A comprehensive new analysis conducted by researchers at Imperial College London reveals a complex global landscape in the battle against chronic diseases, underscoring a significant slowdown in mortality reductions worldwide. This study, which spans data from 185 countries over the decade preceding the COVID-19 pandemic (2010-2019), highlights that while four out of five countries made progress in lowering death rates linked to chronic illnesses such as cancer, cardiovascular disease, and stroke, the pace of improvement has markedly decelerated compared to the previous decade. This deceleration signals an urgent need for renewed commitment and innovative public health strategies.
The study meticulously tracked cause-specific mortality, drawing on diverse and highly variable datasets from multiple regions, some with limited death registration completeness. Despite these challenges, the researchers established benchmarks for national performance by comparing each country’s recent trends not only to their historical data but also to regional peers. These comparative assessments reveal stark disparities: some nations continue to achieve substantial health gains, whereas others face stagnation or even reversal, highlighting the uneven trajectory of global health progress.
Central to the decline in chronic disease mortality is the impressive reduction in cardiovascular deaths, encompassing heart attacks and strokes. These improvements have been powered by widespread adoption of evidence-based interventions, including tobacco control policies, improved management of hypertension and diabetes, and enhanced acute care. However, offsetting these gains are rising mortality rates from neuropsychiatric disorders such as dementia and alcohol use disorder, alongside increases in cancers like those of the pancreas and liver. These opposing trends reflect complex epidemiological transitions and create formidable public health challenges.
A striking feature of the research is the divergent performance among high-income industrialized countries. East Asian nations, particularly South Korea and Singapore, demonstrated some of the greatest reductions in chronic disease mortality, showcasing successful integration of prevention, early detection, and treatment programs. South Korea, for instance, achieved the lowest mortality risk globally for females and ranked highly for males, with sustained declines across age groups and disease types. Conversely, the United States and Germany lagged substantially, with the U.S. showing the smallest mortality decline and concerning stagnation especially among younger adults. These disparities underscore differences in healthcare access, policy implementation, and socioeconomic factors.
The situation in Central and Eastern Europe contrasts with Western trends, with countries like Moldova and Russia registering notable mortality reductions primarily driven by declining cardiovascular deaths and effective alcohol control initiatives. These findings suggest that targeted public health policies can yield rapid dividends, even in regions historically burdened by high chronic disease mortality. However, vigilance is warranted, as variability in data quality and regional socio-economic dynamics may influence these patterns.
In Latin America and the Caribbean, the report reveals a complex mosaic. Chile stands out as a regional exemplar, achieving accelerated reductions in mortality from stroke, respiratory diseases, and diabetes, thus lowering chronic disease risk to levels comparable with advanced economies. In contrast, other countries including Jamaica and Antigua and Barbuda witnessed either deceleration or reversal in mortality declines, with deterioration largely linked to cardiovascular and renal diseases. Such heterogeneity speaks to divergent health system performance and varying degrees of policy enactment across the region.
India and China, home to a substantial proportion of the global population, present contrasting narratives. In India, the probability of premature chronic disease death has actually increased, with women facing a disproportionately higher risk. This uptrend is reinforced by rising incidence of heart disease and diabetes, emphasizing the urgent need for scalable interventions. China, meanwhile, continues to reduce chronic disease mortality robustly, mirroring progress achieved by neighboring East Asian nations. Notably, China recorded significant declines in chronic obstructive pulmonary disease deaths, an achievement attributed to improved air quality controls and rigorous tobacco policies.
A key revelation from the study is the widespread slowdown in progress. Approximately 60% of countries registered slower declines or outright reversals in chronic disease mortality compared to the early 2000s. This phenomenon is apparent across nearly all high-income nations, where initial rapid declines in the millennium’s first decades have plateaued. Factors implicated in this deceleration include plateauing coverage of preventive medications, stagnation in cancer screening expansion, and systemic gaps in equitable healthcare access, particularly for working-age adults who have shown alarming increases in mortality in some countries.
Stratification of mortality trends by age reveals that reductions in deaths among both working-age (under 65) and older adults (65-80) critically shape national performance. Countries like Finland and Norway, despite slower declines in older adults, balanced this with accelerated progress among younger cohorts, thereby limiting overall stagnation. Conversely, countries such as the USA exhibited troubling patterns of worsening mortality in younger populations, compounding challenges and driving poor aggregate outcomes.
Methodologically, the research navigated substantial data limitations, notably the incompleteness and variability of death registration systems, especially in low-income countries and Pacific Island nations. These data constraints necessitate cautious interpretation of trends, particularly in regions with scarce or low-quality mortality data. Additionally, year-on-year fluctuations in mortality statistics, exacerbated in countries with smaller populations, could influence short-term perceptions of progress or decline.
The study’s implications are profound. The initial global successes derived from aggressive tobacco control, early detection via screening, and broad deployment of preventative medications risk being undermined as momentum falters. To rejuvenate progress, the authors advocate for renewed investments in health services that target both prevention and management of chronic diseases, emphasizing evidence-based policy interventions proven effective across diverse socioeconomic contexts. Moreover, addressing social determinants of health and ensuring equitable access remain paramount.
Looking ahead, the report’s findings come at a critical juncture as world leaders convene at the United Nations General Assembly and the forthcoming Fourth High Level Meeting on Non-Communicable Diseases. This gathering aims to galvanize international cooperation and accelerate policy implementation in light of the study’s sobering revelations. The urgency expressed by global health experts underscores that chronic disease mortality, while declining overall, demands sustained and innovative strategies to prevent resurgence and ensure healthy longevity worldwide.
Imperial College London’s research team, led by Professor Majid Ezzati and supported by the UK Medical Research Council and National Institute for Health and Care Research, among others, underscores a complex interplay of successes and setbacks across the globe. This comprehensive data-driven analysis not only benchmarks country-level performance but also serves as a clarion call for reinvigorated global public health efforts to sustain and amplify gains against chronic disease mortality.
Subject of Research: Global trends and country-level analyses in chronic disease mortality reduction from 2010 to 2019.
Article Title: Benchmarking progress in non-communicable diseases: a global analysis of cause-specific mortality from 2001 to 2019.
News Publication Date: Embargo held until 10th September 2025.
Web References: Links to embargoed and post-embargo scientific publication hosted on The Lancet’s platform.
References: Bennett, J., O’Driscoll, O., Stevens, G., et al. “Benchmarking progress in non-communicable diseases: a global analysis of cause-specific mortality from 2001 to 2019”. The Lancet. DOI: 10.1016/S0140-6736(25)01388-1.
Keywords: Chronic diseases, non-communicable diseases, mortality trends, cardiovascular disease, cancer, global health, epidemiology, public health policy, health disparities, screening programs, preventative medicine, international health.
