The health of nations: Stronger health, stronger economies

At a glance

• The world faces a choice: By 2050, the average person could spend three more years in poor health than in 2000 or gain nearly a decade of healthy life if society scales access to proven, cost-effective interventions.
• Nearly two-thirds of this impact would come from preventive interventions. Today, most countries spend less than 2 percent of their health budgets on prevention.
• Scaling proven interventions could create $12.5 trillion in annual economic value by 2050, equal to about 7 percent of global GDP, with an estimated fourfold return on investment.

Public health advances over the past century have driven remarkable gains in human longevity. Global life expectancy has risen sharply due to breakthroughs in communicable disease control, maternal and child health, and widespread adoption of interventions such as vaccination, antibiotics, improved sanitation, and primary care. By 2050, an individual is expected to live to 78 years, on average, an 11-year increase over the prior 50 years. Yet, longer lifespans do not necessarily translate into healthier lives. Although people are living longer, they are also spending more of those years in poor health. The average time lived with illness has increased from about 8.7 years in 2000 to 10.2 years in 2025 and is projected to reach 11.4 years by 2050. The demographic shift toward older populations, combined with a rising prevalence of noncommunicable diseases (NCDs) such as cardiovascular disease, diabetes, cancer, and mental health conditions, means more people will be managing chronic illnesses for longer.

The combination of aging populations and increasing chronic disease prevalence is straining economies and health systems worldwide. As highlighted in the 2025 McKinsey Global Institute report, “Dependency and depopulation? Confronting the consequences of a new demographic reality,” the demographic shift toward more older individuals and fewer working-age people is poised to slow the growth of total hours worked, ultimately dampening GDP per capita growth if left unaddressed.¹“Dependency and depopulation? Confronting the consequences of a new demographic reality,” McKinsey Global Institute, January 15, 2025.

At the same time, fiscal pressures are deepening the challenge. Healthcare budgets in many countries are being squeezed by competing demands, including rising defense expenditures, higher debt-servicing costs, and declining development aid. Debt servicing now exceeds healthcare spending in almost 62 countries, limiting their capacity to invest in health systems and preventive care.²“Lost decade looms for debt‑ridden developing countries: UNCTAD,” UN News, April 12, 2023. In 2024, official developmental assistance fell by 9 percent,³“Cuts in official development assistance: OECD projections for 2025 and the near term,”OECD Policy Briefs, 2025, Number 26. and preliminary estimates suggest that 2025 levels were the lowest in more than 15 years.⁴Financing global health 2025: Cuts in aid and future outlook, Institute for Health Metrics and Evaluation, July 31, 2025. While some middle-income countries may offset these gaps with domestic resources, many low-income nations, particularly in sub-Saharan Africa, lack the fiscal space to do so. Hard-won gains in communicable disease control are therefore at risk of reversal.

This trajectory is not inevitable. By scaling timely access to proven cost-effective health interventions, societies can “bend the curve” of the burden of disease, averting 35 percent of the total burden in 2050, avoiding 33 million premature deaths, and more than 461 million years of poor health (see sidebar “Definitions”). This translates into roughly 18 additional healthy days per person each year. Nearly two-thirds of this impact would come from prevention, yet countries allocate, on average, less than 2 percent of health spending to preventive care. Regardless of the country, those additional days offer benefits beyond productive work: it’s additional time with friends and family, to pursue accomplishments, build a community, or simply live without cognitive or physical impairment.

The economic case for investing in health is equally compelling. Improving access to proven, cost-effective interventions could boost global GDP by an additional $12.5 trillion annually by 2050, equivalent to about 7 percent of global output, yielding a global economic return on investment of about four to one.

Why isn’t this happening already? Persistent barriers such as short-termism, siloed systems, and institutional inertia make it more challenging to prioritize the actions and investments needed for health. However, three actions can help overcome these barriers to make this healthier future a reality. Funders can align incentives to reward long-term investment in prevention. Stakeholders beyond healthcare, both in the public and private sectors, can play a role in unleashing multisectoral action to propel progress in health and beyond. And health systems can generate more health per dollar by pairing investment with better cost management. By doing this, health could become a powerful driver of both societal and economic progress.

Over the past 25 years, the global demographic landscape has experienced profound changes, characterized by aging populations, rapid urbanization, and evolving lifestyle patterns. These demographic shifts have been closely linked to a transition in the global disease burden, with a decline in infectious diseases such as HIV/AIDS, tuberculosis, and malaria, and a concurrent rise in NCDs such as cardiovascular diseases, diabetes, mental disorders, and cancers. This section explores the key demographic and disease burden transitions, the underlying drivers of these changes, and their implications for health systems, economies, and societies worldwide.

Demographic shifts, 2000–50

In addition to national demographic shifts, population distribution within countries is also changing. Rapid urbanization and increased mobility have transformed where and how people live. More than 55 percent of the global population resides in urban areas, with that share projected to rise to 68 percent by 2050.⁶Sustainable Development Goals, “68% of the world population projected to live in urban areas by 2050, says UN,” United Nations, May 16, 2018. This urban growth is altering patterns of disease exposure, placing increasing strain on infrastructure and services, and reshaping both the public health landscape and broader economic systems. This shift also presents an opportunity to design healthy cities that can provide rapid access to high-quality services with economies of scale and create built environments that promote and support healthy behaviors and choices. At the same time, many rural areas face contrasting challenges—such as population decline, limited access to healthcare and digital infrastructure, and shortages of skilled health workers—which risk deepening health inequities between urban and rural populations.

Disease burden shifts, 2000–50

What the growing disease burden means for global health

The world’s population is projected to grow from 8.1 billion in 2025 to 9.3 billion by 2050, and with more people comes a higher absolute burden of disease. But population growth is only part of the story. The world is also aging rapidly: The number of people over 65, the group that already accounts for the majority of healthcare spending, will nearly double from 862.0 million to 1.6 billion.

This demographic shift will sharply increase the prevalence of NCDs such as cardiovascular disease, cancer, and neurological disorders. Between 2025 and 2050, the total global disease burden is expected to rise by 19 percent, driven largely by years lived in poor health. While population growth will contribute to the overall increase in disease burden, a per capita perspective reveals a key turning point: Global disease burden per capita declined by approximately 24 percent over the past 25 years but is projected to increase by about 4 percent over the next 25 years, marking a shift in recent health gain trends.

To put this into perspective, by 2050, the world will face an additional 500 million DALYs, the equivalent of adding 1.5 billion people’s worth of healthcare demand, while the actual population rises by only 1.2 billion. The difference, 334 million people’s worth of demand, is like adding the entire healthcare demand of another United States.

Unsurprisingly, this rising burden will translate into soaring costs. Global healthcare spending is projected to climb from $11.2 trillion today to $20.5 trillion in 2050, rising from 10 percent to 11 percent of global GDP.¹³Financing Global Health: Explore patterns of global health financing, Institute for Health Metrics and Evaluation, 2025. That additional $10 trillion is almost double the size of today’s entire global tech industry.¹⁴Michael O’Grady et al., Global tech market forecast, 2024 to 2029,Forrester Research, February 11, 2025.

