A Lancet’s Commission on global health threats, composed of 35 experts, has published an assessment identifying 17 major hazards that could substantially reduce healthy life years for billions of people in coming decades. The panel stresses that feasible interventions exist for each listed threat.
How the risks were measured
The commission modelled how many disability-adjusted life years (DALYs) each threat could cost if current trends continue. The DALY metric combines years lived with disability and years of life lost due to premature death; in simple terms, 1 DALY equals one year of healthy life lost.
Why AI misuse and nuclear conflict are on the list
The report warns that a nuclear war would pose more than immediate destruction: particles lofted into the upper atmosphere could block sunlight and trigger severe famine. Malicious uses of artificial intelligence could, among other harms, facilitate the creation of biological weapons.
Although experts judge the probability of such apocalyptic scenarios to be low, they emphasize the potential consequences would be catastrophic. An accompanying editorial states that if realised, the scale of damage would amount to an apocalypse for humanity.
The full set of threats and regional differences
Alongside AI misuse and nuclear conflict, the 17 identified threats include air pollution, antimicrobial resistance, childhood undernutrition and climate disaster. The commission also lists traditional armed conflict, reductions in international aid, excessive alcohol consumption, high blood pressure, income inequality, low educational attainment, naturally occurring pandemics, obesity, mental health problems, smoking and unhealthy ageing.
The report notes important regional variation: in higher-income regions obesity and mental health problems represent the dominant burden, while in poorer countries low educational attainment substantially worsens health outlooks.
Health gains from limiting warming
The commission highlights that mitigating climate change would yield large health benefits. Their modelling suggests that keeping global warming to about 1.8°C rather than 4.4°C in worst-case scenarios could prevent an estimated 1.89 billion lost healthy life years (DALYs).
Call for preparedness and investment
Ibrahim Abubakar, an infectious disease epidemiologist at University College London and a commission member, said the intent is not to alarm but to prompt policymakers to act. The authors urge political leaders to prepare before crises occur, invest in technological safeguards and strengthen health systems.
Christopher Murray, co-chair of the commission and director of the Institute for Health Metrics and Evaluation at the University of Washington, warned that current decisions will shape the quality of life for future generations. The work began three years ago: the team started by focusing on three main threats—armed conflict, climate change and pandemics—but found many more causes for concern during their review.
Next steps
The report was presented at the Berlin Health Summit, and the commission says it will update the assessment annually. The experts reiterate that preventive measures and investments are necessary to reduce the health losses linked to the identified threats.
