Global Health Risk and Resilience Report 2026: Baseline Edition, The State of the World’s Health and One Health System.

S.1Abstract

S.2Key messages

Six readings that frame the health baseline, and the eight questions this edition answers, each with its status and source.

1. The service coverage index is 71 of 100 and 4.6 billion people were not fully covered in 2023.²

   How far is the world from universal health coverage?Reported

2. More than before, but 4.9 million under-fives died in 2024 and progress has slowed.¹⁵

   Are children surviving?Reported

3. Noncommunicable diseases lead; tuberculosis, malaria and HIV still kill about 2.4 million a year.¹³⁴⁵⁶

   Which diseases still kill most?Reported

4. Yes. Resistance rose in over 40% of monitored pathogen and antibiotic pairs between 2018 and 2023.¹¹

   Is resistance growing?Reported

5. Aid for health is estimated at USD 38.4 billion in 2025, about half the 2021 peak.⁴⁰

   Where is the pressure on money?Reported

6. Reporting on IHR capacity is near universal, but a large Ebola outbreak is running and no vaccine is authorised.³⁵⁶

   How secure is the world against outbreaks?Reported

7. Density rose 52% since 2006, with a projected shortage of 11.1 million by 2030.³⁹

   Does the workforce hold up?Reported

8. An outbreak that coincides with a funding gap and heat. SCN-GS04-OUT-01

   What will 2027 test first?Expert input

S.3Headline finding

ReportedEQL 5NRF-SECTOR-HEALTH-GLOBAL-2026-BASELINE-HLT-001

In 2023, 4.6 billion people were not fully covered by essential health services, and in 2022, 2.1 billion people faced financial hardship from health costs.

The service coverage index rose from 54 to 71 between 2000 and 2023, but the pace after 2015 fell to one third of the earlier rate. Infectious disease control drove 52% of the gain, while care for noncommunicable diseases lags at 61 index points². At the current trajectory the index reaches 74 and 24% of people still face financial hardship in 2030². The poorest bear the most: out-of-pocket spending is 17.3% of current health spending worldwide⁴².

S.4At a glance

S.5What each steward reads in it

S.6What this edition is, and is not

Notes

Numbers are the edition’s reference numbers, so a note reads the same in every chapter. The full list, with every source and its licence, is in Annex C. Annex C, references

1. 2WHO (ed.), Universal health coverage (UHC), fact sheet (5 December 2025). World Health Organization, Geneva. Observation year 2023 (service coverage) and 2022 (financial hardship). Accessed 2026-11-03.back
2. 15WHO (ed.), Child mortality (under 5 years), fact sheet (1 May 2026). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
3. 4WHO (ed.), Tuberculosis, fact sheet (24 March 2026). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
4. 5WHO (ed.), Malaria, fact sheet (4 December 2025). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
5. 6WHO (ed.), HIV and AIDS, fact sheet (27 July 2026). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
6. 13WHO (ed.), Noncommunicable diseases, fact sheet (25 September 2025). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
7. 12Naghavi, M. et al. (GBD 2021 Antimicrobial Resistance Collaborators), Global burden of bacterial antimicrobial resistance 1990 to 2021: a systematic analysis with forecasts to 2050, The Lancet 404 (10459), September 2024; abstract read through Europe PMC. Institute for Health Metrics and Evaluation and partners. Observation year 2021. Accessed 2026-11-03.back
8. 11WHO (ed.), WHO warns of widespread resistance to common antibiotics worldwide, news release on the Global antibiotic resistance surveillance report 2025 (13 October 2025). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
9. 40Apeagyei, A.E. et al., Tracking development assistance for health, 1990 to 2030: historical trends, recent cuts, and outlook, The Lancet, 2025; abstract read through Europe PMC. Institute for Health Metrics and Evaluation, Seattle. Observation year 2025 (estimate). Accessed 2026-11-03.back
10. 56WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (25 September 2026, data to 23 September 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
11. 55WHO (ed.), Climate inaction is claiming millions of lives every year, warns new Lancet Countdown report, news release on the 2025 Lancet Countdown on health and climate change (29 October 2025; the report itself was not opened). World Health Organization, Geneva. Observation year 2025 (average of about 546 000 heat-related deaths a year; the averaging period is not stated in the release). Accessed 2026-11-03.back
12. 21WHO (ed.), World Health Assembly adopts historic Pandemic Agreement, news release (20 May 2025). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
13. 23WHO (ed.), International Health Regulations: amendments, questions and answers (1 October 2024). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
14. 3UN DESA Statistics Division (ed.), The Sustainable Development Goals Report 2026, Goal 3 storyline, Good health and well-being. United Nations, New York. Observation year 2024. Accessed 2026-11-03.back
15. 39POST-CLOSE, context only: WHO (ed.), One in four doctors nearing retirement age as WHO warns of global health workforce gap, news release on National health workforce accounts: health workforce levels and trends 2026 (19 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
16. 42DATA VINTAGE AFTER CLOSE: World Bank (ed.), World Development Indicators, data service queried for current health expenditure (percentage of GDP), out-of-pocket expenditure and physicians per 1 000 people, world aggregate (database updated 2026-10-08). World Bank, Washington. Observation year 2023 (spending) and 2022 (physicians). Accessed 2026-11-03.back

1.1The questions this part answers

Key questions

• Where is health risk concentrated?
• Which couplings carry health shocks into other systems?
• Which health capabilities hold under compound stress?
• What must 2027 evidence measure first?

In this part

• Narrative
• Headline finding
• Lead figure
• Five coupling chapters
• Twelve-domain reading
• Sector screens
• Dependency matrix
• Risk objects
• Capability ladder
• Scenario
• Three lenses
• Portfolio

1.2The argument

1.3Twenty couplings between five systems

The health-centred matrix types the twenty couplings between the five core systems, read for their health content. Strengths are Nexus estimates (ESTIMATED) from the cited evidence and analogue events; they set the graph that 2027 evidence will test.

Transmission paths

1. 01

   WAT → HLT

   Unsafe water and poor sanitation spread cholera and other diarrhoeal disease.

   Reported 2025 cholera deaths, highest since 1999³⁵

2. 02

   BIO → HLT

   Spillover from animals starts outbreaks that health systems must absorb.

   Reported 2026 Bundibugyo outbreak⁵⁶¹⁷

3. 03

   CLI → HLT

   Heat raises deaths and harms pregnancy and childhood.

   Reported about 546 000 heat deaths a year⁵⁵³⁰

4. 04

   FIN → HLT

   Aid reductions disrupt services and raise out-of-pocket costs.

   Reported 2025 country office reports³⁴⁰

5. 05

   ENE → HLT

   Polluting cooking fuels cause household air pollution deaths.

   Reported 2021 estimate²⁶

Notes

Numbers are the edition’s reference numbers, so a note reads the same in every chapter. The full list, with every source and its licence, is in Annex C. Annex C, references

1. 26WHO (ed.), Household air pollution and health, fact sheet (16 December 2025). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
2. 32WHO (ed.), Food safety, fact sheet (4 June 2026). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
3. 35WHO (ed.), WHO reports latest global trends in cholera, meningitis and plague, news release (29 September 2026). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
4. 2WHO (ed.), Universal health coverage (UHC), fact sheet (5 December 2025). World Health Organization, Geneva. Observation year 2023 (service coverage) and 2022 (financial hardship). Accessed 2026-11-03.back
5. 15WHO (ed.), Child mortality (under 5 years), fact sheet (1 May 2026). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
6. 9WHO (ed.), Measles, fact sheet (15 July 2026). World Health Organization, Geneva. Observation year 2024 (deaths) and 2025 (coverage). Accessed 2026-11-03.back
7. 1WHO (ed.), World Health Statistics 2026: A visual summary and report page (monitoring health for the SDGs, 13 May 2026). World Health Organization, Geneva. Observation year 2023 (deaths and life expectancy). Accessed 2026-11-03.back
8. 40Apeagyei, A.E. et al., Tracking development assistance for health, 1990 to 2030: historical trends, recent cuts, and outlook, The Lancet, 2025; abstract read through Europe PMC. Institute for Health Metrics and Evaluation, Seattle. Observation year 2025 (estimate). Accessed 2026-11-03.back
9. 3UN DESA Statistics Division (ed.), The Sustainable Development Goals Report 2026, Goal 3 storyline, Good health and well-being. United Nations, New York. Observation year 2024. Accessed 2026-11-03.back
10. 39POST-CLOSE, context only: WHO (ed.), One in four doctors nearing retirement age as WHO warns of global health workforce gap, news release on National health workforce accounts: health workforce levels and trends 2026 (19 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
11. 56WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (25 September 2026, data to 23 September 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
12. 11WHO (ed.), WHO warns of widespread resistance to common antibiotics worldwide, news release on the Global antibiotic resistance surveillance report 2025 (13 October 2025). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
13. 55WHO (ed.), Climate inaction is claiming millions of lives every year, warns new Lancet Countdown report, news release on the 2025 Lancet Countdown on health and climate change (29 October 2025; the report itself was not opened). World Health Organization, Geneva. Observation year 2025 (average of about 546 000 heat-related deaths a year; the averaging period is not stated in the release). Accessed 2026-11-03.back
14. 21WHO (ed.), World Health Assembly adopts historic Pandemic Agreement, news release (20 May 2025). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
15. 23WHO (ed.), International Health Regulations: amendments, questions and answers (1 October 2024). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
16. 4WHO (ed.), Tuberculosis, fact sheet (24 March 2026). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
17. 5WHO (ed.), Malaria, fact sheet (4 December 2025). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
18. 7UNAIDS (ed.), Global HIV and AIDS statistics, fact sheet (2026 data release of 27 July 2026). Joint United Nations Programme on HIV/AIDS, Geneva. Observation year 2025. Accessed 2026-11-03.back
19. 17WHO (ed.), One Health, fact sheet (8 May 2026). World Health Organization, Geneva. Observation year 2026 (current text; the share of emerging infections is undated in the sheet). Accessed 2026-11-03.back
20. 30POST-CLOSE, context only: WHO, WMO, UNICEF and UNFPA (eds.), New global framework launched to track increasing health risks of extreme heat for pregnant women, newborns and children, news release (21 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back

2.1Headline finding

ReportedEQL 5NRF-SECTOR-HEALTH-GLOBAL-2026-BASELINE-HLT-001

In 2023, 4.6 billion people were not fully covered by essential health services, and in 2022, 2.1 billion people faced financial hardship from health costs.