At the same time, the economic toll of poor health will deepen. Lost productivity and reduced labor force participation are expected to increase from 17 percent to 23 percent of global GDP. This double bind—higher costs and a shrinking workforce to pay them—poses a major threat to economic growth.

Against this backdrop, investing in health is not just a moral action. It is an economic necessity.

To evaluate the transformative potential of health investments, McKinsey Health Institute (MHI) examined approximately 300 known, evidence-based, cost-effective interventions drawn from systematic reviews and clinical practice guidelines. These interventions span across 90 diseases and 27 risk factors, encompassing about 85 percent of the global disease burden. These interventions represent the achievable impact based on today’s evidence, prior to any additional benefits from future innovations. Using this robust foundation, the incremental health impacts of scaling access to these proven interventions to an aspirational best-practice adoption level were modeled for each country (see sidebars “Methodology” and “Intervention adoption assumptions”).

Our analysis shows that by 2050, scaling these interventions globally could reduce total disease burden by 35 percent, preventing 33 million premature deaths and averting more than 461 million years lived with disability annually. This represents a significant bending of the global disease burden curve, decreasing premature mortality and enhancing quality of life across diverse populations.

The impact of scaling proven health interventions varies across income groups, reflecting differences in disease burden mix and gaps between current and aspirational best-practice intervention adoption rates, resulting in a health impact of 33 percent among higher-income countries and 38 percent among lower-income countries.¹⁵Higher-income countries include high- and upper-middle-income countries, and lower-income countries include lower-middle and low-income countries, as per the World Bank’s country income classification.

While this analysis considers the impact of sustained investments over decades, it is important to recognize that some health interventions can yield benefits far more quickly. For example, universal access to safe drinking water could save an estimated three million lives every year, and light physical exercise can lower the risk of a repeat cardiac event by 50 percent within a year, illustrating how targeted health investments can deliver immediate and profound health benefits.¹⁶Jonathan Atteberry, “What if everyone had access to clean water?,” HowStuffWorks, April 16, 2024; “Even a little daily activity may lower heart, death risks for heart attack survivors,” American Heart Association, May 19, 2025.

Health impact, by condition

The impact of scaling proven health interventions differs across condition groups, shaped by disease burden, treatment availability, efficacy, and the gap between current practice and best-practice standards. Tackling metabolic and behavioral risks, combined with new medications, presents the strongest opportunities to reduce the growing NCD burden. Within NCDs, chronic respiratory diseases, mental disorders, and cardiovascular conditions offer the greatest potential for impact (see sidebars “Metabolic health deep dive” and “Brain health deep dive”). Among communicable diseases, maternal and neonatal disorders, enteric infections, and nutritional deficiencies represent the areas of highest impact, particularly in low-income settings.

Despite advances in medical innovation, many interventions only partially mitigate conditions—by slowing progression (for example, diabetes management) or reducing onset risk (for example, hypertension control)—rather than offering cures. This leaves meaningful scope for breakthrough innovations and new treatments in areas such as neurodegenerative diseases, cancers with poor survival rates, advanced cardiovascular disease, and rare genetic or autoimmune disorders, where effective disease-modifying therapies remain limited.

Designing scalable impact: Intervention types and delivery settings

Realizing the full potential of scaling proven health interventions requires thoughtful consideration of the types of interventions, the settings in which they are delivered, and the key enablers that ensure effective and sustained scale-up.

Types of interventions

Health interventions can be broadly categorized into three types:

• Population-level prevention focuses on reducing health-related risks through broad measures that shape the physical and social environment or influence community behaviors, often through policy and regulation changes (for example, air quality controls, tobacco controls).
• Individual-level prevention and proactive care targets personal behavior change and health risk management at the individual level and is often delivered in clinical settings (for example, vaccines, smoking cessation support).
• Therapeutic interventions address health conditions after they have developed and aim to manage existing diseases (for example, cancer therapies, psychiatric medications).

Prevention is a central pillar of overall health impact. Together, population-level and individual-level prevention strategies could propel 65 percent of the potential health impact. These prevention strategies are particularly effective because they can influence multiple health outcomes simultaneously. For example, tobacco control not only reduces the incidence of lung cancer but also lowers the risk of cardiovascular disease, chronic respiratory conditions, and several other cancers.¹⁷Smoking cessation: A report of the surgeon general – key findings, US Department of Health and Human Services, 2020. Similarly, vaccinations protect against a range of infectious diseases, often preventing outbreaks that could otherwise strain health systems. Improved nutrition supports immune function, reduces the risk of chronic diseases such as Type 2 diabetes and obesity, and promotes healthy development across the lifespan. Because of their broad, multifaceted benefits, most population-level prevention interventions tend to be highly cost-effective because they avoid disease altogether.

Individual behavioral and lifestyle choices also play a pivotal role in shaping health outcomes. Building healthy habits such as eating more fruits and vegetables, engaging in regular physical activity, and ensuring sufficient, high-quality sleep can substantially reduce the risk of chronic diseases, including cardiovascular conditions, diabetes, and certain cancers.¹⁸“Fact sheet: Healthy diet,” WHO, April 29, 2020; Michael R. Irwin, “Why sleep is important for health: A psychoneuroimmunology perspective,” Annual Review of Psychology, 2015, Volume 66. However, achieving widespread adoption of these healthy behaviors requires supportive, population-level interventions that make the healthy choice the easier choice. This analysis, therefore, focuses on evidence-based strategies that promote and facilitate healthier behaviors, such as front-of-package nutrition labeling or subsidies for healthy foods. Together with preventive care and screening initiatives within the healthcare system, these interventions form a strong foundation for improving health.

Therapeutic interventions contribute the remaining 35 percent of health gains. They are essential for treating established conditions and improving outcomes for individuals with advanced disease. While more reactive in nature, they play a critical role in enhancing the quality of life and extending survival as seen in patients receiving cancer treatments.

While both prevention and treatment are essential, scaling prevention presents the greatest opportunity for broad and sustainable improvements in health.

Intervention delivery settings

Understanding the types of care and the settings in which health interventions can be delivered is essential for designing systems that are both efficient and scalable, as well as for identifying the most effective implementation pathways.

About three-quarters of the total potential health impact could be achieved by appropriately scaling interventions delivered in primary care settings (for example, anti-hypertensives, maternal-nutrition strategies) and in specialty care settings (for example, early detection and management of cancers, surgeries, pharmacotherapy). Although some interventions can be delivered across multiple settings, nearly all these interventions are primarily delivered within formal health system settings, suggesting that expanded implementation within health systems could play a critical role in improving global health outcomes. This also indicates a clear opportunity for health systems to improve how care is delivered—boosting patient outcomes while keeping costs contained.

