### The UN at 80: Every human deserves a longer, healthier future

An open letter urging immediate action on non-communicable diseases

For everyone who deserves a healthier future,For eighty years, the United Nations (UN) has guided global health efforts toward extending life expectancy. Today, however, the challenge is shifting. Globally, life expectancy at birth stands at 73 years, yet healthy life expectancy is just 63 years, resulting in a 10-year gap dominated by debilitating chronic diseases that are severely taxing for patients and are increasing pressures and costs for overwhelmed healthcare systems.As governments raise retirement ages to address the fiscal challenges of ageing populations, we are also seeing unprecedented rates of illness and disability among working age people. [i] This erosion of health threatens both productivity and economic resilience. We must urgently recalibrate: prioritise health-span over life-span, support high-risk groups and build sustainable healthcare systems to avoid irreversible societal strain and systemic disruption. NCDs, which include heart disease, respiratory illness, cancer, diabetes and chronic kidney disease, are set to cause 86% of all annual deaths by 2050, representing a staggering 90% increase from 2019 levels. [ii] The impact is disproportionately felt in low- and middle-income countries, where 80% of deaths are currently caused by NCDs. Ageing populations, the climate emergency, urbanisation, lifestyle factors and a lack of access to healthcare all contribute to this chronic disease crisis. While the human cost is staggering, equally so is the toll on buckling health systems and economies – NCDs will cost the global economy more than $47 trillion between 2010 and 2030. [iii] As world leaders gather in New York for the 80th UN General Assembly, we call for urgent action to tackle NCDs, by focusing on three priorities:1. Treating health as an investment, not a cost to cut  Investing strategically in health yields economic and social returns. Governments and health systems must finance healthcare for the long-term so that chronic diseases can be prevented, diagnosed and treated earlier. This would enable a shift from ‘sick care’ systems to ‘health care’ systems that keep people well and out of hospital. The payoff is clear – one-third of economic growth in advanced economies in the past century can be attributed to improvements in health. [i] And, in developing countries, for every $1 invested in health, there is a possible economic return of between $2 to $4. Such data must inform how budgets are allocated. [ii]2. Strengthen health systemsBuilding stronger health systems doesn’t happen overnight, but their collapse can, as is clear from the Covid-19 pandemic. Declining public spending on health, shortages in health workers and growing health inequities are adding further pressures to health systems. The OECD has shown that an additional 1.4% of GDP relative to pre-pandemic levels is needed to better prepare health systems for future shocks. [iii]Data-backed recommendations from the Partnership for Health System Sustainability and Resilience (PHSSR) across 30 countries highlight that robust health systems require investment in primary care access, workforce capacity and data infrastructure – areas currently compromised internationally. 3. Prioritise innovation Science and innovation are essential for outpacing the rising burden of disease, with AI accelerating progress. Yet currently, timely diagnosis and access to evidence-based treatment are lacking, with recent data showing that less than 10% of patients with a common form of heart failure in the US and Canada receive guideline-directed care. [iv], [v] We must improve the adoption of effective treatment and set polices that support equitable access for all.  Innovation must also be incentivised. While innovation in prevention, diagnostics and treatment have contributed significantly to health gains globally, investment in innovation has long been driven by the US. Equitable contributions from other countries are now essential in order to deliver medical breakthroughs and tackle the chronic disease burden which is stifling how we live and thrive.The time to act on the chronic disease crisis is now. By collaborating across borders and prioritising health, we have the power to improve the lives of millions, strengthen communities and workforces and contribute to sustainable, economic growth. Sincerely, 1.    Alfonso Alonso, former Spanish Minister of Health2.    Saleh Mahdi Alhasnawi, Minister of Health, Republic of Iraq 3.    José Manuel Barroso, former President of the European Commission and Chair of Gavi4.    José Luis Castro, WHO Director-General Special Envoy for Chronic Respiratory Diseases5.    Prof. Wen Chen, Dean, School of Public Health, Fudan University6.    Minister Khumbize Chiponda, Minister of Health, Malawi 7.    Prof. Americo Cicchetti, Extraordinary Commissioner, National Agency for Health Services, Italy8.    Michel Demaré, Chair AstraZeneca9.    Dr Victor Dzau, President of the US National Academy of Medicine10.    H.E. Prof. Khaled Abdel Ghaffar, Deputy Prime Minister and Minister of Health and Population, The Arab Republic of Egypt11.    Dr. Githinji Gitahi, Group CEO, AMREF Health Africa12.    Roy Jakobs, CEO Royal Philips13.    Dr. Vanessa Kerry, CEO Seed Global Health and Associate Professor, Harvard T.H. Chan School of Public Health 14.    Lord Andrew Lansley, former UK Health Secretary15.    HRH Princess Dina Mired of Jordan, Patron of International Society of Pediatric Oncology 16.    Prof. Hiroaki Miyata, Professor and Chair, Department of Health Policy Management, Keio University17.    Prof. Brendan Murphy, former Australian Chief Medical Officer and Secretary of the Department of Health18.    Dr. Maria Neira, former WHO Director Environment, Climate Change and Health19.    Ryoji Noritake, Chair, Health and Global Policy Institute, Japan20.    José Martínez Olmos, former Secretary General of Health, Spain21.    Prof. Carol Pollock, Professor of Medicine, University of Sydney, and Chair of Kidney Health Australia22.    Lord David Prior, former Chairman, NHS England23.    Magda Robalo, former Minister of Health of Guinea-Bissau and President of The Institute for Global Health and Development24.    Prof. Liam Smeeth, Director of the London School of Hygiene and Tropical Medicine25.    Prof. Keizo Takemi, Former Minister of Health, Japan26.    Dan Vahdat, CEO Huma [i] House of Commons. Economic update: Inactivity due to illness reaches record. 2024. Available from: https://commonslibrary.parliament.uk/economic-update-inactivity-due-to-illness-reaches-record/[ii] WHO. World Health Statistics 2023: monitoring health for the SDGs. 2023. Available from: https://www.who.int/publications/i/item/9789240074323[iii] World Economic Forum and the Harvard School of Public Health. Methodological Appendix: The Global Economic Burden of Non-Communicable Diseases. 2011. Available from: https://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_MethodologicalAppendix_2011.pdf[iv] McKinsey. Prioritizing health: a prescription for prosperity. 2020. Available from: https://www.mckinsey.com/industries/healthcare/our-insights/prioritizing-health-a-prescription-for-prosperity#section-header-1[v] Brookings. How investing in health has a significant economic payoff for developing economies. 2020. Available from: https://www.brookings.edu/articles/how-investing-in-health-has-a-significant-economic-payoff-for-developing-economies/[vi] OECD. Health care financing in times of high inflation. 2023. Available from: Health care financing in times of high inflation (EN)[vii] Wahid M, Aghanya V, Sepehrvand N, Dover DC, Kaul P, Ezekowitz J. Use of Guideline-Directed Medical Therapy in Patients Aged ≥ 65 Years After the Diagnosis of Heart Failure: A Canadian Population-Based Study. CJC Open. 2022. Available from: https://pubmed.ncbi.nlm.nih.gov/36562009/[viii] Berry NC, Sheu YS, Chesbrough K, Bishop RC, Vupputuri S. Guideline-directed medical therapy rates in heart failure patients with reduced ejection fraction in a diverse cohort. ESC Heart Fail. 2025. Available from: https://pubmed.ncbi.nlm.nih.gov/39829077/