Implication

The service coverage index rose from 54 to 71 between 2000 and 2023, but the pace after 2015 fell to one third of the earlier rate. Infectious disease control drove 52% of the gain, while care for noncommunicable diseases lags at 61 index points². At the current trajectory the index reaches 74 and 24% of people still face financial hardship in 2030². The poorest bear the most: out-of-pocket spending is 17.3% of current health spending worldwide⁴².

What would move it

The next UHC monitoring report, the effect of aid reductions on service coverage and the share of households with financial hardship would each move this finding.

2.2Health

1. ReportedEQL 5NRF-SECTOR-HEALTH-GLOBAL-2026-BASELINE-HLT-001

   In 2023, 4.6 billion people were not fully covered by essential health services, and in 2022, 2.1 billion people faced financial hardship from health costs; progress slowed after 2015.²³

2. ReportedEQL 5NRF-SECTOR-HEALTH-GLOBAL-2026-BASELINE-HLT-002

   An estimated 4.9 million children under five died in 2024, 2.3 million of them in the first 28 days of life, and the number has stagnated since 2022.¹⁵³

3. ReportedEQL 5NRF-SECTOR-HEALTH-GLOBAL-2026-BASELINE-HLT-003

   Tuberculosis killed 1.23 million people in 2024, malaria an estimated 610 000 in 2024 and HIV 570 000 in 2025.⁴⁵⁶⁷

4. ReportedEQL 4NRF-SECTOR-HEALTH-GLOBAL-2026-BASELINE-HLT-004

   In 2025, 13.5 million children received no vaccine and first-dose measles coverage stood at 84%, below the 86% of 2019.⁸⁹³

5. ReportedEQL 5NRF-SECTOR-HEALTH-GLOBAL-2026-BASELINE-HLT-005

   Noncommunicable diseases killed at least 43 million people in 2021, 75% of non-pandemic deaths, and 18 million of them died before age 70.¹³

6. ReportedEQL 4NRF-SECTOR-HEALTH-GLOBAL-2026-BASELINE-HLT-006

   Bacterial antimicrobial resistance was associated with 4.71 million deaths in 2021, 1.14 million of them attributable to it, and one in six laboratory-confirmed infections was resistant in 2023.¹²¹¹¹⁰

2.3Biodiversity

1. ReportedEQL 4NRF-SECTOR-HEALTH-GLOBAL-2026-BASELINE-BIO-007

   More than 60% of emerging infectious diseases reported globally come from animals, wild and domestic.¹⁷¹⁸

2.4Governance

1. ReportedEQL 4NRF-SECTOR-HEALTH-GLOBAL-2026-BASELINE-GOV-008

   A Bundibugyo virus disease outbreak declared in May 2026 reached 7 890 confirmed cases and 3 799 deaths in the Democratic Republic of the Congo by 23 September 2026, and WHO describes it as a public health emergency of international concern.⁵⁶²⁵

2. ReportedEQL 4NRF-SECTOR-HEALTH-GLOBAL-2026-BASELINE-GOV-009

   The amended International Health Regulations entered into force on 19 September 2025, and the Pandemic Agreement, adopted on 20 May 2025, awaits the access and benefit-sharing annex before it can be opened for signature.²¹²³

2.5Finance

1. ReportedEQL 4NRF-SECTOR-HEALTH-GLOBAL-2026-BASELINE-FIN-010

   Development assistance for health fell from USD 80.3 billion in 2021 to USD 49.6 billion in 2024 and is estimated at USD 38.4 billion in 2025.⁴⁰³

2.6Climate forcing

1. ReportedEQL 3NRF-SECTOR-HEALTH-GLOBAL-2026-BASELINE-CLI-011

   Heat was linked to an average of about 546 000 deaths a year in the 2025 Lancet Countdown, against about 489 000 a year in 2000 to 2019 in WHO’s earlier estimate; the periods and methods differ.⁵⁵²⁸

2.7Systemic

1. Expert inputEQL 2NRF-SECTOR-HEALTH-GLOBAL-2026-BASELINE-SYS-012

   The leading compound pathway for 2027 testing is an outbreak that coincides with a funding gap and a heat season in the same fragile health systems. § scenario

Notes

Numbers are the edition’s reference numbers, so a note reads the same in every chapter. The full list, with every source and its licence, is in Annex C. Annex C, references

1. 2WHO (ed.), Universal health coverage (UHC), fact sheet (5 December 2025). World Health Organization, Geneva. Observation year 2023 (service coverage) and 2022 (financial hardship). Accessed 2026-11-03.back
2. 42DATA VINTAGE AFTER CLOSE: World Bank (ed.), World Development Indicators, data service queried for current health expenditure (percentage of GDP), out-of-pocket expenditure and physicians per 1 000 people, world aggregate (database updated 2026-10-08). World Bank, Washington. Observation year 2023 (spending) and 2022 (physicians). Accessed 2026-11-03.back
3. 3UN DESA Statistics Division (ed.), The Sustainable Development Goals Report 2026, Goal 3 storyline, Good health and well-being. United Nations, New York. Observation year 2024. Accessed 2026-11-03.back
4. 15WHO (ed.), Child mortality (under 5 years), fact sheet (1 May 2026). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
5. 4WHO (ed.), Tuberculosis, fact sheet (24 March 2026). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
6. 5WHO (ed.), Malaria, fact sheet (4 December 2025). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
7. 6WHO (ed.), HIV and AIDS, fact sheet (27 July 2026). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
8. 7UNAIDS (ed.), Global HIV and AIDS statistics, fact sheet (2026 data release of 27 July 2026). Joint United Nations Programme on HIV/AIDS, Geneva. Observation year 2025. Accessed 2026-11-03.back
9. 8WHO (ed.), Immunisation coverage, fact sheet (15 July 2026; estimates with UNICEF). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
10. 9WHO (ed.), Measles, fact sheet (15 July 2026). World Health Organization, Geneva. Observation year 2024 (deaths) and 2025 (coverage). Accessed 2026-11-03.back
11. 13WHO (ed.), Noncommunicable diseases, fact sheet (25 September 2025). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
12. 12Naghavi, M. et al. (GBD 2021 Antimicrobial Resistance Collaborators), Global burden of bacterial antimicrobial resistance 1990 to 2021: a systematic analysis with forecasts to 2050, The Lancet 404 (10459), September 2024; abstract read through Europe PMC. Institute for Health Metrics and Evaluation and partners. Observation year 2021. Accessed 2026-11-03.back
13. 11WHO (ed.), WHO warns of widespread resistance to common antibiotics worldwide, news release on the Global antibiotic resistance surveillance report 2025 (13 October 2025). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
14. 10WHO (ed.), Antimicrobial resistance, fact sheet (16 July 2026). World Health Organization, Geneva. Observation year 2023 (resistance) and 2022 (antibiotic use). Accessed 2026-11-03.back
15. 17WHO (ed.), One Health, fact sheet (8 May 2026). World Health Organization, Geneva. Observation year 2026 (current text; the share of emerging infections is undated in the sheet). Accessed 2026-11-03.back
16. 18WHO (ed.), Zoonoses, fact sheet (29 July 2020). World Health Organization, Geneva. Observation year 2020. Accessed 2026-11-03.back
17. 56WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (25 September 2026, data to 23 September 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
18. 25WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (28 August 2026, data to 26 August 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
19. 21WHO (ed.), World Health Assembly adopts historic Pandemic Agreement, news release (20 May 2025). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
20. 23WHO (ed.), International Health Regulations: amendments, questions and answers (1 October 2024). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
21. 40Apeagyei, A.E. et al., Tracking development assistance for health, 1990 to 2030: historical trends, recent cuts, and outlook, The Lancet, 2025; abstract read through Europe PMC. Institute for Health Metrics and Evaluation, Seattle. Observation year 2025 (estimate). Accessed 2026-11-03.back
22. 55WHO (ed.), Climate inaction is claiming millions of lives every year, warns new Lancet Countdown report, news release on the 2025 Lancet Countdown on health and climate change (29 October 2025; the report itself was not opened). World Health Organization, Geneva. Observation year 2025 (average of about 546 000 heat-related deaths a year; the averaging period is not stated in the release). Accessed 2026-11-03.back
23. 28WHO (ed.), Climate change, heat and health, fact sheet (31 July 2026). World Health Organization, Geneva. Observation year 2019 (average of 2000 to 2019) and 2022. Accessed 2026-11-03.back

3.1Where each system stood at evidence close

3.2Domain posture

Each of the twelve coupled domains is read through health, in words, not scored. The coupling column names the dependency that carries health risk into each domain.

3.3Sector screens

All sixteen sectors are screened for their dependence on health, on the same grammar as every national edition. The evidence column describes coverage of the baseline evidence, not the performance of the sector.