Public health interventions, such as tobacco controls and household stove swaps, could account for the remaining quarter of the total potential impact. An estimated 95 percent of this impact can be achieved outside the formal health sector—in settings such as schools, workplaces, community organizations, and through public policy measures. These nontraditional delivery channels can offer substantial opportunities to improve health by engaging with sectors not typically associated with healthcare delivery. Their relevance can be particularly pronounced in lower-income countries, where formal healthcare infrastructure is more limited and community-based interventions can have an outsize effect.¹⁹Iffat Nowrin et al., “Community-based interventions to prevent stroke in low and middle-income countries: A systemic review,” Health Sciences Review, 2023, Volume 9.

Realizing the full impact of scaled interventions depends as much on prevention and care delivery models as on the interventions themselves. Countries can reach similar health outcomes through distinct implementation models suited to their socio-economic realities, as illustrated by polio eradication efforts. India relied on intensive mass-vaccination campaigns, granular microplanning, and targeted community engagement to address scale, mobility, and mistrust.²⁰Roma Solomon, “Involvement of civil society in India’s Polio eradication program: Lessons learned,” American Journal of Tropical Medicine and Hygiene, October 2019, Volume 101. Egypt, by contrast, achieved elimination primarily through consistently high routine immunization embedded in its national health system, complemented by targeted campaigns and strong surveillance.²¹R. Bruce Alylward et al., “The eradication of poliomyelitis in Egypt: critical factors affecting progress to date,” Journal of Infectious Diseases, February 1997, Volume 175. This illustrates how adapting delivery models to the local context could be more effective for scaling than simply replicating solutions.

Scaling proven health interventions could substantially extend both lifespan and health span. By 2050, global life expectancy could rise by an average of six years, with some countries achieving even larger gains. More importantly, the average health-adjusted life expectancy, the years lived free from disabling illness, could increase an average by of nine years worldwide. These additional years of good health not only extend longevity but also enhance the quality of life throughout the entire lifespan, effectively “squaring the curve.”

Quality of life improvements are expected to be especially pronounced in low-income countries, where uptake and implementation of existing interventions are still expanding. In these settings, a healthy lifespan could increase by nearly 11 years, reflecting the opportunity to reduce both infectious and NCD burdens. Many conditions that are less common in higher-income settings, including infectious diseases such as malaria, HIV/AIDS, and diarrheal diseases, remain prevalent in many low-income countries. Scaling interventions in these areas can accelerate the closure of these gaps, delivering rapid and meaningful health gains while also laying the foundation for sustained progress against emerging health challenges. This dual burden presents a powerful case for targeted investment, which could yield substantial returns for both human well-being and economic growth.

Improved health is not only a social good but also a powerful engine for economic development. Research has demonstrated a strong and reciprocal relationship between better health outcomes and enhanced economic performance.²²Richard Horton et al., High‑level commission on health employment and economic growth: Final report of the expert group, WHO, September 3, 2016. This relationship is bidirectional: While economic growth can lead to better health outcomes through improved living conditions and health services,²³Xiao-Tong Niu, You-Cai Yang, and Yu-Cong Wang, “Does the economic growth improve public health? A cross‑regional heterogeneous study in China,” Frontiers in Public Health, 2021, Volume 9. health itself is a form of human capital that fuels economic development by enabling individuals to live longer, work more productively, and contribute more consistently to society.²⁴Health, economic growth and jobs, World Bank, April 17, 2025.

A healthier society leads to a more robust and resilient economy in many ways. To estimate the economic impact of better health, MHI focused its analysis on labor force effects, including enabling greater labor force participation and enhancing individual productivity, identifying six key levers through which better health drives economic gains.

Increased labor force participation involves the following:

• Fewer early deaths: Reducing premature mortality literally means a person stays alive for longer, allowing them to work, support their family, contribute to society, and live fuller lives.²⁵Angela Y. Chang et al., “The economic value of reducing avoidable mortality,”Nature Medicine, 2024, Volume 30, Number 11.
• Fewer health conditions: When chronic and acute diseases are prevented or effectively managed, people are more likely to be able to attend work consistently, reducing absenteeism. Enhanced health empowers them to participate more actively in economic activities, driving greater workforce efficiency and fostering sustained economic growth.²⁶Tam Vuong, Feifei Wei, and Claudia F. Beverly, “Absenteeism due to functional limitations caused by seven common chronic diseases in US workers,”Journal of Occupational and Environmental Medicine, 2015, Volume 57, Number 7.
• Expanded labor force participation from informal caregivers: In healthier populations, the need for informal caregiving, often provided by family members, significantly decreases.²⁷William E. Haley and Joanne Elayoubi, “Family caregiving as a global and lifespan public health issue,”Lancet Public Health, January 2024, Volume 9, Number 1. This reduction can give those caregivers—the majority of whom are women—more time, energy, and resources to pursue paid employment, education, or entrepreneurial activities. Beyond the economic benefits of an expanded labor force,²⁸Ingo W. K. Kolodziej, Arndt R. Reichert, and Hendrik Schmitz, “New evidence on employment effects of informal care provision in Europe,”Health Services Research, 2018, Volume 53, Number 4. this shift also yields important societal gains in promoting gender equity by alleviating the disproportionate caregiving burden on women and contributing to their economic empowerment.²⁹The impact of care responsibilities on women’s labour force participation, International Labour Organization, October 2024.

Enhanced productivity involves the following:

• Increased productivity from better health: Enhancing health has the potential to boost productivity by reducing presenteeism (reduced on-the-job performance due to illness) caused by chronic conditions such as musculoskeletal disorders (for example, osteoarthritis and lower-back pain) and mental disorders, including depressive and anxiety disorders, as well as substance use disorders.³⁰Lars Bernfort et al., “Supervisor ratings of productivity loss associated with presenteeism and sick leave due to musculoskeletal disorders and common mental disorders in Sweden,”WORK: A Journal of Prevention, Assessment & Rehabilitation, 2021, Volume 68, Number 4.
• Higher-future-earnings potential for children: Investments in early childhood health and nutrition and addressing adolescents’ mental health challenges can lead to better educational attainment, cognitive development, and social-emotional skills. These early advantages translate into higher employment rates and greater lifetime earnings.³¹Arindam Nandi et al., “The human capital and productivity benefits of early childhood nutritional interventions,” from Child and Adolescent Health and Development, International Bank for Reconstruction and Development and World Bank, November 2017.
• Enhanced productivity of informal caregivers: Improved health reduces caregiving burdens, enabling former caregivers to participate more fully and productively in the workforce, no longer constrained by the physical and emotional demands of care.³²Grant R. Martsolf et al., “Work performance among informal caregivers: A review of the literature,”Journal of Aging and Health, 2020, Volume 32, Number 9.

