Researchers from The Lancet Commission on 21st Century Global Threats to Health have identified 17 major health threats that could affect humanity over the next 75 years, with malicious use of artificial intelligence (AI) and nuclear conflict topping the list as risks that could lead to human extinction by the end of the century.
Scope of the assessment
The commission, composed of 35 experts, measured potential health loss using disability‑adjusted life years (DALYs), a metric that captures years of healthy life lost to illness, disability or premature death. Each threat was evaluated on the basis of its projected DALY burden and the existence of viable mitigation strategies. The findings will be presented at the World Health Summit in Berlin and will be updated annually to incorporate new data and emerging hazards.
Extinction risks and other catastrophic threats
According to the report, the likelihood of AI‑driven bioweapons or a nuclear war that triggers a “nuclear famine” – where particles injected into the upper atmosphere block sunlight and cause widespread crop failure – remains low, but the potential consequences are existential. The authors note that a successful AI‑created biological weapon or a nuclear conflict capable of blocking sunlight could eradicate humanity.
Beyond these two extreme scenarios, the commission identified 15 additional threats that could each generate more than one billion cumulative DALYs. These include air pollution, antimicrobial resistance, childhood malnutrition, climate breakdown, conventional armed conflict, steep reductions in overseas aid, high alcohol consumption, high blood pressure, income inequality, low educational attainment, naturally occurring pandemics, obesity, poor mental health, smoking, and unhealthy ageing. All of these were deemed “major catastrophic threats” because they combine high health loss with plausible solutions.
Regional impacts and the role of aid
The analysis highlights divergent patterns across income groups. In higher‑income regions, non‑communicable diseases such as obesity and poor mental health dominate the projected health burden. In lower‑income regions, factors like low educational attainment and child malnutrition drive the loss of healthy years. The report warns that recent cuts to foreign aid by major donor nations, including the United States and the United Kingdom, could generate up to 1.5 billion DALYs before 2100, with nearly 70 % of that impact falling on sub‑Saharan Africa.
Limiting global warming to approximately 1.8 °C (3.2 °F) rather than allowing temperatures to rise to 4.4 °C (7.9 °F) could prevent the loss of 1.89 billion years of healthy life, according to the commission’s scenario modelling.
Policy recommendations
Commission co‑chair Professor Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, emphasized that “decisions made by leaders today will shape the health and wellbeing of the next generation.” He added that the scope of threats has expanded far beyond the three originally anticipated—conflict, climate and pandemics—to a broader set that requires dedicated resources for anticipation, prevention and preparation.
Commission member Ibrahim Abubakar, a professor of infectious disease epidemiology at UCL, stressed that the purpose is not to frighten but to inform policymakers about the magnitude of each risk and the potential impact of decisive action. The authors call for increased investment in technological innovations, stronger health systems, and sustained international aid to mitigate the identified threats before they evolve into crises.
The upcoming presentation of the report at the World Health Summit aims to galvanize global leaders to address these intertwined risks through coordinated policy measures, ensuring that humanity can avoid the worst‑case scenarios outlined by the commission.
Helene Elliott is the Lead Science & Space Reporter at News Raise. She reports on aerospace missions, astrophysics discoveries, quantum research, and environmental technology.