Notes

Numbers are the edition’s reference numbers, so a note reads the same in every chapter. The full list, with every source and its licence, is in Annex C. Annex C, references

1. 2WHO (ed.), Universal health coverage (UHC), fact sheet (5 December 2025). World Health Organization, Geneva. Observation year 2023 (service coverage) and 2022 (financial hardship). Accessed 2026-11-03.back
2. 15WHO (ed.), Child mortality (under 5 years), fact sheet (1 May 2026). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
3. 12Naghavi, M. et al. (GBD 2021 Antimicrobial Resistance Collaborators), Global burden of bacterial antimicrobial resistance 1990 to 2021: a systematic analysis with forecasts to 2050, The Lancet 404 (10459), September 2024; abstract read through Europe PMC. Institute for Health Metrics and Evaluation and partners. Observation year 2021. Accessed 2026-11-03.back
4. 40Apeagyei, A.E. et al., Tracking development assistance for health, 1990 to 2030: historical trends, recent cuts, and outlook, The Lancet, 2025; abstract read through Europe PMC. Institute for Health Metrics and Evaluation, Seattle. Observation year 2025 (estimate). Accessed 2026-11-03.back
5. 55WHO (ed.), Climate inaction is claiming millions of lives every year, warns new Lancet Countdown report, news release on the 2025 Lancet Countdown on health and climate change (29 October 2025; the report itself was not opened). World Health Organization, Geneva. Observation year 2025 (average of about 546 000 heat-related deaths a year; the averaging period is not stated in the release). Accessed 2026-11-03.back
6. 56WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (25 September 2026, data to 23 September 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
7. 35WHO (ed.), WHO reports latest global trends in cholera, meningitis and plague, news release (29 September 2026). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
8. 10WHO (ed.), Antimicrobial resistance, fact sheet (16 July 2026). World Health Organization, Geneva. Observation year 2023 (resistance) and 2022 (antibiotic use). Accessed 2026-11-03.back
9. 26WHO (ed.), Household air pollution and health, fact sheet (16 December 2025). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
10. 32WHO (ed.), Food safety, fact sheet (4 June 2026). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
11. 33FAO (ed.), The State of Food Security and Nutrition in the World 2026, publication page with headline figures (hunger in 2025; cost of a healthy diet). Food and Agriculture Organization of the United Nations, Rome. Observation year 2025. Accessed 2026-11-03.back
12. 13WHO (ed.), Noncommunicable diseases, fact sheet (25 September 2025). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
13. 14WHO (ed.), Mental disorders, fact sheet (11 September 2026). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
14. 17WHO (ed.), One Health, fact sheet (8 May 2026). World Health Organization, Geneva. Observation year 2026 (current text; the share of emerging infections is undated in the sheet). Accessed 2026-11-03.back
15. 29POST-CLOSE, context only: WHO (ed.), Climate change is a growing health emergency, Lancet Countdown warns, departmental update summarising the 2026 Lancet Countdown on Health and Climate Change (28 October 2026; the report itself was not opened; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
16. 30POST-CLOSE, context only: WHO, WMO, UNICEF and UNFPA (eds.), New global framework launched to track increasing health risks of extreme heat for pregnant women, newborns and children, news release (21 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
17. 43WHO (ed.), Surveillance System for Attacks on Health Care, dashboard and method note (the dashboard data require an account and were not read). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
18. 42DATA VINTAGE AFTER CLOSE: World Bank (ed.), World Development Indicators, data service queried for current health expenditure (percentage of GDP), out-of-pocket expenditure and physicians per 1 000 people, world aggregate (database updated 2026-10-08). World Bank, Washington. Observation year 2023 (spending) and 2022 (physicians). Accessed 2026-11-03.back
19. 1WHO (ed.), World Health Statistics 2026: A visual summary and report page (monitoring health for the SDGs, 13 May 2026). World Health Organization, Geneva. Observation year 2023 (deaths and life expectancy). Accessed 2026-11-03.back
20. 3UN DESA Statistics Division (ed.), The Sustainable Development Goals Report 2026, Goal 3 storyline, Good health and well-being. United Nations, New York. Observation year 2024. Accessed 2026-11-03.back
21. 16WHO (ed.), Maternal mortality, fact sheet (7 April 2025). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
22. 38WHO (ed.), Dengue and severe dengue, fact sheet (21 August 2025). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
23. 28WHO (ed.), Climate change, heat and health, fact sheet (31 July 2026). World Health Organization, Geneva. Observation year 2019 (average of 2000 to 2019) and 2022. Accessed 2026-11-03.back
24. 21WHO (ed.), World Health Assembly adopts historic Pandemic Agreement, news release (20 May 2025). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
25. 23WHO (ed.), International Health Regulations: amendments, questions and answers (1 October 2024). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
26. 25WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (28 August 2026, data to 26 August 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back

4.1Risk objects

Each risk is read across the chain from hazard to consequence, with its status and evidence-quality level.

1. ReportedEQL 4RSK-GS04-GOV-001

   Epidemic-prone zoonotic outbreak with cross-border spread

   Driver

   Bundibugyo virus disease, with no authorised vaccine or treatment⁵⁶

   Exposure

   affected provinces, border countries, health workers and travellers

   Vulnerability

   late detection: WHO notes a continuing high rate of deaths in communities⁵⁶

   Capacity

   contact tracing, IHR temporary recommendations, treatment trial²⁵⁵⁶

   Cascade

   BIO → HLT → FIN, TRD

   Horizon

   1 to 2 years

2. ReportedEQL 4RSK-GS04-FIN-002

   Health financing contraction

   Driver

   reductions in development assistance for health⁴⁰³

   Exposure

   low-income and lower-middle-income countries; HIV, TB and immunisation programmes

   Vulnerability

   about 70% of 108 WHO country offices reported disruption; 24% reported higher out-of-pocket costs³

   Capacity

   domestic HIV funding rose 4% in 2025⁷; domestic resource mobilisation

   Cascade

   FIN → HLT → FOO, DAT

   Horizon

   1 to 5 years

3. ReportedEQL 4RSK-GS04-HLT-003

   Antimicrobial resistance

   Driver

   misuse of antibiotics, weak infection control and poor access to diagnostics¹⁰

   Exposure

   bloodstream, urinary and gastrointestinal infections; surgery and neonatal care

   Vulnerability

   resistance exceeds 70% for third-generation cephalosporins in some pathogens in the African Region¹¹

   Capacity

   surveillance in 104 reporting countries; UN target of a 10% cut in deaths by 2030¹¹¹⁰

   Cascade

   HLT → FIN, FOO

   Horizon

   1 to 10 years

4. InferredEQL 3RSK-GS04-CLI-004

   Heat and climate-sensitive disease

   Driver

   rising heat exposure and an El Niño event with a graded WHO response²⁹

   Exposure

   older people, pregnant women, newborns, outdoor workers³⁰

   Vulnerability

   facility cooling and power are not consolidated here

   Capacity

   national health adaptation plans and early warning systems growing²⁹

   Cascade

   CLI → HLT → FOO, FIN

   Horizon

   1 to 5 years

4.2Capability ladder

Existence is not readiness. Each of the fifteen capability functions is placed on the ladder by the strongest public evidence for health at the global level.

Notes

Numbers are the edition’s reference numbers, so a note reads the same in every chapter. The full list, with every source and its licence, is in Annex C. Annex C, references

1. 56WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (25 September 2026, data to 23 September 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
2. 25WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (28 August 2026, data to 26 August 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
3. 40Apeagyei, A.E. et al., Tracking development assistance for health, 1990 to 2030: historical trends, recent cuts, and outlook, The Lancet, 2025; abstract read through Europe PMC. Institute for Health Metrics and Evaluation, Seattle. Observation year 2025 (estimate). Accessed 2026-11-03.back
4. 3UN DESA Statistics Division (ed.), The Sustainable Development Goals Report 2026, Goal 3 storyline, Good health and well-being. United Nations, New York. Observation year 2024. Accessed 2026-11-03.back
5. 7UNAIDS (ed.), Global HIV and AIDS statistics, fact sheet (2026 data release of 27 July 2026). Joint United Nations Programme on HIV/AIDS, Geneva. Observation year 2025. Accessed 2026-11-03.back
6. 10WHO (ed.), Antimicrobial resistance, fact sheet (16 July 2026). World Health Organization, Geneva. Observation year 2023 (resistance) and 2022 (antibiotic use). Accessed 2026-11-03.back
7. 11WHO (ed.), WHO warns of widespread resistance to common antibiotics worldwide, news release on the Global antibiotic resistance surveillance report 2025 (13 October 2025). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
8. 29POST-CLOSE, context only: WHO (ed.), Climate change is a growing health emergency, Lancet Countdown warns, departmental update summarising the 2026 Lancet Countdown on Health and Climate Change (28 October 2026; the report itself was not opened; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
9. 30POST-CLOSE, context only: WHO, WMO, UNICEF and UNFPA (eds.), New global framework launched to track increasing health risks of extreme heat for pregnant women, newborns and children, news release (21 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
10. 9WHO (ed.), Measles, fact sheet (15 July 2026). World Health Organization, Geneva. Observation year 2024 (deaths) and 2025 (coverage). Accessed 2026-11-03.back
11. 8WHO (ed.), Immunisation coverage, fact sheet (15 July 2026; estimates with UNICEF). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
12. 1WHO (ed.), World Health Statistics 2026: A visual summary and report page (monitoring health for the SDGs, 13 May 2026). World Health Organization, Geneva. Observation year 2023 (deaths and life expectancy). Accessed 2026-11-03.back
13. 23WHO (ed.), International Health Regulations: amendments, questions and answers (1 October 2024). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
14. 22POST-CLOSE, context only: WHO (ed.), WHO welcomes adoption of United Nations political declaration on pandemic prevention, preparedness and response, news release (12 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva and New York. Observation year 2026. Accessed 2026-11-03.back
15. 35WHO (ed.), WHO reports latest global trends in cholera, meningitis and plague, news release (29 September 2026). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
16. 2WHO (ed.), Universal health coverage (UHC), fact sheet (5 December 2025). World Health Organization, Geneva. Observation year 2023 (service coverage) and 2022 (financial hardship). Accessed 2026-11-03.back
17. 42DATA VINTAGE AFTER CLOSE: World Bank (ed.), World Development Indicators, data service queried for current health expenditure (percentage of GDP), out-of-pocket expenditure and physicians per 1 000 people, world aggregate (database updated 2026-10-08). World Bank, Washington. Observation year 2023 (spending) and 2022 (physicians). Accessed 2026-11-03.back
18. 19FAO, UNEP, WOAH and WHO (eds.), One Health Joint Plan of Action (2022 to 2026): working together for the health of humans, animals, plants and the environment, publication page (14 October 2022). World Health Organization, Geneva. Observation year 2022. Accessed 2026-11-03.back
19. 39POST-CLOSE, context only: WHO (ed.), One in four doctors nearing retirement age as WHO warns of global health workforce gap, news release on National health workforce accounts: health workforce levels and trends 2026 (19 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
20. 24POST-CLOSE, context only: WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo, Kenya and Nigeria (23 October 2026, data to 20 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back

5.1Assumptions

Scenario SCN-GS04-OUT-01: what is assumed, and what is held constant.