By quantitatively modeling the six economic levers linked to improved health, MHI estimates that enhancing global health could generate approximately 288 million additional full-time equivalent of work-years by 2050, more than twice the current United States’s labor force and equivalent a 4 percent increase in the current global labor force participation rate.³³“Full time employment,” Trading Economics, September 2025. This expansion in productive labor could add $12.5 trillion to global GDP, representing an increase of about 7 percent over baseline economic projections. Notably, the vast majority of this economic gain (about 85 percent) is driven by increased labor force participation.

Achieving this level of global health improvement would require substantial investment estimated at approximately $3.3 trillion annually by 2050, representing about 16 percent of projected global healthcare spending in 2050 ($20.5 trillion). While this represents a meaningful commitment, the returns are equally substantial. Not all current health spending delivers commensurate health gains, and reallocating resources toward more effective interventions could substantially increase economic impact. For every dollar invested, an estimated $4 in economic benefit is generated by scaling cost-effective interventions, reflecting a fourfold return on investment.

Higher-income countries account for a larger share of the absolute economic impact (82 percent) largely because they represent approximately 86 percent of global GDP. However, their economic ROI in health interventions is not disproportionately higher compared with other income groups. In fact, lower-middle-income countries are projected to achieve the highest return on investment, with an estimated sixfold return from implementing cost-effective health interventions. Low-income countries show the lowest return, at 1.9 times, which may reflect structural challenges such as limited health infrastructure and higher relative implementation costs. These factors can constrain the scalability and affordability of interventions, especially given the smaller economic base of these countries; however, targeted investments still present a significant opportunity for impactful health improvements and long-term economic growth.

The economic return on health investments is not uniform across all countries or interventions. Each country has a unique demographic, economic, and epidemiological profile that shapes which health challenges are most pressing and which solutions are most effective and affordable. For example, investing in newer obesity or chronic obstructive pulmonary disease medicines may generate substantial economic returns in high-income countries where health systems can absorb the high cost of these drugs. However, the same intervention may offer smaller economic returns in lower-income countries where the costs of such medications would be prohibitive.

It is important to note that this analysis is not intended to suggest that countries should avoid investing in interventions with lower economic returns. Many such interventions are essential for promoting equity and building long-term resilience, even if their immediate economic benefits are limited. Instead, the goal is to support evidence-based decision-making by offering a clearer understanding of the health and economic impacts of investments in health, enabling policymakers to allocate resources in ways that best address the diverse needs of their populations.

How to get started

Crucially, scaling cost-effective interventions does not require an all-or-nothing approach. By prioritizing a targeted set of high-impact actions, countries can capture a substantial share of the total economic and health benefits at a fraction of the total cost.

The WHO’s “Best Buys” provide a globally recognized set of interventions that are proven, cost-effective, and feasible across income levels. These include measures such as tobacco and alcohol taxation, hypertension control programs, salt and sugar reduction policies, vaccination campaigns, and early detection of noncommunicable diseases. Prioritizing these interventions can deliver 17 percent of the health benefits at a fraction of the cost ($242 billion or 7 percent) with a return of 6:1.

While the cost-effectiveness of interventions varies widely, our analysis highlights those that deliver the greatest impact per dollar spent, offering policymakers a practical framework to prioritize investments with the strongest combined health and economic returns in their national contexts.

Many of the most valuable health investments are both affordable and widely available, yet they do not currently reach all who could benefit from them. For instance, the routine use of antihypertensive medications prevents costly complications such as stroke and heart disease, resulting in substantial long-term savings. Fiscal policies that discourage harmful behaviors, such as tobacco and alcohol use, also demonstrate particularly high economic and social returns. Tobacco taxation, for example, has a return on investment of 35 to 1, generating immediate fiscal revenue while reducing disease burden and mortality associated with tobacco use. Similarly, alcohol taxation delivers an estimated eight-to-one return, curbing harmful consumption while strengthening fiscal capacity for reinvestment in prevention and treatment.

These examples demonstrate how well-designed health investments can be fiscally self-reinforcing, producing near-term fiscal gains alongside long-term improvements in productivity and well-being. In the face of constrained budgets and difficult choices, embedding such interventions within broader health and economic strategies can enable governments to pursue strong economic returns while advancing population well-being and accelerating progress toward better health, increased economic resilience, and sustained growth.

This research builds on and strengthens the growing body of evidence that makes a clear and urgent case for investing in health as a driver of social and economic progress. Yet action lags behind evidence. Resources are finite, and decision-makers face constant trade-offs between urgent demands and longer-term investments whose benefits may not be immediately visible. As a result, high-value interventions remain underused, and much of health’s potential for economic and social progress goes untapped.

But knowing what to do is only the first step. How to implement a high-value set of interventions is often the harder part—but also one that we have made progress against in the past decade. Stakeholders now have a far better understanding of what it takes to create scaled change in healthcare delivery, powered by advances in data and technology. These tools, alongside burgeoning use cases in AI, are beginning to transform how health systems target resources, predict outcomes, and scale what works, fueling new levels of efficiency and impact. At the same time, a growing base of proven case studies, new platforms for global collaboration, and more effective channels for sharing best practices are enabling faster learning cycles.

Translating this momentum into sustained progress requires changing some of the core structures of the healthcare system. Progress on implementing scaled change depends on a health workforce that is large enough and appropriately skilled, supported by care delivery platforms and tools that combine physical infrastructure, digital technology, and community-based models to reach people where they are. It also requires foundational capabilities such as supply chains, financing, and incentive structures, as well as data and information systems, to ensure providers have the medicines, facilities, and insights needed to act earlier and more effectively.

Against this backdrop, achieving better health for all will require three actions:

• aligning incentives to reward long-term investment in prevention
• unleashing multisectoral action to drive progress in health and beyond
• boosting efficiency of health spending to maximize outcomes

Together, these actions can help address the central challenge of our time: building health systems and societies that not only deliver care but also create massive population-wide health improvements, resilience, and shared prosperity.

1. Aligning incentives to reward long-term investment in prevention

Prevention is one of the highest-return investments a health system can make. The WHO and numerous economic evaluations show that preventive measures consistently deliver some of the highest returns on investment, earning their place in the WHO’s “Best Buys” for health.³⁴Tackling NCDs: Best buys and other recommended interventions for the prevention and control of noncommunicable diseases, WHO, 2024.

Many of these investments are remarkably affordable. For example, studies estimate that scaling up access to affordable blood pressure treatment could avert millions of premature deaths over the next 25 years at a cost of less than five dollars per person per year.³⁵“First WHO report details devastating impact of hypertension and ways to stop it,” WHO, September 19, 2023; Andrew E. Moran et al., “Building the health-economic case for scaling up the WHO-HEARTS hypertension control package in low- and middle-income countries,” Pan American Journal of Public Health, 2022, Volume 46. Importantly, it is a myth that all preventive interventions take decades to deliver a measurable return. Hospital-initiated smoking cessation has been found to reduce the risk of readmission and emergency department attendance within a month,³⁶Kerri A. Mullen et al., “Effectiveness of a hospital-initiated smoking cessation programme: 2-year health and healthcare outcomes,” Tobacco Control, 2017, Volume 26. and many of the WHO “Best Buys” have been shown to produce measurable results within five years.³⁷Gauden Galea et al., “Quick buys for prevention and control of noncommunicable diseases,”Lancet Regional Health – Europe, 2025 Volume 52.

