Post-Covid All's Not ‘HALE’ & Hearty: UN

Data in the latest edition of the WHO's World Health Statistics makes for grim reading. The numbers indicate that post-COVID-19 life expectancy and healthy life expectancy (HALE) at birth are not rising steadily as before. In fact, the pandemic has apparently this trend. 

In just two years, the pandemic erased close to ten years of progress in improving life expectancy. Between 2019 and 2021, global life expectancy went back to the 2012 level of 71.4 years, dropping by 1.8 years. Similarly, global healthy life expectancy receded by 1.5 years to 61.9 years in 2021.

The 2024 report also highlights how the effects have been felt unequally across the world. The WHO regions for the Americas and Southeast Asia were hit hardest, with life expectancy dropping by approximately 3 years and healthy life expectancy by 2.5 years between 2019 and 2021. In contrast, the Western Pacific Region was minimally affected during the first two years of the pandemic, with losses of less than 0.1 years in life expectancy and 0.2 years in healthy life expectancy.

“There continues to be major progress in global health, with billions of people who are enjoying better health, better access to services, and better protection from health emergencies,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “But we must remember how fragile progress can be. In just two years, the COVID-19 pandemic erased a decade of gains in life expectancy. That's why the new Pandemic Agreement is so important: not only to strengthen global health security but to protect long-term investments in health and promote equity within and between countries.”

COVID-19 rapidly emerged as a leading cause of death, ranking as the third highest cause of mortality globally in 2020 and the second in 2021. Nearly 13 million lives were lost during this period. The latest estimates reveal that except in the African and Western Pacific regions, COVID-19 was among the top five causes of death, notably becoming the leading cause of death in the Americas for both years.

The WHO report highlights those non-communicable conditions, among them stroke, ischemic heart disease, cancers, chronic obstructive pulmonary disease, Alzheimer's disease and other dementias, and diabetes, were the biggest killers before the pandemic, responsible for 74 percent of all deaths in 2019. Even during the pandemic, NCDs continued to account for 78 percent of non-COVID deaths.

The coexistence of undernutrition with overweight and obesity confronts the world with a complex challenge. In 2022, over one billion people aged five years and older were living with obesity, while more than half a billion were underweight. Malnutrition in children was also striking, with 148 million children under five years old affected by stunting (too short for age), 45 million suffering from wasting (too thin for height), and 37 million overweight.

The report further highlights the significant health challenges faced by persons with disabilities, refugees and migrants. In 2021, about 1.3 billion people, or 16 percent of the global population, had a disability. This group is disproportionately affected by health inequities resulting from avoidable, unjust and unfair conditions.

Access to healthcare for refugees and migrants remains limited, with only half of the 84 countries surveyed between 2018 and 2021 providing government-funded health services to these groups at levels comparable to their citizens. This highlights the urgent need for health systems to adapt and address the persisting inequities and changing demographic needs of global populations.

Despite setbacks caused by the pandemic, the world has made some progress towards achieving the Triple Billion targets and health-related indicators of the Sustainable Development Goals (SDGs).

Since 2018, an additional 1.5 billion people have achieved better health and well-being. Parallely, rising obesity, high tobacco use, and persistent air pollution continue to hinder progress.

Universal Health Coverage expanded to 585 million more people, falling short of the goal of one billion. Additionally, only 777 million more people are likely to be adequately protected during health emergencies by 2025, falling short of the one billion targets set in WHO’s 13th General Programme of Work. This protection is increasingly important as the effects of climate change and other global crises increasingly threaten health security.