Baseline

the 2026 reference state in this edition

Drivers

a zoonotic outbreak with cross-border spread that coincides with reduced external funding and a heat season with high demand on clinics

Analogues

the 2026 Bundibugyo outbreak; the 2025 aid reductions⁵⁶⁴⁰

Interventions

none modelled: the specification describes the unmitigated case

Run state

narrative specification; quantified run scheduled for 2027

5.2The cascade, step by step

1. 1

   BIO → HLT

   spillover starts an outbreak; detection is late and deaths occur in communities

   2026

2. 2

   FIN → HLT

   external funding gaps limit surveillance, supplies and staff

   2025

3. 3

   CLI → HLT

   heat raises demand for care and strains facilities

   2023

4. 4

   HLT → FOO

   illness and movement limits reduce labour and market access

   analogue

5. 5

   TRD → HLT

   travel and trade measures conflict with health advice

   2026

6. 6

   HLT → FIN

   response costs and lost output strain public budgets

   analogue

5.3The scenario as a table of steps

How the shock in scenario SCN-GS04-OUT-01 would travel through Global Health and One Health‘s coupled systems, step by step, under the assumptions the edition states.

A teaching model of a conditional scenario under the edition’s stated assumptions: not a forecast, not a prediction and not a warning. Sources: Global Health and One Health 2026, scenario SCN-GS04-OUT-01 (2026); Global Health and One Health 2026, references (NR-CIT-1) (2026).

Notes

Numbers are the edition’s reference numbers, so a note reads the same in every chapter. The full list, with every source and its licence, is in Annex C. Annex C, references

1. 56WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (25 September 2026, data to 23 September 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
2. 40Apeagyei, A.E. et al., Tracking development assistance for health, 1990 to 2030: historical trends, recent cuts, and outlook, The Lancet, 2025; abstract read through Europe PMC. Institute for Health Metrics and Evaluation, Seattle. Observation year 2025 (estimate). Accessed 2026-11-03.back

6.1The other desks’ editions of this subject

Federation: each desk writes its own edition for the subjects in its remit. Until a desk releases, its edition shows its frame and the reading this edition printed for it.

6.2Three lenses

One edition, read by each steward. The lens of this site comes first.

6.3Standards, Academy and steward contributions

How the Nexus Standards drafts, the Risk Academy and the three stewards feed each quarterly edition for health. The standards are a preparatory working draft (2026) and are cited as drafts, never as adopted standards.

6.4GCRI reading: the model card

GCRI’s reading of this edition is its model card: what the national model is, what it computes and where it stops. It is printed in full in Annex A, with the methods it belongs to. Annex A, methodology

6.5Global Risks Forum reading: editorial essays

Four signed essays by the Reports editorial team set out the positions this edition takes. They are interpretation, labelled as such; the evidence they draw on is in the findings register.

6.6Global Risks Alliance reading: 2027 health readiness pack

The registers that open the 2027 global cycle. At baseline each is initialised from this edition.

Publication dispositions

• Publish
• Hold
• Needs evidence
• Restricted
• Superseded

6.7Nexus Standards reading: standards and regulatory watch

Instruments and published guidance that shape the systems in this edition, by status on the retrieval date. The edition assesses no one’s compliance.

• IN FORCE
• ADOPTED
• PUBLISHED · GUIDANCE
• PUBLISHED · VOLUNTARY

6.8Risk Academy reading: literature and evidence review, science and assessments

The review behind this edition covers health assessments, peer-reviewed science and the institutional reports that bind its findings. Systematic reviews for each agenda item begin in 2027.

Review protocol

Question

What does the published evidence establish about the world’s health and One Health system and its couplings?

Sources searched

agency flagships; peer-reviewed health and One Health literature; statistics; WHO notices

Window

releases available at evidence close, 30 September 2026

Selection

sources that bind or contextualise a finding in this edition

Next step

systematic reviews for agenda items 01 to 05 in 2027

Notes

Numbers are the edition’s reference numbers, so a note reads the same in every chapter. The full list, with every source and its licence, is in Annex C. Annex C, references

1. 40Apeagyei, A.E. et al., Tracking development assistance for health, 1990 to 2030: historical trends, recent cuts, and outlook, The Lancet, 2025; abstract read through Europe PMC. Institute for Health Metrics and Evaluation, Seattle. Observation year 2025 (estimate). Accessed 2026-11-03.back
2. 42DATA VINTAGE AFTER CLOSE: World Bank (ed.), World Development Indicators, data service queried for current health expenditure (percentage of GDP), out-of-pocket expenditure and physicians per 1 000 people, world aggregate (database updated 2026-10-08). World Bank, Washington. Observation year 2023 (spending) and 2022 (physicians). Accessed 2026-11-03.back
3. 23WHO (ed.), International Health Regulations: amendments, questions and answers (1 October 2024). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
4. 21WHO (ed.), World Health Assembly adopts historic Pandemic Agreement, news release (20 May 2025). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
5. 22POST-CLOSE, context only: WHO (ed.), WHO welcomes adoption of United Nations political declaration on pandemic prevention, preparedness and response, news release (12 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva and New York. Observation year 2026. Accessed 2026-11-03.back
6. 51UNVERIFIED, not opened: United Nations General Assembly, Political declaration of the high-level meeting on antimicrobial resistance, September 2024; the target of a 10% cut in resistance deaths by 2030 is taken from the opened fact sheet [10]. United Nations, New York. Observation year 2024. Accessed 2026-11-03.back
7. 19FAO, UNEP, WOAH and WHO (eds.), One Health Joint Plan of Action (2022 to 2026): working together for the health of humans, animals, plants and the environment, publication page (14 October 2022). World Health Organization, Geneva. Observation year 2022. Accessed 2026-11-03.back
8. 52UNVERIFIED, not opened: ISO 35001:2019, Biorisk management for laboratories and other related organisations, cited from memory with no figure. International Organization for Standardization, Geneva. Observation year 2019. Accessed 2026-11-03.back
9. 53UNVERIFIED, not opened: ISO 15189:2022, Medical laboratories: requirements for quality and competence, cited from memory with no figure. International Organization for Standardization, Geneva. Observation year 2022. Accessed 2026-11-03.back
10. 25WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (28 August 2026, data to 26 August 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
11. 10WHO (ed.), Antimicrobial resistance, fact sheet (16 July 2026). World Health Organization, Geneva. Observation year 2023 (resistance) and 2022 (antibiotic use). Accessed 2026-11-03.back
12. 12Naghavi, M. et al. (GBD 2021 Antimicrobial Resistance Collaborators), Global burden of bacterial antimicrobial resistance 1990 to 2021: a systematic analysis with forecasts to 2050, The Lancet 404 (10459), September 2024; abstract read through Europe PMC. Institute for Health Metrics and Evaluation and partners. Observation year 2021. Accessed 2026-11-03.back
13. 41Projected health workforce requirements and shortage for addressing the disease burden in the WHO Africa Region, 2022 to 2030: a needs-based modelling study, BMJ Global Health, 2024; abstract read through Europe PMC. BMJ Publishing Group, London. Observation year 2022. Accessed 2026-11-03.back
14. 45UNVERIFIED, not opened: Romanello, M. et al., The 2025 report of the Lancet Countdown on health and climate change, The Lancet 406 (10521), December 2025; the bibliographic record was read, the full text was blocked and no figure from it is used. Lancet Countdown, London. Observation year 2024. Accessed 2026-11-03.back
15. 50UNVERIFIED, not opened: IPBES (ed.), Thematic Assessment Report on the Interlinkages among Biodiversity, Water, Food and Health (Nexus Assessment), 2024; the page returned no readable text and no figure is used. Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, Bonn. Observation year 2024. Accessed 2026-11-03.back
16. 49UNVERIFIED, not opened: UNEP and ILRI (eds.), Preventing the next pandemic: zoonotic diseases and how to break the chain of transmission, 2020; the page returned an access error and no figure is used. United Nations Environment Programme, Nairobi. Observation year 2020. Accessed 2026-11-03.back
17. 1WHO (ed.), World Health Statistics 2026: A visual summary and report page (monitoring health for the SDGs, 13 May 2026). World Health Organization, Geneva. Observation year 2023 (deaths and life expectancy). Accessed 2026-11-03.back
18. 2WHO (ed.), Universal health coverage (UHC), fact sheet (5 December 2025). World Health Organization, Geneva. Observation year 2023 (service coverage) and 2022 (financial hardship). Accessed 2026-11-03.back
19. 11WHO (ed.), WHO warns of widespread resistance to common antibiotics worldwide, news release on the Global antibiotic resistance surveillance report 2025 (13 October 2025). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
20. 17WHO (ed.), One Health, fact sheet (8 May 2026). World Health Organization, Geneva. Observation year 2026 (current text; the share of emerging infections is undated in the sheet). Accessed 2026-11-03.back
21. 46UNVERIFIED, not opened: WHO (ed.), Global Tuberculosis Report 2025. World Health Organization, Geneva; cited for the tables behind the opened fact sheet [4], with no figure taken from it. Observation year 2024. Accessed 2026-11-03.back
22. 47UNVERIFIED, not opened: WHO (ed.), World Malaria Report 2025. World Health Organization, Geneva; cited for the tables behind the opened fact sheet [5], with no figure taken from it. Observation year 2024. Accessed 2026-11-03.back
23. 44WHO (ed.), State of the world’s nursing report 2025, publication page (12 May 2025; no figure used). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
24. 3UN DESA Statistics Division (ed.), The Sustainable Development Goals Report 2026, Goal 3 storyline, Good health and well-being. United Nations, New York. Observation year 2024. Accessed 2026-11-03.back
25. 7UNAIDS (ed.), Global HIV and AIDS statistics, fact sheet (2026 data release of 27 July 2026). Joint United Nations Programme on HIV/AIDS, Geneva. Observation year 2025. Accessed 2026-11-03.back
26. 33FAO (ed.), The State of Food Security and Nutrition in the World 2026, publication page with headline figures (hunger in 2025; cost of a healthy diet). Food and Agriculture Organization of the United Nations, Rome. Observation year 2025. Accessed 2026-11-03.back
27. 39POST-CLOSE, context only: WHO (ed.), One in four doctors nearing retirement age as WHO warns of global health workforce gap, news release on National health workforce accounts: health workforce levels and trends 2026 (19 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
28. 48UNVERIFIED, not opened: WOAH (ed.), Annual report on antimicrobial agents intended for use in animals (ANIMUSE); the report page returned an access error and no figure is used. World Organisation for Animal Health, Paris. Observation year 2022. Accessed 2026-11-03.back
29. 56WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (25 September 2026, data to 23 September 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
30. 20FAO, WOAH, UNEP and WHO (eds.), Tripartite and UNEP support the One Health High Level Expert Panel’s definition of One Health, joint statement (1 December 2021). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
31. 43WHO (ed.), Surveillance System for Attacks on Health Care, dashboard and method note (the dashboard data require an account and were not read). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
32. 54UNVERIFIED, not opened: WOAH (ed.), Terrestrial Animal Health Code, current edition, cited from memory with no figure. World Organisation for Animal Health, Paris. Observation year 2025. Accessed 2026-11-03.back
33. 15WHO (ed.), Child mortality (under 5 years), fact sheet (1 May 2026). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
34. 28WHO (ed.), Climate change, heat and health, fact sheet (31 July 2026). World Health Organization, Geneva. Observation year 2019 (average of 2000 to 2019) and 2022. Accessed 2026-11-03.back
35. 55WHO (ed.), Climate inaction is claiming millions of lives every year, warns new Lancet Countdown report, news release on the 2025 Lancet Countdown on health and climate change (29 October 2025; the report itself was not opened). World Health Organization, Geneva. Observation year 2025 (average of about 546 000 heat-related deaths a year; the averaging period is not stated in the release). Accessed 2026-11-03.back
36. 8WHO (ed.), Immunisation coverage, fact sheet (15 July 2026; estimates with UNICEF). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back