Despite overwhelming evidence of near- and long-term returns, preventative care remains chronically underfunded. Modifiable risk factors such as poor diet, tobacco use, physical inactivity, and harmful alcohol consumption account for well over 40 percent of the global disease burden. These risk factors are often framed as matters of individual choice, but in reality, they are deeply influenced by the environments in which people live, learn, and work—from food systems and urban design to marketing and social norms. Recognizing this overlap between personal behavior and societal structure reframes prevention as a shared responsibility.

Yet, most nations spend only a sliver of their health budgets on prevention. In the European Union, for example, after a temporary increase driven by the COVID-19 pandemic response, in 2023, preventive-care spending accounted for just 3.65 percent of total healthcare expenditures (€62.8 billion), returning to prepandemic levels.³⁸“Expenditure for selected health care functions by health care providers,” Eurostat, accessed November 7, 2025. Most OECD countries spend less than 2 percent of their health expenditure on prevention.³⁹Martin De Benito Gellner, “Which countries are spending the most on preventive care?,” Healthcare Business International, June 16, 2023. However, countries that spend more on prevention tend to achieve better health outcomes. Longitudinal evidence across OECD countries shows that sustained preventive spending is associated with lower mortality and longer life expectancy, highlighting a widening gap between what evidence shows works and how resources are allocated in practice.⁴⁰Mehdi Ammi and Farzaneh Davarzani, “Econometric analysis of the long-run relationship between preventive care spending and mortality: evidence from OECD countries, 1970–2019,”Empirical Economics, September 2025, Volume 69.

This disconnect is not driven by a lack of evidence but by persistent structural barriers rooted in time frame challenges, including the following:

• Attribution challenges: Preventive interventions face attribution difficulties, the “counterfactual problem,” because success means an illness did not occur. Unlike treatment, where outcomes are immediate and visible, prevention’s effect is harder to quantify or value.⁴¹Jaithri Ananthapavan et al., Economics of prevention: Synthesis of knowledge from the Prevention Centre, The Australian Prevention Partnership Centre, June 2024. Prevention often generates broad trickle-down effects that unfold across time and sectors: Healthier populations foster more resilient communities, lower costs, greater productivity, and stronger economies. These diffused, system-wide benefits make prevention both more valuable and less measurable: the farther its impact extends, the harder it becomes to capture and credit in conventional evaluation frameworks.
• Payment and operating model challenges: Health systems were originally designed around treating illness rather than maintaining health.⁴²Eyal Zimlichman et al., “Health care 2030: The coming transformation,”NEJM Catalyst, 2021, Volume 2, Number 2. Infrastructure, workflows, and professional roles are designed to respond to acute needs rather than sustain long-term well-being. Workforce composition and training of healthcare professionals are heavily oriented toward hospital- and specialist-based treatment, limiting capacity for prevention and community health services.⁴³Abigail M. Ross and Lisa de Saxe Zerden, “Prevention, health promotion, and social work: Aligning health and human service systems through a workforce for health,”American Journal of Public Health, 2020, Volume 110, Number 10. Payment systems reward procedures and hospital activity rather than proactive management, while data systems and performance metrics prioritize clinical outcomes over population health indicators. Many payers underfund or exclude preventive services from coverage, reinforcing the bias toward treatment and reactive care.⁴⁴Susan Levine et al., “Health care industry insights: Why the use of preventive services is still low,” Preventing Chronic Disease, 2019, Volume 16. This reactive legacy operating model makes it difficult to integrate, fund, and scale prevention and early intervention services.
• Time horizons: The perception that prevention is primarily a long-term investment conflicts with political and budget cycles.⁴⁵Brianne Schell, “Let’s talk money: Barriers and benefits of investment in public health,” Network for Public Health Law, November 1, 2022. For example, standard ten-year fiscal windows used in countries such as the United States systematically undervalue the full effects of preventive health measures over time,⁴⁶Jackson Hammond, “CBO scoring of preventive health measures – important considerations,” American Action Forum, May 31, 2023. contributing to chronic underinvestment in human capital.⁴⁷World Bank Blogs, “Returns to early interventions at sufficient scale are high,” blog entry by Sergio Schmukler, Michael Toman, and Adam Wagstaff, April 9, 2020; “Investors shun long-term ESG rewards in quest for short-term gains,” EY press release, December 10, 2024.
• Misaligned incentives: When prevention works, the gains are rarely returned to the provider of those interventions: for example, a community care provider does not see a return from an avoided hospital admission, or share the value of their clients’ higher productivity and attainment in the workplace. Even within the health sector, savings may be perceived as lost revenue by some providers. Moreover, for many health system leaders, the challenge of dealing with a growing population of older and sicker people takes precedence over promoting holistic health over the lifespan. This focus is understandable, yet it is self-perpetuating and unsustainable, and can only be solved by a rebalancing of priorities in favor of more upstream investments.

Path forward

To break the cycle, governments should reframe disease burden as an invisible debt on their national balance sheet: Interest is paid through lower labor force participation, lower productivity, and higher healthcare costs, and keeps compounding year over year. Investing in prevention is therefore a form of fiscal risk reduction, effectively paying down the principal on that debt to lower future economic and fiscal interest payments and stabilize long-term fiscal health.

To operationalize this shift from reactive treatment to proactive care and prevention, governments can take a series of targeted actions that encourage greater measurability, financial visibility, and political durability.

