– The most important aspect of preparedness is how we develop our society

She has served on the expert commission assessing which health threats could have the greatest global impact between now and 2100.

The analyses cover 204 countries. A total of 15 health threats are classified as catastrophic. These include antimicrobial resistance, age-related health loss, obesity, high alcohol consumption, high blood pressure, income inequality, climate change, the collapse of health aid, conventional war, low educational attainment, air pollution, pandemics, mental ill health, smoking and child undernutrition.

Two threats were classified as having the potential to cause human extinction: the malicious use of artificial intelligence (AI) and nuclear war.

– These threats may seem unlikely, and their probability is difficult to estimate. Nevertheless, we should keep them in mind and consider how to prevent them and how to respond if they do occur, says Stoltenberg.

A total of 63 experts and researchers contributed to the report, which identifies the 17 greatest threats to global health.

– There have been many major threats to health, including the COVID-19 pandemic. We need an evidence base to prepare for health threats. The main concern is that several crises could strike at the same time. Another concern is that planning and preparedness do not take a sufficiently long-term view, says Stoltenberg.

The Lancet therefore convened this commission to work more systematically on future challenges, taking a longer-term perspective than usual.

– Preparedness efforts are often shaped by looking backwards. We prepare for the flood or pandemic that has just happened, but struggle to imagine how to approach several crises occurring at once, says the CEO.

One of the issues the expert commission’s members had to agree on was the time frame. They chose to look ahead to the end of this century.

– The researchers have made projections and selected scenarios: what happens if we continue as we are, and what are the best-case and worst-case scenarios? All these choices have been made amid considerable uncertainty. But I think it is a very worthwhile exercise. It forces us to think further ahead and across fields. It makes us consider what we can do to be as well prepared as possible to handle several crises at once, says Stoltenberg.

She is particularly pleased that inequality was identified as one of the threats to health.

– It has led to many important discussions, she says.

“Invisible” crises such as obesity are also on the list.

– Showing how significant inequality will be through to 2100 is useful for preparedness overall. For example, the countries hardest hit by the pandemic were those with high levels of obesity. The obesity epidemic is unevenly distributed, with a much greater burden in countries with lower economic and social status. This causes considerable suffering for individuals, as well as costs to society and reduced preparedness. These findings allow us to focus on the societal dimensions of obesity and adopt society-wide measures rather than placing the responsibility on individuals, says Stoltenberg.

– What do the findings mean for how we should approach research — at NORCE and elsewhere?

– Without research, this would not have been possible. The report is based on data and research. What matters is the quality of the research carried out day in, day out, says Stoltenberg.

– What do you consider the most important finding?

– That the threats are partly interconnected, forming a kind of cluster. The most important aspect of preparedness is how society develops. A resilient society that looks after everyone, has good health services, is democratic, enables participation and has less inequality helps protect against these threats.