7.1Questions for the operational series

1. H-01

   How would an outbreak that coincides with a funding gap and a heat season travel through clinics, supply chains and food at once?

   INI-GS04-OUT-01 · outbreak under strain; first output: concurrency analysis for six regions.

2. H-02

   Which One Health surveillance links between human, animal and environment data are missing at the points of spillover?

   INI-GS04-OHS-02 · One Health surveillance; first output: link register by region.

3. H-03

   Where does aid reduction coincide with high burden and low domestic financing, and what would close the gap?

   INI-GS04-FIN-03 · health financing gap; first output: country-group overlay.

4. H-04

   How do heat, vector-borne disease and clinic services interact in the same places?

   INI-GS04-HET-04 · heat and health; first output: exposure and service overlay.

5. H-05

   Which health facilities lack reliable power, safe water and trained staff, and where?

   INI-GS04-FAC-05 · facility resilience; first output: facility service table.

6. H-06

   Where is resistance rising fastest and what drives it in people, animals and the environment?

   To be admitted in 2027; first output: resistance and use overlay.

7. H-07

   How many deaths go unrecorded, and how does that distort risk readings?

   To be admitted in 2027; first output: scoping note.

8. H-08

   Which health-security capabilities have been tested in real emergencies, and which are only planned?

   Health capability register; first output: rung evidence for 15 functions.

7.2Portfolio proposed for the Q1 2027 alignment

Five initiatives and one Universe mission candidate are proposed for the 2027 health portfolio. They are programme objects: no partner, funder or member is attached to them in this edition.

7.3The pathway

The health edition reads national health chapters, regional outbreak and surveillance evidence and the global edition through one governed evidence graph. At baseline the federation is designed; the Canada and global health chapters are drafted. This page states what exists today and what comes next.

1. 01

   National health chapters

   health system of each national edition

   DRAFTED · further national baselines

2. 02

   Outbreak and surveillance evidence

   cross-border outbreak zones, laboratories and borders

   PLANNED · regional Baseline Editions

3. 03

   Health sector model

   the global health and One Health system

   v0 SPECIFIED · v1 with federation evidence

4. 04

   Global and strategic links

   GLB · SR-02 Critical Infrastructure and Lifeline Systems

   PLANNED · strategic baselines

5. 05

   Universe

   annual proving environment

   CANDIDATE MISSION · mandate in 2027

6. 06

   Global Health Report

   this series

   BASELINE DRAFT · 2027 annual edition

7. 07

   Evidence and correction

   one graph, many projections

   OPEN · first correction cycle in 2027

7.4Universe 2027: evidence pack for the health candidate mission

1. 01

   Mandate

2. 02

   Core Build · 1 month

3. 03

   Action · 1 week

4. 04

   Evidence seal

5. 05

   Portfolio correction

6. 06

   Next mandate

Mission

ID

MSN-GS04-2027-01 · Outbreak under strain Universe mission

Role spine

Leadership sponsor · Institutional anchor · Mission lead: drawn from national pathways

Receiving actors

to be identified with the mandate

7.5Handoffs and routing

Where the baseline’s findings go next. A handoff routes a finding for awareness, review or work; it transfers no authority.

7.6Feeds and signal register

Escalation routes

• none · keep monitoring
• research question
• project
• risk object
• annual publication
• signal report

Notes

Numbers are the edition’s reference numbers, so a note reads the same in every chapter. The full list, with every source and its licence, is in Annex C. Annex C, references

1. 56WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (25 September 2026, data to 23 September 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
2. 40Apeagyei, A.E. et al., Tracking development assistance for health, 1990 to 2030: historical trends, recent cuts, and outlook, The Lancet, 2025; abstract read through Europe PMC. Institute for Health Metrics and Evaluation, Seattle. Observation year 2025 (estimate). Accessed 2026-11-03.back
3. 3UN DESA Statistics Division (ed.), The Sustainable Development Goals Report 2026, Goal 3 storyline, Good health and well-being. United Nations, New York. Observation year 2024. Accessed 2026-11-03.back
4. 29POST-CLOSE, context only: WHO (ed.), Climate change is a growing health emergency, Lancet Countdown warns, departmental update summarising the 2026 Lancet Countdown on Health and Climate Change (28 October 2026; the report itself was not opened; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back

8.1Health and water

Safe water, sanitation and hygiene protect people from diarrhoeal disease and slow the spread of resistance. Cholera shows the cost when they fail.

Related editions

• GLB Global Systems
• GS-01 Water
• GS-02 Energy
• GS-03 Food and Agrifood Systems
• GS-11 Biodiversity and Ecosystems
• SR-02 Critical Infrastructure and Lifeline Systems

8.2Health and energy

Cooking fuels and household power shape health. Polluting fuels cause household air pollution, and clinics need reliable power for vaccines and surgery.

Related editions

• GLB Global Systems
• GS-01 Water
• GS-02 Energy
• GS-03 Food and Agrifood Systems
• GS-11 Biodiversity and Ecosystems
• SR-02 Critical Infrastructure and Lifeline Systems

8.3Health and food

Food shapes health through safety, nutrition and cost. Unsafe food and hunger are two faces of the same system, and zoonoses cross between farms and clinics.

Related editions

• GLB Global Systems
• GS-01 Water
• GS-02 Energy
• GS-03 Food and Agrifood Systems
• GS-11 Biodiversity and Ecosystems
• SR-02 Critical Infrastructure and Lifeline Systems

8.4Health and nature

The health of people, animals and ecosystems is linked. More than 60% of emerging infections come from animals, and resistance moves between people, animals and the environment.

Related editions

• GLB Global Systems
• GS-01 Water
• GS-02 Energy
• GS-03 Food and Agrifood Systems
• GS-11 Biodiversity and Ecosystems
• SR-02 Critical Infrastructure and Lifeline Systems

8.5Health security, climate and extremes

Health security now spans outbreaks, resistance, heat and financing. The 2025 and 2026 evidence shows detection delay, rising resistance and heat deaths near half a million a year.

Related editions

• GLB Global Systems
• GS-01 Water
• GS-02 Energy
• GS-03 Food and Agrifood Systems
• GS-11 Biodiversity and Ecosystems
• SR-02 Critical Infrastructure and Lifeline Systems

Notes

Numbers are the edition’s reference numbers, so a note reads the same in every chapter. The full list, with every source and its licence, is in Annex C. Annex C, references