• Make prevention’s fiscal and health value visible: Governments could treat prevention like any other capital investment—measured, modeled, and managed for return. Integrating prevention as a distinct category in national health accounts, standardized through frameworks such as the OECD System of Health Accounts, can make spending more transparent.⁴⁸“A System of Health Accounts guidelines,” OECD, March 16, 2017. In addition to tracking fiscal flows, governments could establish a complementary “national health outcomes account” that links preventive spending to measurable changes in the health of populations, such as DALYs averted or disease incidence reduced, creating a full picture of prevention’s fiscal and health returns. Additionally, prevention could be appraised using the same economic tools applied to infrastructure or energy projects, with ministries of finance mandating ROI and cost-effectiveness analyses. Advanced modeling and data analytics, including AI-driven forecasting, can be leveraged to track preventive investments in real time, estimating lives saved, productivity gains, and costs avoided, thus transforming prevention’s “invisible” success into clear fiscal and social value.
• Design a new operating model for prevention: Innovation in who delivers care, how it is delivered, and where it happens can transform health systems from reactive to proactive models of care. Reimagining service delivery can help shift care from high-acuity, resource-intensive settings toward primary and community-based environments that keep people healthy. Retraining the workforce, as seen in the NHS community health model, empowers multidisciplinary teams to take responsibility for defined populations and deliver low-barrier, prevention-focused care in everyday settings.⁴⁹“Population health management,” National Health Service (NHS) England, updated April 4, 2025. Expanding the “workforce for health” to include new, prevention-oriented, community-based roles, similar to social workers, can further bridge clinical and social systems, addressing the behavioral and environmental determinants of health.⁵⁰Abigail M. Ross and Lisa de Saxe Zerden, “Prevention, health promotion, and social work: Aligning health and human service systems through a workforce for health,”American Journal of Public Health, 2020, Volume 110. At the same time, empowering individuals to be their own healthcare workers and take greater ownership of their well-being, by managing care at home and staying physically and mentally active, can reduce disease risk and improve long-term outcomes.⁵¹Heartbeat of health: Reimagining the healthcare workforce of the future, McKinsey Health Institute, May 14, 2025. Additionally, advances in AI can reshape how we approach health screening and management. In Abu Dhabi, for example, the Department of Health’s Population Health Intelligence platform aims at using AI-driven analytics to integrate population and individual data, predict health risks, and enable early, personalized interventions, showing how technology can prevent disease before it becomes acute.⁵²A new era for digital health: Abu Dhabi’s leap to health intelligence, Abu Dhabi’s Department of Health and World Economic Forum, January 2026; “Department of Health – Abu Dhabi unveils world’s 1st AI-powered Population Health Intelligence platform at GITEX Global 2025,” Abu Dhabi Media Office, October 15, 2025. This approach can also help identify sex-specific care pathways, enabling more targeted interventions and improved outcomes.⁵³Blueprint to close the women’s health gap: How to improve lives and economies for all, McKinsey Health Institute, January 21, 2025.Together, these strategies redefine the roles, tools, and settings of care, empowering patients to manage their health, embedding preventive services in daily life, and creating a system designed to sustain wellness rather than treat illness.
• Build financing models for long-term investment: Because the full benefits of prevention accrue over decades, governments could adopt financing mechanisms that create lasting revenue streams. Thailand’s Health Promotion Foundation uses ring-fenced funds provided by health taxes to safeguard prevention from political volatility.⁵⁴Suladda Pongutta et al., “Lessons from the Thai Health Promotion Foundation,” Bulletin of the World Health Organization, 2019, Volume 97, Number 3. The Health Impact Investment Platform, launched by the WHO and multilateral development banks, provides multiyear concessional financing to strengthen primary healthcare and prevention in low- and middle-income countries, creating predictable, long-term funding that supports strategic investment in health system resilience.⁵⁵“WHO and multilateral development banks kick off €1.5 billion primary health financing platform with new funds and launch of first investment plans in 15 countries,” WHO press release, September 23, 2024. To complement these mechanisms, governments can also deploy catalytic capital to stimulate private and philanthropic investment for long-term, high-impact initiatives such as digital health and NCD prevention. Global partnerships such as the Global Financing Facility, which has mobilized more than $1.4 billion in private and domestic resources, demonstrate how public or concessional funding can derisk private investment and sustain prevention financing over time.⁵⁶“Nineteenth investors group meeting: GFF strategy approach 2026–2030,” Global Financing Facility, November 5–6, 2024.
• Align incentives for businesses and consumers: Population sentiment and market incentives are shifting from rewarding poor health to promoting health, as consumers increasingly demand healthier options, overturning the long-held belief that wellness-oriented offerings are less lucrative. Health systems and societies could empower individuals and communities to play an active role in maintaining their own well-being, and businesses have a pivotal role in making healthy living accessible, appealing, and easy. By designing products and experiences that integrate health into everyday life, companies can shift consumer behavior while capturing growing market demand. Growing consumer interest in functional nutrition and digital wellness solutions is driving spending toward nutrient-rich, clean food offerings and platforms such as fitness trackers and mindfulness apps, illustrating how design and gamification can make evidence-based, healthier choices the default.⁵⁷“The $2 trillion global wellness market gets a millennial and Gen Z glow-up,” McKinsey, May 29, 2025. To accelerate this shift, governments can help realign markets through evidence-based fiscal and regulatory tools, such as subsidies for healthy foods, front-of-pack labeling, and differential taxes on sugary drinks, that reward health-promoting behavior. When implemented well, these mechanisms are effective at reducing consumption without reducing economic growth or employment.⁵⁸Guillermo R. Paraje et al., “Taxation of tobacco, alcohol, and sugar-sweetened beverages: Reviewing the evidence and dispelling the myths,”BMJ Global Health, 2023, Volume 8, Number 8. Well-designed regulations can also encourage companies to invest in reformulation and innovation. Strong reporting standards for nutrition and safety, along with standardized health-impact metrics built into credit ratings, create trust and transparency for investors and consumers, further enhancing accountability.

2. Unleashing multisectoral action to drive progress in health and beyond

Investing in the health of populations yields benefits that extend far beyond the health sector. Stronger health enables better educational attainment, greater workforce productivity, and more inclusive economic growth.⁵⁹Yujie Cui, Gordon Liu, and Yao Yao, “The impact of health on growth: From the perspective of economic structure evolution,”Health Economics Review, 2025, Volume 15, Number 57. In turn, progress in these areas reinforces healthier lives, creating a virtuous cycle where multisectoral action amplifies outcomes across society. Unlocking this flywheel effect requires intentional collaboration and shared accountability across all sectors.

Studies show that countries achieve stronger and more sustainable economic growth when their health investments are integrated with investments in the wider determinants of health.⁶⁰“Intersectorality,” European Observatory on Health Systems and Policies, accessed November 2025. For example, school meals and micronutrient programs improve attendance and learning outcomes, while investments in safe water and sanitation deliver high returns by reducing disease and increasing workforce participation.⁶¹The state of school feeding worldwide 2024, World Food Programme, 2025; “Mission-critical: Invest in water, sanitation and hygiene for a healthy and green economic recovery,” WaterAid, 2020. Cleaner air and safer, more active transport systems similarly yield a “triple dividend” of better health, productivity, and environmental gains.

Ultimately, healthier populations are not just the outcome of progress; they are the engine that sustains it. Why, then, is cross-sector execution still rare?

• Fragmented incentives: Ministries often pursue sector-specific goals, limiting collaboration on shared outcomes.⁶²Working together for equity and healthier populations: Sustainable multisectoral collaboration based on health in all policies approaches, WHO, August 31, 2023.
• Siloed budgets and accountability: Funding streams and performance metrics are structured within institutional boundaries, making joint investments difficult.⁶³Robin S. Lau et al., “Siloed mentality, health system suboptimization and the healthcare symphony: A Canadian perspective,” Health Research Policy and Systems, 2024, Volume 22, Number 87.
• Limited measurement of cross-sector returns: The broader benefits of health investments for education, labor, and the economy are often not systematically tracked, leaving finance and planning ministries unable to see the full value of prevention and health promotion.⁶⁴Mariana Dyakova et al., Investment for health and well-being: A review of the social return on investment from public health policies to support implementing the Sustainable Development Goals by building on health, WHO Regional Office for Europe, 2017.

