2025 Global Health Report: Big Gains, Fragile Systems
Geneva: By the end of 2025, 1.4 billion people were living healthier lives than they would have just a few years earlier — breathing cleaner air, drinking safer water, smoking less, and facing lower risks from infectious diseases that once defined global health failure. The figure, drawn from WHO’s World Health Statistics 2025, is not a projection or an aspiration; it is a count of lives already changed. Yet it also captures the fragile balance global health found itself in this year: unprecedented gains achieved at a moment when funding cuts, conflict, climate shocks and political fragmentation were threatening to undo decades of progress.
The improvements were not evenly distributed, nor were they inevitable. They were the product of sustained vaccination drives, disease elimination campaigns, policy shifts on tobacco and air pollution, and emergency responses that often had to be launched within days, sometimes hours. At the same time, WHO warned that progress slowed or stalled where primary health systems were underfunded, where wars disrupted care, and where misinformation weakened trust in science.
Some of the most concrete wins of 2025 came in disease elimination. The Maldives became the first country in the world to achieve “triple elimination” of mother-to-child transmission of HIV, syphilis and hepatitis B, while Brazil eliminated mother-to-child HIV transmission, making it the most populous country in the Americas to do so. These milestones depended on reliable antenatal care, testing, treatment access and follow-up — conditions that remain absent in many low-income and conflict-affected settings, explaining why similar successes have not yet been replicated globally.
Neglected tropical diseases, long a marker of health inequity, also continued their retreat. Burundi, Egypt and Fiji eliminated trachoma; Guinea and Kenya eliminated sleeping sickness; and Niger became the first African country to eliminate river blindness. WHO’s latest data show that since 2010, the number of people needing treatment for neglected tropical diseases has fallen by 32%, with 867 million people treated in 2023 alone. But these gains rest heavily on mass drug administration and surveillance systems that are highly vulnerable to funding interruptions — a risk that grew more acute in 2025.
Tuberculosis illustrated both progress and peril. Deaths fell sharply over the past decade, declining by 46% in Africa and 49% in Europe, yet TB still killed 1.2 million people in 2024. WHO stressed that medical tools alone are not enough: TB continues to thrive where HIV, diabetes, smoking and undernutrition go untreated, and where health systems cannot sustain long-term care.
Malaria control advanced on multiple fronts. Georgia, Suriname and Timor-Leste were certified malaria-free, while seven additional African countries introduced malaria vaccines in 2025, bringing the total to 24 countries and more than 10 million children reached each year. New tools — including dual-ingredient insecticide-treated nets and WHO-recommended vaccines — helped prevent an estimated 170 million malaria cases and one million deaths in 2024. Yet WHO cautioned that climate change is reshaping malaria risk, pushing the disease into areas previously considered safe.
Vaccination more broadly remained one of global health’s most powerful tools — and one of its most fragile. Measles deaths fell by 88% between 2000 and 2024, and nearly 59 million lives have been saved since 2000 through measles vaccination. At the same time, measles cases surged, with an estimated 11 million infections in 2024, nearly 800 000 more than before the COVID-19 pandemic. WHO explained the contradiction plainly: high coverage saves lives, but even small gaps allow outbreaks. At least 95% coverage with two doses is needed to stop transmission, a threshold many countries failed to reach.
While 89% of infants globally received at least one dose of the diphtheria-tetanus-polio vaccine, 20 million children missed essential vaccines in 2024, largely due to conflict, supply disruptions and rising vaccine misinformation. HPV vaccination offered a counter-example of what scale-up can achieve. On World Cervical Cancer Elimination Day in November, WHO announced that 86 million girls had been vaccinated against HPV, with countries including Bhutan, Brazil, China, Indonesia, Nigeria, Pakistan, Rwanda and Tajikistan expanding vaccination and screening in 2025.
Behind these disease-specific outcomes lay broader changes in how people lived and worked. WHO data showed that reductions in tobacco use, improvements in air quality, and better access to water and sanitation were central to the 1.4 billion-person health gain. HIV and tuberculosis rates fell, and fewer people required treatment for neglected diseases. But WHO also warned that essential health-service coverage and emergency protection lagged behind targets, while maternal and child deaths were declining too slowly. Underinvestment in primary health care — especially immunisation and safe childbirth — was cited as a central reason.