1. 35WHO (ed.), WHO reports latest global trends in cholera, meningitis and plague, news release (29 September 2026). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
2. 34WHO (ed.), Cholera, fact sheet (29 September 2026). World Health Organization, Geneva. Observation year 2026 (current text). Accessed 2026-11-03.back
3. 10WHO (ed.), Antimicrobial resistance, fact sheet (16 July 2026). World Health Organization, Geneva. Observation year 2023 (resistance) and 2022 (antibiotic use). Accessed 2026-11-03.back
4. 43WHO (ed.), Surveillance System for Attacks on Health Care, dashboard and method note (the dashboard data require an account and were not read). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
5. 26WHO (ed.), Household air pollution and health, fact sheet (16 December 2025). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
6. 27WHO (ed.), Ambient (outdoor) air pollution, fact sheet (24 October 2024). World Health Organization, Geneva. Observation year 2019. Accessed 2026-11-03.back
7. 32WHO (ed.), Food safety, fact sheet (4 June 2026). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
8. 33FAO (ed.), The State of Food Security and Nutrition in the World 2026, publication page with headline figures (hunger in 2025; cost of a healthy diet). Food and Agriculture Organization of the United Nations, Rome. Observation year 2025. Accessed 2026-11-03.back
9. 36WHO (ed.), Rabies, fact sheet (17 September 2026). World Health Organization, Geneva. Observation year 2026 (current text). Accessed 2026-11-03.back
10. 2WHO (ed.), Universal health coverage (UHC), fact sheet (5 December 2025). World Health Organization, Geneva. Observation year 2023 (service coverage) and 2022 (financial hardship). Accessed 2026-11-03.back
11. 17WHO (ed.), One Health, fact sheet (8 May 2026). World Health Organization, Geneva. Observation year 2026 (current text; the share of emerging infections is undated in the sheet). Accessed 2026-11-03.back
12. 18WHO (ed.), Zoonoses, fact sheet (29 July 2020). World Health Organization, Geneva. Observation year 2020. Accessed 2026-11-03.back
13. 12Naghavi, M. et al. (GBD 2021 Antimicrobial Resistance Collaborators), Global burden of bacterial antimicrobial resistance 1990 to 2021: a systematic analysis with forecasts to 2050, The Lancet 404 (10459), September 2024; abstract read through Europe PMC. Institute for Health Metrics and Evaluation and partners. Observation year 2021. Accessed 2026-11-03.back
14. 37WHO (ed.), Influenza (avian and other zoonotic), fact sheet (21 January 2026). World Health Organization, Geneva. Observation year 2024 (cattle outbreaks). Accessed 2026-11-03.back
15. 38WHO (ed.), Dengue and severe dengue, fact sheet (21 August 2025). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
16. 48UNVERIFIED, not opened: WOAH (ed.), Annual report on antimicrobial agents intended for use in animals (ANIMUSE); the report page returned an access error and no figure is used. World Organisation for Animal Health, Paris. Observation year 2022. Accessed 2026-11-03.back
17. 56WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (25 September 2026, data to 23 September 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
18. 55WHO (ed.), Climate inaction is claiming millions of lives every year, warns new Lancet Countdown report, news release on the 2025 Lancet Countdown on health and climate change (29 October 2025; the report itself was not opened). World Health Organization, Geneva. Observation year 2025 (average of about 546 000 heat-related deaths a year; the averaging period is not stated in the release). Accessed 2026-11-03.back
19. 11WHO (ed.), WHO warns of widespread resistance to common antibiotics worldwide, news release on the Global antibiotic resistance surveillance report 2025 (13 October 2025). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
20. 25WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (28 August 2026, data to 26 August 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
21. 21WHO (ed.), World Health Assembly adopts historic Pandemic Agreement, news release (20 May 2025). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
22. 23WHO (ed.), International Health Regulations: amendments, questions and answers (1 October 2024). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
23. 29POST-CLOSE, context only: WHO (ed.), Climate change is a growing health emergency, Lancet Countdown warns, departmental update summarising the 2026 Lancet Countdown on Health and Climate Change (28 October 2026; the report itself was not opened; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
24. 30POST-CLOSE, context only: WHO, WMO, UNICEF and UNFPA (eds.), New global framework launched to track increasing health risks of extreme heat for pregnant women, newborns and children, news release (21 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
25. 31WHO (ed.), Climate change and health, fact sheet (12 October 2023). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back

A.1Methods

The global baseline uses published values and four simple derivations. Each is shown in full so that any reader can reproduce it.

A.2Model card, Health Sector Model v0

Model ID

MDL-GS04-HEALTH · v0.1

Purpose

represent the global health and One Health system and its couplings to water, energy, food, climate and biodiversity

Family

graph-based system of systems

Inputs

the cited sources of this edition; no proprietary data

Method

expert-specified coupling strengths (STRONG · MODERATE · WEAK) from assessments and analogue events

Validation

none yet, first validation against federation evidence in 2027

Uncertainty

qualitative; strengths are hypotheses, not measurements

Domain of validity

global scale; not for asset-, site- or country-level use

Reproducibility

strength table and sources published in this edition

A.3The baseline evidence cut

Every Nexus edition is published from a frozen evidence cut. The global baseline cut is documentary: it pins the exact edition of every source cited. Federation cuts begin with the first national Foundry cuts in 2027.

Cut ID

DC-SECTOR-HEALTH-GLOBAL-2026-B0

Type

baseline documentary cut

Resolution policy

pinned · as of 30 September 2026

Sources pinned

56 cited sources, each at the edition and access date in the references

Model runs

none at baseline, analytical values are stated with their method

Digest

computed at freeze and recorded in the publication record

Supersedes

nothing, first cut of the series

Superseded by

the 2027 health annual cut

Lineage

1. 01

   source edition

2. 02

   pinned citation

3. 03

   finding

4. 04

   page

5. 05

   publication record

A.4Evidence age and coverage

A 2026 global edition rests on evidence observed in many different years. This page shows each time base, so that no single year label hides older evidence.

A.5Evidence cards, two anchor sources

Evidence cards to follow in 2027

• WHO¹: country tables of the Global Health Estimates
• WHO⁵⁶: situation reports with age and sex tables
• IHME⁴⁰: disbursements by recipient country
• WHO³⁹: workforce density by cadre and country

A.6Publication acceptance record

Editorial self-check at evidence close. Every applicable item carries a disposition; the remaining items are review, approval and deposit.

A.7Status words

A.8How the edition is made, released and corrected

Every edition is built from a sealed evidence cut, reviewed under three keys, signed and deposited before any site shows it as published; corrections go to Nexus Standards as change proposals and feed the next cut.

A teaching model of the process, not a forecast and not a record of any run; dates and counts on this page come from the programme record. Sources: Reports governance at GCRI Canada (2026); Zenodo, repository of record for Reports deposits (2026).

Lifecycle, one state at a time: Draft, Computed, Evidence bound, Reviewed, Approved for release, Published, Corrected, Superseded. This edition is a draft.

A.9Glossary and abbreviations

A.10Technical annex

A.1 · indicator definition: universal health coverage service index

Construct

a composite of essential service coverage across reproductive, maternal, newborn and child health, infectious disease, noncommunicable disease and service capacity

Unit

index from 0 to 100

Method

custodian indicator based on national surveys and administrative data

Source

WHO universal health coverage fact sheet²

Uncertainty

modelled where survey data are missing

Known limits

measures contact with services, not the quality or timeliness of care

Notes

Numbers are the edition’s reference numbers, so a note reads the same in every chapter. The full list, with every source and its licence, is in Annex C. Annex C, references

1. 56WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (25 September 2026, data to 23 September 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
2. 24POST-CLOSE, context only: WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo, Kenya and Nigeria (23 October 2026, data to 20 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
3. 25WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (28 August 2026, data to 26 August 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
4. 43WHO (ed.), Surveillance System for Attacks on Health Care, dashboard and method note (the dashboard data require an account and were not read). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
5. 48UNVERIFIED, not opened: WOAH (ed.), Annual report on antimicrobial agents intended for use in animals (ANIMUSE); the report page returned an access error and no figure is used. World Organisation for Animal Health, Paris. Observation year 2022. Accessed 2026-11-03.back
6. 45UNVERIFIED, not opened: Romanello, M. et al., The 2025 report of the Lancet Countdown on health and climate change, The Lancet 406 (10521), December 2025; the bibliographic record was read, the full text was blocked and no figure from it is used. Lancet Countdown, London. Observation year 2024. Accessed 2026-11-03.back
7. 29POST-CLOSE, context only: WHO (ed.), Climate change is a growing health emergency, Lancet Countdown warns, departmental update summarising the 2026 Lancet Countdown on Health and Climate Change (28 October 2026; the report itself was not opened; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
8. 49UNVERIFIED, not opened: UNEP and ILRI (eds.), Preventing the next pandemic: zoonotic diseases and how to break the chain of transmission, 2020; the page returned an access error and no figure is used. United Nations Environment Programme, Nairobi. Observation year 2020. Accessed 2026-11-03.back
9. 17WHO (ed.), One Health, fact sheet (8 May 2026). World Health Organization, Geneva. Observation year 2026 (current text; the share of emerging infections is undated in the sheet). Accessed 2026-11-03.back
10. 50UNVERIFIED, not opened: IPBES (ed.), Thematic Assessment Report on the Interlinkages among Biodiversity, Water, Food and Health (Nexus Assessment), 2024; the page returned no readable text and no figure is used. Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, Bonn. Observation year 2024. Accessed 2026-11-03.back
11. 42DATA VINTAGE AFTER CLOSE: World Bank (ed.), World Development Indicators, data service queried for current health expenditure (percentage of GDP), out-of-pocket expenditure and physicians per 1 000 people, world aggregate (database updated 2026-10-08). World Bank, Washington. Observation year 2023 (spending) and 2022 (physicians). Accessed 2026-11-03.back
12. 46UNVERIFIED, not opened: WHO (ed.), Global Tuberculosis Report 2025. World Health Organization, Geneva; cited for the tables behind the opened fact sheet [4], with no figure taken from it. Observation year 2024. Accessed 2026-11-03.back
13. 47UNVERIFIED, not opened: WHO (ed.), World Malaria Report 2025. World Health Organization, Geneva; cited for the tables behind the opened fact sheet [5], with no figure taken from it. Observation year 2024. Accessed 2026-11-03.back
14. 1WHO (ed.), World Health Statistics 2026: A visual summary and report page (monitoring health for the SDGs, 13 May 2026). World Health Organization, Geneva. Observation year 2023 (deaths and life expectancy). Accessed 2026-11-03.back
15. 40Apeagyei, A.E. et al., Tracking development assistance for health, 1990 to 2030: historical trends, recent cuts, and outlook, The Lancet, 2025; abstract read through Europe PMC. Institute for Health Metrics and Evaluation, Seattle. Observation year 2025 (estimate). Accessed 2026-11-03.back
16. 39POST-CLOSE, context only: WHO (ed.), One in four doctors nearing retirement age as WHO warns of global health workforce gap, news release on National health workforce accounts: health workforce levels and trends 2026 (19 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
17. 2WHO (ed.), Universal health coverage (UHC), fact sheet (5 December 2025). World Health Organization, Geneva. Observation year 2023 (service coverage) and 2022 (financial hardship). Accessed 2026-11-03.back

B.1The indicator set

B.2Global source register

The governed source set behind this edition. Each source keeps its authority, coverage, cadence and role; categories describe origin, not truth.

Domains bound by the register

• HLT
• BIO
• FIN
• CLI
• FOO
• WAT
• ENE
• GOV
• DAT
• TRD

B.3Regional reading: health across ten clusters

Map plates follow with the regional Baseline Editions, when boundary sources and public-safe resolutions are bound. This page gives the regional reading in table form and ranks no region.

