Key Findings of The Lancet Commission on 21st Century Global Threats to Health, Presented at the World Health Summit 2026
During the World Health Summit 2026, experts presented the findings of The Lancet Commission on 21st Century Global Threats to Health. The Commission analyzed 17 catastrophic threats that could have the greatest impact on global public health by 2100 and assessed what proportion of these losses could be prevented through timely policy decisions, investments, and innovations. The report’s main conclusion is that the future of human health will be determined not only by medical advances but also by social, economic, environmental, and geopolitical factors. At the same time, most threats will disproportionately affect the poorest and most vulnerable communities.
Extreme poverty remains a critical health factor
The report’s authors emphasize that long-standing progress in reducing extreme poverty is slowing. Of particular concern is sub-Saharan Africa, which is projected to remain the region with the highest concentration of people living in extreme poverty throughout the 21st century.
For public health, this means higher risks of malnutrition, infectious diseases, and maternal and child mortality, as well as limited access to prevention and treatment.
The Threat of Declining International Health Aid
The Commission identified the collapse of international health aid (Development Assistance for Health, DAH) as one of 17 global threats. According to researchers’ estimates, Sub-Saharan African countries will bear the heaviest burden of such a scenario. It is international funding that currently supports a significant portion of programs to combat HIV, tuberculosis, malaria, vaccination, and the development of health care systems. A reduction in aid could jeopardize the achievements of recent decades and exacerbate global health inequities.
Antimicrobial resistance: a particular threat to the fight against tuberculosis
Antimicrobial resistance (AMR) is given special attention in the report. The Commission estimates that by the end of the century, it could result in the loss of approximately 3.44 billion healthy life-years worldwide. For the tuberculosis community, this threat is particularly pressing. Drug-resistant forms of TB already require longer, more complex, and more expensive treatment. The further spread of antimicrobial resistance could significantly complicate efforts to achieve global tuberculosis elimination goals.
That is why investments in the following remain critically important:
- new anti-tuberculosis drugs;
- modern diagnostics;
- sustained access to treatment;
- and strengthening public health systems.
Pandemics Remain Among the Greatest Threats
Experts reiterated that pandemics continue to pose one of the most serious risks to humanity. The experience with COVID-19 has demonstrated how quickly new infectious threats can impact public health, the economy, and the stability of societies.
The Commission calls on countries to invest in preparedness for future crises, disease surveillance systems, and resilient health care systems.
Education and Inequality Directly Affect Health
The report emphasizes that low levels of education and socioeconomic inequality remain significant risk factors for public health. Access to education is associated with better disease prevention, higher adherence to treatment, and longer life expectancy.
New Challenges of the 21st Century
Among other threats identified by the Commission:
- climate change;
- air pollution;
- child malnutrition;
- obesity;
- harmful alcohol use;
- smoking;
- mental health;
- population aging;
- conventional and nuclear conflicts;
- and the malicious use of artificial intelligence. The authors emphasize that while the scale of these threats is significant, their impact is not inevitable. The decisions made today will determine the health of future generations.
What does this mean for the fight against tuberculosis?
For the TBpeople community, the findings of The Lancet Commission on 21st Century Global Threats to Health serve as an important reminder: overcoming tuberculosis is impossible without tackling poverty, ensuring access to education, developing sustainable health care systems, combating antimicrobial resistance, and maintaining international solidarity in public health.
Tuberculosis remains more than just a medical problem. It is an indicator of social justice, equitable access to healthcare, and the world’s willingness to invest in the health of the most vulnerable people.