• Ole F Norheim, Angela Y Chang, Sarah Bolongaita, Mariana Barraza-Lloréns, Ayodamope Fawole, Lia Tadesse Gebremedhin, Eduardo González-Pier, Prabhat Jha, Emily K Johnson, Omar Karlsson, Mizan Kiros, Sarah Lewington, Wenhui Mao, Osondu Ogbuoji, Muhammad Pate, Jennifer L Sargent, Xuyang Tang, David Watkins, Gavin Yamey, Dean T Jamison, and Richard Peto.
• Bergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. Electronic address: Ole.norheim@uib.no.
• Lancet. 2024 Dec 14; 404 (10470): 243724462437-2446.

BackgroundAlthough death in old age is unavoidable, premature death-defined here as death before age 70 years-is not. To assess whether halving premature mortality by 2050 is feasible, we examined the large variation in premature death rates before age 70 years and trends over the past 50 years (1970-2019), covering ten world regions and the 30 most-populous nations. This analysis was undertaken in conjunction with the third report of The Lancet Commission on Investing in Health: Global Health 2050: the path to halving premature death by mid-century.MethodsIn this cross-country analysis of past mortality trends and future directions, all analyses on the probability of premature death (PPD) were conducted using life tables from the UN World Population Prospects 2024. For each sex, country, and year, probability of death was calculated from these life tables with 1-year age-specific mortality rates.FindingsGlobally, PPD decreased from 56% in 1970 to 31% in 2019, although some countries saw reversals because of conflict, social instability, or HIV and AIDS. Child mortality has decreased faster than adult mortality. Among all countries, 34 halved their PPD over three decades between 1970 and 2019. Among the 30 most-populous countries, seven countries, with varying levels of baseline PPD and income, halved their PPD in the past half century. Seven of the most-populous countries had average annual rates of improvement in the period 2010-19 that, if sustained, could lead to a halving of PPD by 2050, including Korea (3·9%), Bangladesh (2·8%), Russia (2·7%), Ethiopia (2·4%), Iran (2·4%), South Africa (2·4%), and Türkiye (2·3%).InterpretationHalving premature death by 2050 is feasible, although substantial investments in child and adult health are needed to sustain or accelerate the rate of improvement for high-performing and medium-performing countries. Particular attention must be paid to countries with very low or a worsening rate of improvement in PPD. By reducing premature mortality, more people will live longer and more healthy lives. However, as people live longer, the absolute number of years lived with chronic disease will increase and investments in services reducing chronic disease morbidity are needed.FundingThe Norwegian Agency for Development Cooperation, the Bill & Melinda Gates Foundation, and a Norwegian Research Council Centre of Excellence grant.Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY CC 4.0 license. Published by Elsevier Ltd.. All rights reserved.

29 keywords...

hide…