B.4Outbreak card: Bundibugyo virus disease, eastern Democratic Republic of the Congo and neighbours

• outbreak
• zoonotic
• cross-border
• no authorised vaccine

Systems in view

health, communities, borders, trade

Defining events

outbreak declared in May 2026; cases in Uganda and France by 26 August²⁵

Couplings

BIO → HLT spillover; HLT → FIN response cost; TRD travel advice

Capability evidence

treatment trial enrolling confirmed cases; IHR temporary recommendations²⁵⁵⁶

Gaps

position after 23 September; funding gap; community deaths

Agenda items

H-01 · H-05

B.5How countries appear in the health edition

Countries enter the health edition through the health chapters of their own national editions, on one card grammar. They are read against peer distributions and thresholds, never ranked.

Editions in the 2026 Baseline programme

How to read a country card

• Each system is shown against the distribution of its peers, with thresholds where they exist
• Couplings and risk objects come from the country’s own national edition
• Capability rungs record evidence, not a judgement of institutions
• Evidence age is printed, so older national data are visible as such

B.6Licences

B.7Formats and provenance

Provenance

Edition pack

The edition’s content pack (JSON), from which the print and web editions are built

Evidence cut

DC-SECTOR-HEALTH-GLOBAL-2026-B0, closed 30 September 2026

Reproducibility

sourced values cited; analytical values reproducible from stated parameters

Self-check

14 of 23 at evidence close; a fail on any item blocks release

Review

five passes scheduled before release (in Annex C)

Publisher of record

GCRI for the Nexus Consortium

Corrections

Registry correction pathway; upheld corrections are published as notices with a new version

Notes

Numbers are the edition’s reference numbers, so a note reads the same in every chapter. The full list, with every source and its licence, is in Annex C. Annex C, references

1. 2WHO (ed.), Universal health coverage (UHC), fact sheet (5 December 2025). World Health Organization, Geneva. Observation year 2023 (service coverage) and 2022 (financial hardship). Accessed 2026-11-03.back
2. 15WHO (ed.), Child mortality (under 5 years), fact sheet (1 May 2026). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
3. 16WHO (ed.), Maternal mortality, fact sheet (7 April 2025). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
4. 4WHO (ed.), Tuberculosis, fact sheet (24 March 2026). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
5. 5WHO (ed.), Malaria, fact sheet (4 December 2025). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
6. 7UNAIDS (ed.), Global HIV and AIDS statistics, fact sheet (2026 data release of 27 July 2026). Joint United Nations Programme on HIV/AIDS, Geneva. Observation year 2025. Accessed 2026-11-03.back
7. 8WHO (ed.), Immunisation coverage, fact sheet (15 July 2026; estimates with UNICEF). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
8. 3UN DESA Statistics Division (ed.), The Sustainable Development Goals Report 2026, Goal 3 storyline, Good health and well-being. United Nations, New York. Observation year 2024. Accessed 2026-11-03.back
9. 13WHO (ed.), Noncommunicable diseases, fact sheet (25 September 2025). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
10. 14WHO (ed.), Mental disorders, fact sheet (11 September 2026). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
11. 12Naghavi, M. et al. (GBD 2021 Antimicrobial Resistance Collaborators), Global burden of bacterial antimicrobial resistance 1990 to 2021: a systematic analysis with forecasts to 2050, The Lancet 404 (10459), September 2024; abstract read through Europe PMC. Institute for Health Metrics and Evaluation and partners. Observation year 2021. Accessed 2026-11-03.back
12. 40Apeagyei, A.E. et al., Tracking development assistance for health, 1990 to 2030: historical trends, recent cuts, and outlook, The Lancet, 2025; abstract read through Europe PMC. Institute for Health Metrics and Evaluation, Seattle. Observation year 2025 (estimate). Accessed 2026-11-03.back
13. 39POST-CLOSE, context only: WHO (ed.), One in four doctors nearing retirement age as WHO warns of global health workforce gap, news release on National health workforce accounts: health workforce levels and trends 2026 (19 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
14. 35WHO (ed.), WHO reports latest global trends in cholera, meningitis and plague, news release (29 September 2026). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
15. 55WHO (ed.), Climate inaction is claiming millions of lives every year, warns new Lancet Countdown report, news release on the 2025 Lancet Countdown on health and climate change (29 October 2025; the report itself was not opened). World Health Organization, Geneva. Observation year 2025 (average of about 546 000 heat-related deaths a year; the averaging period is not stated in the release). Accessed 2026-11-03.back
16. 56WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (25 September 2026, data to 23 September 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
17. 28WHO (ed.), Climate change, heat and health, fact sheet (31 July 2026). World Health Organization, Geneva. Observation year 2019 (average of 2000 to 2019) and 2022. Accessed 2026-11-03.back
18. 29POST-CLOSE, context only: WHO (ed.), Climate change is a growing health emergency, Lancet Countdown warns, departmental update summarising the 2026 Lancet Countdown on Health and Climate Change (28 October 2026; the report itself was not opened; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
19. 1WHO (ed.), World Health Statistics 2026: A visual summary and report page (monitoring health for the SDGs, 13 May 2026). World Health Organization, Geneva. Observation year 2023 (deaths and life expectancy). Accessed 2026-11-03.back
20. 6WHO (ed.), HIV and AIDS, fact sheet (27 July 2026). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
21. 11WHO (ed.), WHO warns of widespread resistance to common antibiotics worldwide, news release on the Global antibiotic resistance surveillance report 2025 (13 October 2025). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
22. 42DATA VINTAGE AFTER CLOSE: World Bank (ed.), World Development Indicators, data service queried for current health expenditure (percentage of GDP), out-of-pocket expenditure and physicians per 1 000 people, world aggregate (database updated 2026-10-08). World Bank, Washington. Observation year 2023 (spending) and 2022 (physicians). Accessed 2026-11-03.back
23. 37WHO (ed.), Influenza (avian and other zoonotic), fact sheet (21 January 2026). World Health Organization, Geneva. Observation year 2024 (cattle outbreaks). Accessed 2026-11-03.back
24. 27WHO (ed.), Ambient (outdoor) air pollution, fact sheet (24 October 2024). World Health Organization, Geneva. Observation year 2019. Accessed 2026-11-03.back
25. 38WHO (ed.), Dengue and severe dengue, fact sheet (21 August 2025). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
26. 25WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (28 August 2026, data to 26 August 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back

C.156 sources

NR-CIT-1, editor first. A DOI is linked where the source has one; Nexus records carry a UNI once the catalogue allocates it (NS-1).

