Draft, not yet released. In stewardship review. Not indexed until the first approved release.

Executive summary

The edition on a few pages: the abstract, the key messages, the headline finding and what each steward reads in it.

7 min read1 figure0 tables16 notesNR-SECTOR-HEALTH-GLOBAL-2026-BASELINE

Contents
  1. ·Edition home
  2. ·Executive summary
    1. S.1 Abstract
    2. S.2 Key messages
    3. S.3 Headline finding
    4. S.4 At a glance
    5. S.5 What each steward reads in it
    6. S.6 What this edition is, and is not
  3. 1Health is where the systems meet
  4. 2Key findings
  5. 3Systems and sectors at baseline
  6. 4Risks and capability
  7. 5Outbreak, funding gap and heat season in fragile health systems
  8. 6Readings from the other desks
  9. 7The 2027 agenda
  10. 8Systems in depth
  11. AMethodology
  12. BData appendix
  13. CReferences and record
  14. ·Complete edition, for print

S.1Abstract

The world enters 2027 with a health system that has made lasting gains and is now under financial and biological strain at the same time. The UHC service coverage index rose from 54 to 71 between 2000 and 2023, yet 4.6 billion people were not fully covered in 2023 and 2.1 billion faced financial hardship from health costs in 20222. Under-five deaths stagnated at about 4.9 million a year15. Tuberculosis killed 1.23 million people in 2024, malaria 610 000 and HIV 570 000 in 2025456. Noncommunicable diseases killed at least 43 million people in 202113. Bacterial resistance to antibiotics was associated with 4.71 million deaths in 2021 and one in six common infections was resistant in 20231211. Financing is the sharpest pressure: development assistance for health peaked at USD 80.3 billion in 2021 and is estimated at USD 38.4 billion in 202540. Health security is under test. WHO reports a Bundibugyo virus disease outbreak that began in May 2026 and reached 7 890 confirmed cases and 3 799 deaths in the Democratic Republic of the Congo by 23 September, with no authorised vaccine or treatment56. Heat is rising as a health hazard: the 2025 Lancet Countdown, as summarised by WHO, links an average of about 546 000 deaths a year to heat55. Governance is moving: the amended International Health Regulations entered into force in September 2025 and the Pandemic Agreement awaits its access and benefit-sharing annex2123. This baseline sets out what the evidence supports and where it is thin. It ranks no country and recommends no policy.

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.

Figure S.1People left behind on the path to UHC (million)
ItemBar, scaled to the largest valueValue
Not fully covered by essential health services, 20234,600
Faced financial hardship from health costs, 20222,100

Source: WHO universal health coverage fact sheet2. The measures count different things and overlap.

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

71of 100

UHC service coverage index, 20232

4.9million

deaths of children under five, 202415

43million

deaths from noncommunicable diseases, 202113

1.14million

deaths attributable to bacterial resistance, 202112

38.4USD billion

development assistance for health, 2025e40

11.1million

projected health-worker shortage by 203039

S.5What each steward reads in it

GCRI · KEY T

Technical Truth

The evidence supports reading health as the outcome layer of the WEFH+B system.

GRF · KEY M

Public Meaning

For most people health risk arrives as a missed vaccine, a bill they cannot pay or a clinic without staff.

GRA · KEY F

Capital Meaning

Readiness implications only. Aid for health has halved since 2021 and out-of-pocket spending is 17.3% of health spending.

NEXUS

Synthesis

Health is well measured at the level of deaths and coverage and thinly measured at the level of facilities, animal-side drivers and deaths without a recorded cause.

S.6What this edition is, and is not

What this edition is

A baseline: the 2026 state of the world’s health and One Health system and the couplings through which it carries risk into other systems. It synthesises published evidence and ranks no country, company or asset.

What it is not

Not a health-system ranking, a clinical guideline, a forecast of any outbreak, a funding recommendation or an assessment of any ministry, hospital, programme or government. Health policy, clinical practice and emergency declarations rest with national authorities and WHO under the International Health Regulations.

What comes next

National, regional and sector evidence feeds the 2027 health edition through the federation. Each edition reports what changed against this baseline: observations, source revisions, method changes, scenario updates and corrections.

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

Cite this summary

Valadbaygi, S. (Ed.). (2026). Executive summary: Executive summary. In Global Health Risk and Resilience Report 2026: Baseline Edition, The State of the World’s Health and One Health System. (Baseline Edition 2026, Report No. NR-SECTOR-HEALTH-GLOBAL-2026-BASELINE) [Draft under review]. The Global Centre for Risk and Innovation (GCRI).

Every citation form of the whole report, BibTeX and RIS included, is on the edition home. Cite this report

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The sectors behind Global Health and One Health.

A reading aid: the sectors the findings run through and how strongly they depend on each other.

Select corners · hover lines6 / 15 relations

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Health and its partners

Health gives workforce for operations to infrastructure (0.3), farm labour to food (0.3) and utility workforce to water (0.2).

W · E · I · F · H · B

Sectors
4 of 6
Relations
6 of 15
Coupling
0.42 share of total

Strongest relations in play

  • Water → Food · irrigation0.8
  • Food → Health · nutrition0.7
  • Infrastructure → Water · pipes, dams and treatment works0.6
  • Water → Health · drinking water and sanitation0.7
Teaching values for a typical city-region, not measurements for any place. Coupling is the summed strength of the relations in play, as a share of all fifteen.
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