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Systems and sectors at baseline

8 min read0 figures2 tables26 notesNR-SECTOR-HEALTH-GLOBAL-2026-BASELINE

Contents
  1. ·Edition home
  2. ·Executive summary
  3. 1Health is where the systems meet
  4. 2Key findings
  5. 3Systems and sectors at baseline
    1. 3.1 Where each system stood at evidence close
    2. 3.2 Domain posture
    3. 3.3 Sector screens
  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

3.1Where each system stood at evidence close

HLT · Health

People not fully covered by essential health services

4.6billion

service coverage index 71 of 100; 2.1 billion with financial hardship in 2022.

Reported2023WHO2

HLT · Child survival

Deaths of children under five

4.9million

rate 37.4 per 1 000 live births; progress has slowed since 2015.

Reported2024WHO15

BIO · One Health

Deaths attributable to bacterial resistance

1.14million

4.71 million deaths associated with resistance.

Reported2021IHME Lancet12

FIN · Finance

Development assistance for health

38.4USD billion

issuer estimate; USD 80.3 billion in 2021.

Reported2025eIHME40

CLI · Climate

Average yearly deaths linked to heat

546thousand

the rate of heat-related mortality is up 23% since the 1990s.

Reported2025Lancet Countdown via WHO55

SYS · Cross-system

Confirmed Bundibugyo virus disease cases

7 890cases

3 799 deaths; as at 23 September 2026.

Reported2026WHO56

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.

Table 3.1Each domain read in words, not scored
DomainPosture at baselineCouplingStatus
WATUnsafe water and poor sanitation drive cholera: 7 870 deaths were reported to WHO in 2025, the most since 199935. Resistance rises where water, sanitation and hygiene are poor10.WAT → HLTReported EQL 4
ENEAbout 2.1 billion people cook with polluting fuels; household air pollution caused 2.9 million deaths in 202126. Power in health facilities is not consolidated here.ENE → HLTReported EQL 4
FOOAn estimated 866 million people fall ill from unsafe food each year and 645 million faced hunger in 20253233.FOO → HLTReported EQL 4
HLTCoverage index 71 of 100, 4.9 million child deaths, 43 million noncommunicable deaths and 1.2 billion people with a mental disorder2151314.the core systemReported EQL 5
BIOMore than 60% of emerging infectious diseases come from animals; land use, trade and habitat loss raise spillover. Evidence on drivers is not consolidated here17.BIO → HLTReported EQL 4
CLIHeat was linked to an average of about 546 000 deaths a year55 and 1.5 billion children are exposed to worsening heatwaves2930.CLI → HLTReported EQL 3
INFHospitals, laboratories and supply chains are infrastructure. Attacks on health care are monitored, but the series is not open; facility power and water are not consolidated here43.INF ↔ HLTExpert input EQL 2
FINAid for health is estimated at USD 38.4 billion in 2025; out-of-pocket spending is 17.3% of current health spending4042.FIN → HLTReported EQL 4
DATOnly about one third of 2023 deaths carry cause-of-death information; 195 of 196 States Parties reported IHR capacity in 202413.DAT → HLTReported EQL 4
AICDigital and AI tools in health are used in many settings; no opened source supports a figure here and none is used.AIC → HLTExpert input EQL 1
MINMedicines, diagnostics and devices rest on supply chains whose chokepoints are not mapped here; no figure is used.MIN → HLTExpert input EQL 1
TRDTrade in live animals and food carries spillover and food safety risk; WHO advises against travel and trade restrictions for Ebola-affected countries173256.TRD ↔ HLTReported EQL 3

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.

Table 3.2Sectors: baseline evidence and the exposure to watch
CodeSectorBaseline evidenceExposure to watchEvidence coverage
GS-00Cross-systemhealth couples to every other system173outbreak, funding gap and heatPARTIAL
GS-01Waterunsafe water and sanitation drive cholera35flood and outbreakPARTIAL
GS-02Energy2.1 billion people cook with polluting fuels26clinic power and cooking fuelsPARTIAL
GS-03Food and Agrifood Systems866 million ill from unsafe food32hunger and food safetyGOOD
GS-04Health and One Healthcoverage index 71; 4.6 billion not fully covered2coverage under shocksGOOD
GS-05Finance and Economyaid for health at an estimated USD 38.4 billion40financing shockGOOD
GS-06Development and Humanitarianchild and maternal deaths concentrated in fragile settings1516conflict and displacementGOOD
GS-07Climate and Earth Systemsheat deaths averaging about 546 000 a year55heat seasonPARTIAL
GS-08Disaster and ResilienceIHR capacity scores 49 to 77 by country group3concurrent emergenciesPARTIAL
GS-09Infrastructure, Transport and Logisticscold chains and referral routesvaccine and medicine supplyTHIN
GS-10Cities and Urban Systemsdengue and heat in dense settings3828urban heat and vectorsTHIN
GS-11Biodiversity and Ecosystemszoonotic spillover from wild and domestic animals17spillover driversPARTIAL
GS-12Earth Observation and Planetary Intelligenceclimate-informed early warning for health29heat and vector signalsTHIN
GS-13Cyber and Digital Systemshealth data and hospital systemsattacks on hospitalsTHIN
GS-14Policy, Institutions and Governanceamended IHR and the Pandemic Agreement2123annex negotiationPARTIAL
GS-15Science and Engineering Frontiertreatment trial in the outbreak25; resistance science12countermeasuresPARTIAL

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

Cite this chapter

Valadbaygi, S. (Ed.). (2026). Chapter 3: Systems and sectors at baseline. 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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Sector signature

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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