1. 1WHO (ed.), World Health Statistics 2026: A visual summary and report page (monitoring health for the SDGs, 13 May 2026). World Health Organization, Geneva. Observation year 2023 (deaths and life expectancy). Accessed 2026-11-03. Cited in chapter 1, chapter 3, chapter 4, chapter 6
2. 2WHO (ed.), Universal health coverage (UHC), fact sheet (5 December 2025). World Health Organization, Geneva. Observation year 2023 (service coverage) and 2022 (financial hardship). Accessed 2026-11-03. Cited in the summary, chapter 1, chapter 2, chapter 3, chapter 4, chapter 6, chapter 8
3. 3UN DESA Statistics Division (ed.), The Sustainable Development Goals Report 2026, Goal 3 storyline, Good health and well-being. United Nations, New York. Observation year 2024. Accessed 2026-11-03. Cited in the summary, chapter 1, chapter 2, chapter 3, chapter 4, chapter 6, chapter 7
4. 4WHO (ed.), Tuberculosis, fact sheet (24 March 2026). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03. Cited in the summary, chapter 1, chapter 2
5. 5WHO (ed.), Malaria, fact sheet (4 December 2025). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03. Cited in the summary, chapter 1, chapter 2
6. 6WHO (ed.), HIV and AIDS, fact sheet (27 July 2026). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03. Cited in the summary, chapter 2
7. 7UNAIDS (ed.), Global HIV and AIDS statistics, fact sheet (2026 data release of 27 July 2026). Joint United Nations Programme on HIV/AIDS, Geneva. Observation year 2025. Accessed 2026-11-03. Cited in chapter 1, chapter 2, chapter 4, chapter 6
8. 8WHO (ed.), Immunisation coverage, fact sheet (15 July 2026; estimates with UNICEF). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03. Cited in chapter 2, chapter 4, chapter 6
9. 9WHO (ed.), Measles, fact sheet (15 July 2026). World Health Organization, Geneva. Observation year 2024 (deaths) and 2025 (coverage). Accessed 2026-11-03. Cited in chapter 1, chapter 2, chapter 4
10. 10WHO (ed.), Antimicrobial resistance, fact sheet (16 July 2026). World Health Organization, Geneva. Observation year 2023 (resistance) and 2022 (antibiotic use). Accessed 2026-11-03. Cited in chapter 2, chapter 3, chapter 4, chapter 6, chapter 8
11. 11WHO (ed.), WHO warns of widespread resistance to common antibiotics worldwide, news release on the Global antibiotic resistance surveillance report 2025 (13 October 2025). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03. Cited in the summary, chapter 1, chapter 2, chapter 4, chapter 6, chapter 8
12. 12Naghavi, M. et al. (GBD 2021 Antimicrobial Resistance Collaborators), Global burden of bacterial antimicrobial resistance 1990 to 2021: a systematic analysis with forecasts to 2050, The Lancet 404 (10459), September 2024; abstract read through Europe PMC. Institute for Health Metrics and Evaluation and partners. Observation year 2021. Accessed 2026-11-03. Cited in the summary, chapter 2, chapter 3, chapter 6, chapter 8
13. 13WHO (ed.), Noncommunicable diseases, fact sheet (25 September 2025). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03. Cited in the summary, chapter 2, chapter 3
14. 14WHO (ed.), Mental disorders, fact sheet (11 September 2026). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03. Cited in chapter 3
15. 15WHO (ed.), Child mortality (under 5 years), fact sheet (1 May 2026). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03. Cited in the summary, chapter 1, chapter 2, chapter 3, chapter 6
16. 16WHO (ed.), Maternal mortality, fact sheet (7 April 2025). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03. Cited in chapter 3
17. 17WHO (ed.), One Health, fact sheet (8 May 2026). World Health Organization, Geneva. Observation year 2026 (current text; the share of emerging infections is undated in the sheet). Accessed 2026-11-03. Cited in chapter 1, chapter 2, chapter 3, chapter 6, chapter 8
18. 18WHO (ed.), Zoonoses, fact sheet (29 July 2020). World Health Organization, Geneva. Observation year 2020. Accessed 2026-11-03. Cited in chapter 2, chapter 8
19. 19FAO, UNEP, WOAH and WHO (eds.), One Health Joint Plan of Action (2022 to 2026): working together for the health of humans, animals, plants and the environment, publication page (14 October 2022). World Health Organization, Geneva. Observation year 2022. Accessed 2026-11-03. Cited in chapter 4, chapter 6
20. 20FAO, WOAH, UNEP and WHO (eds.), Tripartite and UNEP support the One Health High Level Expert Panel’s definition of One Health, joint statement (1 December 2021). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03. Cited in chapter 6
21. 21WHO (ed.), World Health Assembly adopts historic Pandemic Agreement, news release (20 May 2025). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03. Cited in the summary, chapter 1, chapter 2, chapter 3, chapter 6, chapter 8
22. 22POST-CLOSE, context only: WHO (ed.), WHO welcomes adoption of United Nations political declaration on pandemic prevention, preparedness and response, news release (12 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva and New York. Observation year 2026. Accessed 2026-11-03. Cited in chapter 4, chapter 6
23. 23WHO (ed.), International Health Regulations: amendments, questions and answers (1 October 2024). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03. Cited in the summary, chapter 1, chapter 2, chapter 3, chapter 4, chapter 6, chapter 8
24. 24POST-CLOSE, context only: WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo, Kenya and Nigeria (23 October 2026, data to 20 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03. Cited in chapter 4
25. 25WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (28 August 2026, data to 26 August 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03. Cited in chapter 2, chapter 3, chapter 4, chapter 6, chapter 8
26. 26WHO (ed.), Household air pollution and health, fact sheet (16 December 2025). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03. Cited in chapter 1, chapter 3, chapter 8
27. 27WHO (ed.), Ambient (outdoor) air pollution, fact sheet (24 October 2024). World Health Organization, Geneva. Observation year 2019. Accessed 2026-11-03. Cited in chapter 8
28. 28WHO (ed.), Climate change, heat and health, fact sheet (31 July 2026). World Health Organization, Geneva. Observation year 2019 (average of 2000 to 2019) and 2022. Accessed 2026-11-03. Cited in chapter 2, chapter 3, chapter 6
29. 29POST-CLOSE, context only: WHO (ed.), Climate change is a growing health emergency, Lancet Countdown warns, departmental update summarising the 2026 Lancet Countdown on Health and Climate Change (28 October 2026; the report itself was not opened; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03. Cited in chapter 3, chapter 4, chapter 7, chapter 8
30. 30POST-CLOSE, context only: WHO, WMO, UNICEF and UNFPA (eds.), New global framework launched to track increasing health risks of extreme heat for pregnant women, newborns and children, news release (21 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03. Cited in chapter 1, chapter 3, chapter 4, chapter 8
31. 31WHO (ed.), Climate change and health, fact sheet (12 October 2023). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03. Cited in chapter 8
32. 32WHO (ed.), Food safety, fact sheet (4 June 2026). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03. Cited in chapter 1, chapter 3, chapter 8
33. 33FAO (ed.), The State of Food Security and Nutrition in the World 2026, publication page with headline figures (hunger in 2025; cost of a healthy diet). Food and Agriculture Organization of the United Nations, Rome. Observation year 2025. Accessed 2026-11-03. Cited in chapter 3, chapter 6, chapter 8
34. 34WHO (ed.), Cholera, fact sheet (29 September 2026). World Health Organization, Geneva. Observation year 2026 (current text). Accessed 2026-11-03. Cited in chapter 8
35. 35WHO (ed.), WHO reports latest global trends in cholera, meningitis and plague, news release (29 September 2026). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03. Cited in chapter 1, chapter 3, chapter 4, chapter 8
36. 36WHO (ed.), Rabies, fact sheet (17 September 2026). World Health Organization, Geneva. Observation year 2026 (current text). Accessed 2026-11-03. Cited in chapter 8
37. 37WHO (ed.), Influenza (avian and other zoonotic), fact sheet (21 January 2026). World Health Organization, Geneva. Observation year 2024 (cattle outbreaks). Accessed 2026-11-03. Cited in chapter 8
38. 38WHO (ed.), Dengue and severe dengue, fact sheet (21 August 2025). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03. Cited in chapter 3, chapter 8
39. 39POST-CLOSE, context only: WHO (ed.), One in four doctors nearing retirement age as WHO warns of global health workforce gap, news release on National health workforce accounts: health workforce levels and trends 2026 (19 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03. Cited in the summary, chapter 1, chapter 4, chapter 6
40. 40Apeagyei, A.E. et al., Tracking development assistance for health, 1990 to 2030: historical trends, recent cuts, and outlook, The Lancet, 2025; abstract read through Europe PMC. Institute for Health Metrics and Evaluation, Seattle. Observation year 2025 (estimate). Accessed 2026-11-03. Cited in the summary, chapter 1, chapter 2, chapter 3, chapter 4, chapter 5, chapter 6, chapter 7
41. 41Projected health workforce requirements and shortage for addressing the disease burden in the WHO Africa Region, 2022 to 2030: a needs-based modelling study, BMJ Global Health, 2024; abstract read through Europe PMC. BMJ Publishing Group, London. Observation year 2022. Accessed 2026-11-03. Cited in chapter 6
42. 42DATA VINTAGE AFTER CLOSE: World Bank (ed.), World Development Indicators, data service queried for current health expenditure (percentage of GDP), out-of-pocket expenditure and physicians per 1 000 people, world aggregate (database updated 2026-10-08). World Bank, Washington. Observation year 2023 (spending) and 2022 (physicians). Accessed 2026-11-03. Cited in the summary, chapter 2, chapter 3, chapter 4, chapter 6
43. 43WHO (ed.), Surveillance System for Attacks on Health Care, dashboard and method note (the dashboard data require an account and were not read). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03. Cited in chapter 3, chapter 6, chapter 8
44. 44WHO (ed.), State of the world’s nursing report 2025, publication page (12 May 2025; no figure used). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03. Cited in chapter 6
45. 45UNVERIFIED, not opened: Romanello, M. et al., The 2025 report of the Lancet Countdown on health and climate change, The Lancet 406 (10521), December 2025; the bibliographic record was read, the full text was blocked and no figure from it is used. Lancet Countdown, London. Observation year 2024. Accessed 2026-11-03. Cited in chapter 6
46. 46UNVERIFIED, not opened: WHO (ed.), Global Tuberculosis Report 2025. World Health Organization, Geneva; cited for the tables behind the opened fact sheet [4], with no figure taken from it. Observation year 2024. Accessed 2026-11-03. Cited in chapter 6
47. 47UNVERIFIED, not opened: WHO (ed.), World Malaria Report 2025. World Health Organization, Geneva; cited for the tables behind the opened fact sheet [5], with no figure taken from it. Observation year 2024. Accessed 2026-11-03. Cited in chapter 6
48. 48UNVERIFIED, not opened: WOAH (ed.), Annual report on antimicrobial agents intended for use in animals (ANIMUSE); the report page returned an access error and no figure is used. World Organisation for Animal Health, Paris. Observation year 2022. Accessed 2026-11-03. Cited in chapter 6, chapter 8
49. 49UNVERIFIED, not opened: UNEP and ILRI (eds.), Preventing the next pandemic: zoonotic diseases and how to break the chain of transmission, 2020; the page returned an access error and no figure is used. United Nations Environment Programme, Nairobi. Observation year 2020. Accessed 2026-11-03. Cited in chapter 6
50. 50UNVERIFIED, not opened: IPBES (ed.), Thematic Assessment Report on the Interlinkages among Biodiversity, Water, Food and Health (Nexus Assessment), 2024; the page returned no readable text and no figure is used. Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, Bonn. Observation year 2024. Accessed 2026-11-03. Cited in chapter 6
51. 51UNVERIFIED, not opened: United Nations General Assembly, Political declaration of the high-level meeting on antimicrobial resistance, September 2024; the target of a 10% cut in resistance deaths by 2030 is taken from the opened fact sheet [10]. United Nations, New York. Observation year 2024. Accessed 2026-11-03. Cited in chapter 6
52. 52UNVERIFIED, not opened: ISO 35001:2019, Biorisk management for laboratories and other related organisations, cited from memory with no figure. International Organization for Standardization, Geneva. Observation year 2019. Accessed 2026-11-03. Cited in chapter 6
53. 53UNVERIFIED, not opened: ISO 15189:2022, Medical laboratories: requirements for quality and competence, cited from memory with no figure. International Organization for Standardization, Geneva. Observation year 2022. Accessed 2026-11-03. Cited in chapter 6
54. 54UNVERIFIED, not opened: WOAH (ed.), Terrestrial Animal Health Code, current edition, cited from memory with no figure. World Organisation for Animal Health, Paris. Observation year 2025. Accessed 2026-11-03. Cited in chapter 6
55. 55WHO (ed.), Climate inaction is claiming millions of lives every year, warns new Lancet Countdown report, news release on the 2025 Lancet Countdown on health and climate change (29 October 2025; the report itself was not opened). World Health Organization, Geneva. Observation year 2025 (average of about 546 000 heat-related deaths a year; the averaging period is not stated in the release). Accessed 2026-11-03. Cited in the summary, chapter 1, chapter 2, chapter 3, chapter 6, chapter 8
56. 56WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (25 September 2026, data to 23 September 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03. Cited in the summary, chapter 1, chapter 2, chapter 3, chapter 4, chapter 5, chapter 6, chapter 7, chapter 8

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