Path forward

The remedy is to reposition health as a driver of national development and institutionalize cooperation, financing mechanisms, and metrics to align incentives across sectors by doing the following:

• Creating cross-departmental coordination and financing mechanisms: One effective strategy is to establish interministerial prevention or health promotion funds that pool resources from health, education, transport, and environment budgets. Some countries, such as Zambia, have already included such pooled funding in their national strategy.⁶⁵National Health Strategic Plan 2022–2026: Towards attainment of quality universal health coverage through decentralisation, Republic of Zambia Ministry of Health, 2023; for more, see the Health Promotion Fund Resource Hub. This enables cofinancing of interventions that deliver benefits across multiple domains. Governments can go further by adopting outcome-based cofinancing models, in which each ministry contributes based on measurable results such as improved school attendance, reduced absenteeism, or lower pollution levels, ensuring every sector sees tangible ROI. Joint pilot programs can demonstrate how collaboration pays off in practice. For example, investments in physical infrastructure (such as roads, schools, water systems) deliver greater returns when populations are healthier, underscoring the value of coordinated investment strategies.⁶⁶Charles Kenny and George Yang, “Should infrastructure investors care about human capital?,” Center for Global Development working paper, number 624, October 2022. Similarly, blended development funds, combining public, donor, and private capital, can finance infrastructure projects that yield both health and economic dividends, such as clean water systems, sanitation, and active-mobility networks that improve physical activity while reducing emissions.
• Mobilizing innovative finance and private partnerships to shape healthier markets: Health-positive innovation can be accelerated through public–private partnerships (PPPs) that can co-design healthier products, digital wellness tools, responsible marketing, and healthier employee environments (see sidebar “The role of employers in advancing health and productivity”).⁶⁷Sharon McDonnell et al., “The private partners of public health: Public-private alliances for public good,”Preventing Chronic Disease, 2009, Volume 6, Number 2. Partnerships with tech companies can further amplify prevention and wellness through data-driven nudges,⁶⁸Lilja Gudrun Johannsdottir et al., “Digital nudging in digital health technologies: a systematic review,” CoLab, June 27, 2025. credible information campaigns, and healthier digital environments,⁶⁹Robert S. Gold et al., “Digital health communication common agenda 2.0: An updated consensus for the public and private sectors to advance public health,”Health Education & Behavior, December 2019, Volume 46. while blended-finance models and catalytic capital derisk private investment in reformulation, digital health, and supply chain modernization.⁷⁰“Insights & Impact: Blended finance,” Health Finance Institute, 2025. Impact-linked instruments, such as outcome bonds or results-based tax incentives, reward measurable health improvements, and debt-for-health swaps can free new resources for sustainable production in emerging markets. For example, the Cameroon Cataract Development Impact Bond (2018–23) mobilized $2 million in up-front capital to expand access to cataract surgery and repaid investors in full with performance returns, proving that health-focused impact investments can deliver both measurable outcomes and financial returns.⁷¹“Case studies: Cameroon Cataract Bond,” Government Outcomes Lab, February 22, 2022.
• Embedding health into national development planning: Health impact assessments can be mandated for major economic, infrastructure, and environmental policies to ensure they contribute positively to population well-being. Over the long term, health could be made a core pillar of national performance frameworks, explicitly linked to economic competitiveness and human capital development. Countries that have embedded health in multisector long-term development strategies, such as Chile and Thailand,⁷²Patricia Frenz et al., “Achieving effective universal health coverage with equity: evidence from Chile,”Health Policy and Planning, September 2014, Volume 29, Number 6; Kanitsorn Sumriddetchkajorn et al., “Universal health coverage and primary care, Thailand,”Bulletin of the World Health Organization, 2019, Volume 97. show how universal coverage, social protection, and education can reinforce one another when designed as a system rather than in silos.⁷³Health at a glance: Europe 2022: State of health in the EU cycle, OECD, 2022.
• Building shared metrics and accountability systems: Governments could develop indicators that capture how cross-sector investments improve both health and non-health-related outcomes, such as reduced sick days, improved school attendance, and higher labor productivity. In Finland, for example, the government’s “Health in All Policies” initiative uses such shared indicators to track health and socioeconomic outcomes across ministries.⁷⁴“Management of health and wellbeing promotion: Health in All Policies,” Finnish Institute for Health and Welfare, July 12, 2023. These metrics are reported through Finland’s National Health and Well-being indicator portal (Sotkanet) and jointly reviewed by ministries and municipalities, ensuring the fiscal and social benefits of prevention are visible across government.⁷⁵“National Health Index,” Finnish Institute for Health and Welfare, September 6, 2025. Such transparency reinforces political commitment and helps make the fiscal benefits of prevention visible to ministries of finance and planning.

3. Boosting health spending efficiency to maximize outcomes

As health spending reaches historically high levels, the dialogue is often framed as a trade-off between controlling costs and continuing to invest in health.⁷⁶Financing Global Health: Explore patterns of global health financing, Institute for Health Metrics and Evaluation, 2025. In practice, these objectives must be reconciled. By generating greater health impact from existing resources through choosing the right portfolio of high-return interventions, optimizing care delivery, and reducing waste, health systems can get the most health per dollar. This approach creates the fiscal space needed to invest in areas that reduce avoidable demand and bend the cost curve over time. In this sense, managing costs and investing in health are not competing priorities but mutually reinforcing elements of the same strategy. Cross-country analysis by the International Monetary Fund has found sizable, actionable differences in health-spending efficiency, suggesting there is an opportunity to deliver better overall health outcomes through more effective use of current resources and spending.⁷⁷Mercedes Garcia-Escribano, Pedro Juarros, and Tewodaj Mogues, Patterns and drivers of health spending efficiency, International Monetary Fund working paper, number 2022/048, March 2022.