Those weaknesses were amplified by funding cuts in 2025 that disrupted maternal care, vaccination programmes, HIV prevention and disease surveillance. A study published in March warned that such cuts could lead to 4–10 million new HIV infections and three million deaths by 2030. Even so, the WHO approved twice-yearly injectable lenacapavir for HIV treatment and prevention and supported countries in shifting toward local production of medicines and diagnostics, as well as low-cost HIV testing.
Health financing trends showed gradual improvement but persistent inequity. Since 2000, most countries expanded health-service coverage and reduced financial hardship, with the share of people facing catastrophic out-of-pocket health costs falling from 34% to 26% by 2022. Still, 1.6 billion people remain impoverished or pushed deeper into poverty by health expenses, prompting the WHO to call for free essential health care for vulnerable populations and higher public investment in health systems. At the same time, WHO warned of a looming shortfall of 11.1 million health workers by 2030, despite global nursing numbers approaching 30 million.
The year also marked a turning point for noncommunicable diseases and mental health. At the UN General Assembly, world leaders adopted the strongest political declaration yet on NCDs and mental health, committing to fast-track targets for 2030: 150 million fewer tobacco users, 150 million more people with controlled hypertension, and 150 million more with access to mental-health care. WHO recognised Austria, Norway, Oman and Singapore for eliminating industrial trans fats, while nearly 60 countries now have best-practice trans-fat policies covering half the world’s population. WHO also issued its first recommendations on GLP-1 therapies for obesity, as more than one billion people worldwide live with the condition.
Tobacco control showed long-term impact — more than 120 million people quit tobacco since 2010 — but WHO warned that aggressive marketing of e-cigarettes to young people risks reversing those gains. The WHO Framework Convention on Tobacco Control marked its 20th anniversary, now covering over 90% of the global population.
Mental health remained a defining challenge. More than one billion people live with mental-health conditions, suicide remains a leading cause of death among young people, and one in five people in emergencies experiences a mental-health condition. WHO supported mental-health care in more than 40 emergencies in 2025 and reported that 71% of countries now have coordinated mechanisms to deliver psychosocial support during crises.
Science and preparedness shaped the year’s most consequential political development: the adoption of the world’s first Pandemic Agreement at the World Health Assembly in May, alongside amendments to the International Health Regulations. The agreement aims to ensure fairer access to vaccines, medicines and diagnostics, and to strengthen global cooperation when the next pandemic emerges. WHO Director-General Tedros Adhanom Ghebreyesus described it as the clearest demonstration yet of what multilateralism can deliver.
That framework was tested repeatedly. WHO assessed 1.2 million health-threat signals in 2025, verified around 500 threats, and worked with countries to respond to 450 events. Outbreak responses ranged from the fastest-ever launch of a clinical vaccine trial during a Sudan virus outbreak in Uganda, to the containment of an Ebola outbreak in the Democratic Republic of the Congo within six weeks, aided by rapid deployment of experts, supplies and vaccination of more than 47 000 people.
Cholera underscored the cost of inaction on water, sanitation and conflict. More than half a million people were infected across 32 countries in 2025, with over 7 000 deaths from a disease that WHO stressed is both preventable and treatable. Through global stockpiles, more than 61 million vaccine doses were approved for emergency response to cholera, Ebola, yellow fever and meningitis.
Humanitarian crises defined much of the WHO’s operational work. The organisation responded to 48 emergencies across 79 countries and territories, delivering medicines, supporting hospitals, restoring immunization and maintaining care in places where health systems were under direct attack. By mid-December, 1 283 attacks on health care had been recorded, killing 1 980 people and injuring 1 163 others. In Gaza alone, the WHO delivered over 2 500 metric tons of medical supplies, coordinated millions of consultations, supported thousands of medical evacuations and worked to restore partially functional hospitals amid ongoing insecurity.
As 2025 closed, WHO framed the year not as a victory lap but as a warning. The fact that 1.4 billion people are healthier today proves what coordinated public health action can achieve. The fact that those gains remain vulnerable shows how quickly they could be lost. With the Pandemic Agreement’s next phase due in 2026, WHO argued that the choice ahead is no longer about whether global cooperation works, but whether the world is willing to sustain it before the next crisis forces the question again.
– global bihari bureau
