World Health Statistics 2023

Since the turn of the century, the world has made substantial global progress improving the health of mothers and children.

Between 2000 and 2020, the global number of maternal deaths fell from 447 000 to 287 000 and the global maternal mortality ratio decreased from 339 deaths per 100 000 live births to 223 deaths per 100 000 live births. Both decreased by more than one third.

The global under-five mortality rate saw even faster progress. It was reduced by half between 2000 and 2021, from 76 deaths per 1000 live births to 38 deaths per 1000 live births. In 2000, there were 9.9 million deaths in children under five. In 2021, this number had fallen to 5 million.

Almost half of these 5 million deaths occurred during the very first month of a baby’s life. The global neonatal mortality rate – infant deaths within the first month of life – improved from 31 deaths per 1000 live births (2000) to 18 deaths per 1000 live births (2021).

This heartening progress was particularly evident during the MDG era of 2000-2015. However, since the start of the SDG era in 2015, there has been a pronounced slowdown.

Between 2000 and 2015, the annual rate of reduction (ARR) of the global maternal mortality ratio was 2.7%. But this plummeted to -0.04% between 2016 and 2020, revealing a stall in progress protecting maternal health during the SDG era.

In the case of under-five mortality rate, the ARR fell from 4.0% during the first decade (2000–2009) to 2.7% during the second decade (2010–2021). Meanwhile, the ARR of the neonatal mortality rate fell from 3.2% (2000–2009) to 2.2% (2010–2021). This slowdown is particularly pronounced since 2015.

Annual rate of reduction in maternal and child mortality has dropped in recent years

Note: Maternal mortality ratio is per 100 000 live births and under-five and neonatal mortality rates are per 1000 live births.
Source: Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division.​ Levels and trends in child mortality: Report 2022. Estimates developed by the UN Inter-agency Group for Child Mortality Estimation.

There is a similar pattern in many other mortality indicators on a global level. Since 2015, there has been a slowdown in the reduction of premature mortality due to major noncommunicable diseases (NCDs), along with mortality rates due to road traffic injuries, suicide and homicide.

Acceleration of progress is needed in these areas, all of which are high in the global development agenda as part of the SDG targets.

Not only do noncommunicable diseases (NCDs) continue to cause the highest disease burden worldwide, but their impact has worsened in the past two decades.

Between 2000 and 2019, the number of deaths caused by NCDs increased by more than one third, from 31 million lives lost to 41 million lives lost – almost 3 of every four deaths worldwide. Similarly, in 2000, NCDs caused 47% of global disability-adjusted life years (1.3 billion years); by 2019, NCDs caused 63% (1.6 billion years).

The four major NCDs, namely cardiovascular disease (17.9 million deaths), cancer (9.3 million deaths), chronic respiratory disease (4.1 million deaths) and diabetes (2.0 million deaths), collectively killed about 33.3 million people in 2019, a 28% increase compared to 2000.

The increase in absolute numbers of deaths and DALYs due to NCDs was mainly driven by the ageing and growth of population. At an individual level, however, the risk of dying from NCDs has been declining globally overall, showing progress over the last two decades.

Globally, the biggest declines in NCD deaths between 2000 and 2019 were for chronic respiratory diseases (a 37% drop in age-standardized rates for all ages combined), followed by cardiovascular diseases (27%) and cancer (16%). Deaths due to diabetes, however, increased slightly (by 3% in that same period).

Consequently, a 30-year-old person in 2019 had a 17.8% chance of dying from one of the four major NCDs before they reach the age of 70. This is a 22% improvement globally in relative terms and represents progress in all regions since 2000.

On a regional level, the probability of dying prematurely from one of the four major NCDs is highest in WHO Eastern Mediterranean Region (24.5%) and lowest in the Region of the Americas (14.0%). Improvements ranged from roughly a 13% reduction in probability of premature death in the South-East Asia and Eastern Mediterranean regions to a more than 25% reduction in the Western Pacific (27%) and European (31%) regions.

However, progress has slowed since the beginning of the SDG era in 2015. If the annual rate of reduction (ARR) in premature mortality from the major NCDs continues, none of the WHO regions will achieve the SDG target of one third reduction by 2030.

Without faster progress, no regions will achieve the SDG target for NCD mortality by 2030 – and half still won’t by 2048

Note: Major NCDs are cardiovascular disease, cancer, chronic respiratory disease and diabetes.
Source: WHO World Health Statistics 2023.

The global target will be missed unless progress can be considerably accelerated. And acceleration in reducing exposure to underlying NCD risk factors and improving treatment will be fundamental to meeting the target.

Progress has been made in addressing many of the risk factors. However, the pace of this progress is overall inadequate and unequal across populations. Globally, the age-standardized prevalence of current tobacco use among persons aged 15 years or older has declined by over 30% since 2000. And age-standardized prevalence of hypertension among adults aged 30–79 years has been rising since 1990 before peaking around 2009 followed by a recent decline.