Improving the efficiency of healthcare services involves addressing significant barriers, such as the following:

• Institutional resistance and transition costs: An honest conversation about whether the highest health ROI interventions are truly being resourced and incentivized will often challenge entrenched interests and established funding structures. Additionally, current financing structures frequently reward activity over value, paying for the volume of treatment rather than the outcomes of treatment.⁷⁸Luca Lindner and Luca Lorenzoni, Innovative providers’ payment models for promoting value-based health systems, OECD working paper number 154, April 2023. At the same time, transitions often require significant up-front investment in infrastructure, workforce retraining, and temporary parallel operations, costs that can deter change even when long-term savings are clear. Compounding this challenge, health systems sometimes invest in infrastructure or technology solutions that add cost and complexity without improving outcomes, mistaking expansion or digitalization for transformation.
• Systemic complexity and governance fragmentation: Implementing efficiency reforms such as centralized procurement, integrated logistics, or digital health systems demands coordination and performance-based financing. Misaligned incentives, siloed budgets, and fragmented decision-making structures make it difficult to reallocate funds toward higher-value uses.⁷⁹Agnes Gatome-Munyua et al., “Reducing fragmentation of primary healthcare financing for more equitable, people-centred primary healthcare,”BMJ Global Health, 2025, Volume 10, Number 1. Without clear accountability and coordination, even well-designed efficiency initiatives can stall.
• Technology limitations and low analytical trust: Many health systems lack the data infrastructure and analytical capacity needed to guide reallocation based on performance in real time.⁸⁰SCORE for health data technical package: Global report on health data systems and capacity, WHO, 2020. Complex data protection and confidentiality requirements and a lack of common data standards limit interoperability and data sharing. Moreover, where AI or predictive analytics are introduced, weak transparency and governance can undermine trust, limiting their adoption and impact.

Path forward

Governments have a critical role in supporting healthcare providers across all sectors—public and private—to improve productivity. The goal is not to cut spending but to ensure resources are directed to the highest-return interventions and support objectives such as expanding access, propelling innovation, and strengthening equity. Advances in digital infrastructure, data analytics, and AI are making long-standing efficiency challenges increasingly feasible to address. These technologies, combined with redesigned implementation pathways, are enabling smarter operations and real-time resource allocation, turning efficiency reform into a practical, achievable agenda.

• Reorient care toward high-value models: Governments can reorient service delivery toward primary and community-based care through their funding choices. In Kenya, for example, investments in primary healthcare yielded up to $16 in health system savings per dollar invested.⁸¹Daniel Mwai et al., “Investment case for primary health care in low‑ and middle‑income countries: A case study of Kenya,”PLoS One, 2023, Volume 18, Number 3. Public and private payers can use claims data (collected in some form by health systems everywhere) to identify opportunities for more proactive and lower-cost care. For example, in the United Kingdom, an AI-driven program analyzing real-world healthcare data identified older adults at high risk of hospitalization, reducing admissions by up to 70 percent and saving the National Health Service an estimated $1 billion annually.⁸²John Edwards, “The new cost engine: How AI and automation are reshaping health care economics,” Medical Economics, August 14, 2025. By prioritizing evidence-based investments and scaling solutions that reduce costs and improve outcomes, governments can ensure that every dollar spent drives measurable health value.
• Create incentives for providers to modernize systems and operations: To improve efficiency and accountability, governments can align financial incentives to reward providers for adopting smarter, technology-enabled operations, for example, using pricing mechanisms that reimburse providers not on the basis of average historic costs (as many systems do today) but on the basis of efficient delivery of best-practice care in the most appropriate and least resource-intensive setting.⁸³2025/26 NHS Payment Scheme, UK National Health Service (NHS), April 4, 2025. For example, governments could create value-based payment models that align financial incentives with cost-effectiveness. In the United States, Accountable Care Organizations (ACOs) link provider payments to health outcomes. Under this approach, groups of healthcare providers, such as hospitals, physicians, and community clinics, are held accountable for managing the total cost of care for a defined patient population against a per-member-per-month spending benchmark set by public payers such as the Centers for Medicare & Medicaid Services. If the ACO delivers high-quality care and keeps total spending below an agreed benchmark, the participating providers share in the savings. However, if costs exceed that benchmark, they may share in the losses, creating a two-way incentive to limit costs and optimize outcomes.⁸⁴Joe Albanese, “Two paths for Medicare’s future: Medicare Advantage and accountable care organizations,” Paragon Health Institute, January 15, 2025. These types of incentives can encourage providers to adopt more efficient care delivery practices, including improved care coordination, reduced low-value utilization, and strengthened chronic-disease management.

• Institutionalize tech-enabled efficiency and reinvestment for sustainable impact: Efficiency reforms are most effective when anchored in strong data systems and clear governance. Integrated health-data platforms and real-time analytics enable governments and providers to identify inefficiencies and improve outcomes while reducing costs. Reforms such as pooled purchasing, centralized tendering, and integrated logistics consistently deliver savings and improve access to essential medicines. Shifting to digital payments and performance-based financing enhances transparency and ensures funds reach frontline services quickly.⁸⁵“Health Financing and Economics: Digital technologies in health financing,” WHO, accessed January 2026. Additionally, AI-driven supply chains now forecast demand, automate replenishment, and optimize distribution, reducing delays, stockouts, and overordering.⁸⁶Pradeep Verma, “Transforming supply chains through AI: Demand forecasting, inventory management, and dynamic optimization,”Integrated Journal of Science and Technology, September 2024. Evidence also shows that AI-enabled triage systems can cut time to treatment by up to 20 percent.⁸⁷Adebayo DeCosta et al., “AI-driven triage in emergency departments: A review of benefits, challenges, and future directions,” Lancet Digital Health, 2025, Volume 197. These efficiency gains free up valuable resources, allowing cost savings to be reinvested in health. To ensure the benefits of more efficient care delivery are directed toward transforming our health systems for better health and prosperity for all, governments could establish data-driven reinvestment systems to channel savings into priority areas such as prevention and innovation, using efficiency-to-impact pipelines to ensure funds are not lost to general expenditure. For example, in 2024, Ireland’s Department of Health launched a national Productivity and Savings Taskforce that identified more than €600 million in health system efficiency savings, with plans to reinvest these funds to improve frontline services and patient outcomes.⁸⁸“Minister for Health Jennifer Carroll MacNeill updates Cabinet on details of the Productivity and Savings Action Plan for 2025,” Ireland Department of Health, April 1, 2025. Innovation can also change what it looks like to spend on health, shifting systems from labor-intensive delivery models to tech-enabled prevention and primary care. But innovation does not automatically create value: Evidence in areas such as oncology shows that some new, high-cost therapies have delivered only modest average gains in survival or rely on surrogate endpoints, underscoring the importance of directing adoption and reinvestment toward innovations that measurably slow disease progression or improve outcomes per dollar.⁸⁹Huseyin Naci et al., “Overall survival benefits of cancer drugs initially approved by the US Food and Drug Administration on the basis of immature survival data: a retrospective analysis,”Lancet Oncology, June 2024, Volume 25, Number 6.

In the next quarter century, investing in health represents a critical and strategic opportunity to transform both global health and economic outcomes. Scaling access to known, cost-effective interventions could prevent millions of premature deaths, extend healthy life expectancy, and generate trillions of dollars in economic gains annually by 2050, with a fourfold estimated global ROI.

Amid demographic shifts, increasing chronic disease prevalence, and tightening fiscal constraints, postponing health investments threatens to undo decades of progress. Now is the time for decisive action to promote healthier populations, enhance workforce productivity, and reinforce economic resilience.

Yet, despite compelling evidence, health remains underprioritized in budgetary and policy frameworks worldwide. What will it take to make smart investments in health and seize our economic future?