health problems faced by individuals.
On that note, one of the key points the researchers emphasize is just how interconnected many of these health dangers are, and how solving these problems calls for a long-term and multi-faceted approach that doesn’t simply combat individual problems in isolation.
Instead, the researchers make three key recommendations, calling for governments to build and fund threat-ready health systems, to dramatically increase investment in breakthrough innovation (in areas like health, climate, and technology), and to create a “Monitor of 21st Century Global Threats to Health” to continually track and update threat assessments.
“Perhaps the most important contribution of this Commission is to move global health beyond the consideration of individual harms,” The Lancet‘s editors write in an accompanying editorial perspective.
“The unpleasant reality is that the threats we face are multiple, complex, and difficult… We believe this Commission can catalyze international, regional, and national actions to protect and strengthen the future of health and humanity. Doing so will require all of us to think much more broadly about where the biggest threats lie.”
The findings are reported in The Lancet.
This article was fact-checked by Rebecca Dyer and edited by Rebecca Dyer. While we pride ourselves on our process, we are only human. If you spot a mistake, please let us know.