Yet the age-standardized prevalence rates remained unacceptably high, with over 20% for current tobacco use in 2020 and 33% for hypertension in 2019. More alarmingly, the age-standardized prevalence of obesity among adults aged 18 years or older has been rising since the 1970s. In 2016, 13% of adults globally were obese.

Additionally, almost the entire global population (99%) breathes unhealthy levels of fine particulate matter and nitrogen dioxide. In 2019, an estimated 6.7 million deaths globally were attributed to the joint effects of ambient and household air pollution.

Significant further improvement is also imperative for other preventive, diagnostic and treatment services for NCDs through UHC. Nearly one half of the global population with hypertension were not diagnosed in 2019 and only around one fifth of those with hypertension were receiving effective treatment, despite the substantial increase in hypertension diagnostic, treatment and control rates since 2000.

Additionally, only 20% of countries were reported to have early detection programmes for childhood cancers at the primary health care level, while 38% had programmes for colon cancer, 59% for breast cancer and 62% for cervical cancer.

An indispensable way to prevent and control NCDs is to focus on lowering the associated risk factors. Low-cost solutions exist for governments and other stakeholders to reduce the common modifiable risk factors. A comprehensive approach is needed to require all sectors – health, finance, transport, education, agriculture, trade and others – to work together towards a common goal.

It is equally critical to invest in better management of NCDs, including in the detection, screening and treatment of these diseases, as well as access to palliative care for people in need. High-impact essential NCD interventions can be delivered through a primary health care approach in order to strengthen early detection and timely treatment.

The average life expectancy of a human born in 1950 was just 46.5 years. But by 2019, it had increased to 73 years. According to the United Nations projection, by WHO’s 100th anniversary in 2048, global life expectancy at birth is projected to reach 77 years – an increase of more than 30 years since WHO was established.

This remarkable progress in human longevity reflects the rapid epidemiological transition that has taken place during the last century. This global transition is characterized by the shifting burden of diseases – from high child mortality and deaths from infectious diseases to high prevalence of chronic non-communicable diseases (NCDs).

In 2000, 61% of global deaths were due to NCDs. Another 31% were deaths from communicable, maternal, perinatal and nutritional conditions (which we’ll refer to as the communicable group).

By 2019, global deaths from NCDs had increased to 74%, while the communicable group had fallen to 18%. A rise and fall of nearly equal proportions. Deaths attributed to injuries remained roughly constant at around 8%. This broad trend has been observed across all regions.

As a result of population growth and ageing, the total number of annual deaths will grow dramatically in the decades ahead.

According to the projections by the UN, the total annual global deaths will reach nearly 90 million in 2048. WHO projects that 77 million will be NCD deaths, representing a 90% increase in the NCD death toll from 2019.

On a regional level, the relative increase in NCD deaths between 2019 and 2048 will range from under 30% in the European Region to over 210% in the African Region. NCDs will take their greatest toll in Western Pacific, where nearly 21 million NCD deaths are projected annually by 2048.

By 2048, NCDs are projected to cause the vast majority of global deaths

Note: Communicable category includes communicable, maternal, perinatal and nutritional conditions. Percentages may not add up to 100% due to rounding.
Source: WHO World Health Statistics 2023.

Despite the expected decline in NCD mortality rates in many parts of the world, the mortality burden of NCDs remains a daunting challenge and a significant priority in the global mission to create longer healthier lives for all.

Counting lives lost often requires different measures of mortality. Excess mortality is the difference in the total number of deaths in a crisis compared to those expected under normal conditions.

This measure of mortality came into sharp focus during the pandemic, when reported deaths due to COVID-19 generally underestimated its true toll on human mortality.

WHO’s updated estimates of excess mortality show that, globally, 14.9 million excess deaths could be attributed to the COVID-19 pandemic by the end of 2021. And that the pandemic disproportionately affected the age group of 45 years and above.

Excess deaths in the age group of 45 years and above account for about 95% of all excess deaths globally: 31% between 45 and 64 years, 46% between 65 and 84 years, and 18% for 85 years and above. Globally, age-specific excess mortality rates among men are consistently higher than among females.

Excess mortality provides a unique lens through which to evaluate the toll of the pandemic. However it does not comprehensively account for the impact of each death due to the pandemic on a wide range of social and economic issues.

Years of Life Lost (YLL) provides additional insight into the pandemic’s impact as it accounts not only for the number of deaths and the age at which death occurs, but also for the associated loss of a potential number of life-years.

YLL estimates show that a total of 336.8 million life-years have been lost globally due to COVID-19. And YLL is the highest globally in ages 55-64 years old, with a total of over 90 million years of life lost.

Total years of life lost due to COVID-19 by age-group

Source: WHO World Health Statistics 2023.

Although the age groups beyond 65 years collectively accounted for 64% of the global excess deaths, YLL due to excess mortality accounted for less than half of the global YLL at 43%.

Conversely, YLL in ages younger than 45 years accounted for 10% of the global YLL, even though excess deaths in the same age group accounted for only 5% of the global total.

On a regional level, the Region of the Americas (21%), European Region (17%) and South-East Asia Region (44%) each accounted for over 10% of the global YLL due to excess mortality.