According to the WHO’s World Health Estimates 2019 released today, non-communicable diseases now account for seven of the top 10 causes of death worldwide, up from four of the top 10 causes in 2000. The new data covers the period 2000-2019.
The estimates highlight trends in mortality and morbidity due to diseases and injuries over the past two decades, underscoring the need for a global focus on preventing and treating cardiovascular diseases, cancer, diabetes, chronic respiratory diseases, and tackling injuries in all regions of the world, as set out in the UN Sustainable Development Goals agenda.
“These new estimates are a fresh reminder that we need to rapidly strengthen the prevention, diagnosis and treatment of non-communicable diseases,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “They highlight the urgency of significantly improving primary health care, equitably and inclusively. Strong primary health care is clearly the foundation for everything from fighting non-communicable diseases to managing a global pandemic.”
Heart disease remains the number one cause of death, with diabetes and dementia in the top 10
Heart disease has remained the number one cause of death globally for the past two decades. However, more people are dying from heart disease than ever before. Deaths from heart disease have increased by more than 2 million since 2000, reaching nearly 9 million in 2019. Heart disease now accounts for 16% of deaths from all causes. More than half of the 2 million additional deaths occur in the WHO Western Pacific Region. In contrast, the European Region has seen a relative decline in heart disease deaths, with deaths falling by 15%. [1].
Alzheimer’s disease and other dementias currently rank among the top 10 causes of death worldwide, and ranked third in both the Americas and Europe in 2019. Women are disproportionately affected: globally, 65% of deaths from Alzheimer’s disease and other dementias are women.
Diabetes deaths increased by 70% globally between 2000 and 2019, with deaths in men increasing by 80%. The Eastern Mediterranean region has seen the largest increase in diabetes deaths across the WHO region, with diabetes deaths more than doubling.
Although the number of deaths from infectious diseases is declining globally, it remains a major challenge in low- and middle-income countries.
In 2019, pneumonia and other lower respiratory tract infections were the deadliest group of infectious diseases and together ranked fourth among the leading causes of death. However, lower respiratory tract infections are causing fewer deaths than ever before, with approximately 500,000 fewer deaths globally compared to 2000.
This decline is consistent with a global decline in infectious disease mortality. For example, HIV/AIDS fell from the eighth leading cause of death in 2000 to the 19th leading cause of death in 2019, reflecting successful prevention, testing and treatment efforts over the past two decades. While it remains the fourth leading cause of death in Africa, deaths have fallen by more than half, from more than 1 million in 2000 to 435,000 in Africa in 2019.
Tuberculosis has also fallen out of the global top 10, dropping from seventh in 2000 to 13th in 2019, with a 30% decline in global deaths. However, in Africa and South-East Asia, tuberculosis remains in the top 10 causes of death, ranking eighth and fifth, respectively. TB deaths have risen in Africa since 2000, but have started to decline in recent years.
The new estimates also highlight the toll that communicable diseases continue to take in low-income countries: six of the top 10 causes of death in low-income countries remain communicable diseases, including malaria (6th), tuberculosis (8th) and HIV/AIDS (9th). Meanwhile, recent WHO reports have noted that progress against infectious diseases such as HIV, tuberculosis and malaria has generally slowed or stagnated.
Life expectancy is increasing, but so are disabilities
The estimate further confirms the trend of increasing lifespan: in 2019, people were living more than six years longer than in 2000, with the global average rising from about 67 years in 2000 to over 73 years in 2019. However, on average, only five of those gained years were lived in good health.
In fact, disability is on the rise. The diseases and health conditions that cause most deaths are also often the biggest contributors to lost healthy life years: heart disease, diabetes, stroke, lung cancer and chronic obstructive pulmonary disease were responsible for almost 100 million more years of healthy life lost in 2019 compared to 2000.
Injuries are another major cause of disability and death. Since 2000, the African Region has seen a large increase in road traffic injuries, with both deaths and lost healthy life years increasing by almost 50%. A similar, slightly smaller increase (about 40%) was seen in the Eastern Mediterranean Region. Globally, 75% of road traffic deaths are men.
In the Americas, drug use has emerged as a significant contributor to both disability and death. Deaths from drug use disorders in the Americas increased almost threefold between 2000 and 2019. The region is also the only one where drug use disorders are in the top 10 causes of premature death and healthy life years lost due to disability, while in all other regions drug use is not in the top 25.
Data sources and methodology
WHO’s World Health Estimates provide comprehensive, comparable and transparent time series data on population health, including life expectancy, healthy life expectancy, mortality, morbidity and disease burden at global, regional and country levels disaggregated by age, sex and cause since 2000.
“These estimates are prepared using data from the best available sources from countries and the international community,” said Dr Bochen Cao, WHO technical lead for Global Health Estimates. “They are based on robust scientific methods for processing, synthesizing and analysing data. These latest estimates also benefit from valuable contributions made by WHO Member States through active national consultations and dialogue.”
The availability of services to prevent, diagnose and treat disease is key to reducing mortality and disability rates and influences the ranking of different medical conditions. These new estimates clearly highlight where additional investment in services is most urgently needed.
“Robust health data is essential to address inequalities, prioritize policies and allocate resources to prevent disability and save lives,” adds Dr Samira Asma, Deputy Director-General of WHO’s Data, Analysis and Impact Delivery Division. “WHO’s Global Health Estimates are a powerful tool to maximise health and economic impact. We call on governments and stakeholders to urgently invest in data and health information systems to support timely and effective decision-making.”
To date, COVID-19 has tragically claimed over 1.5 million lives. People with pre-existing health conditions (such as heart disease, diabetes, and respiratory conditions) are at higher risk of complications and death from COVID-19.
Health authorities around the world rely on timely, reliable and actionable data to make informed decisions. This is especially true during a global pandemic. The next update to these estimates will include an assessment of the direct and indirect effects of the COVID-19 pandemic on mortality and morbidity.