On 2 October 2026 the World Health Organization (WHO) released its latest Global Health Estimates, covering every year from 2000 to 2023. The headline is that noncommunicable diseases (NCDs) caused 74% of global deaths in 2023, up from 58% in 2000.
The less noticed finding may matter more. For the first time, communicable diseases accounted for less than half of all deaths in low-income countries. That shift changes what health systems need to measure, and it exposes how little many countries can currently see.
What the new estimates show
The Global Health Estimates are WHO’s comparable time series of deaths and disability by country, age, sex and cause. The 2026 release reports that global life expectancy was 73.3 years in 2023, close to the 73.4 years recorded in 2019, before the COVID-19 pandemic.
Healthy life expectancy has recovered more slowly. It stood at 62.8 years in 2023, still 0.4 years below its 2019 level. In other words, people are living about as long as before the pandemic, but with more of those years spent in ill health.
The leading causes of death
According to WHO’s updated fact sheet on the top 10 causes of death, there were 61 million deaths worldwide in 2023. The ten leading causes accounted for 33 million of them, and eight of the ten were NCDs.
Ischaemic heart disease remained the largest single cause, with about 9.5 million deaths in 2023, followed by stroke and chronic obstructive pulmonary disease. Alzheimer’s disease and other dementias rose to fifth place, up from 19th in 2000. WHO reports that global dementia deaths roughly tripled over that period.
COVID-19, which WHO estimates directly caused 9.4 million deaths in 2021, fell to 14th place in 2023, with 0.9 million deaths.
Mental health is rising in the burden data
The estimates also measure disability-adjusted life years (DALYs), which combine years lost to early death and years lived in poor health. Between 2019 and 2023, WHO reports that the global age-standardised DALY rate rose by about 20% for depressive disorders and by nearly 45% for anxiety disorders. Together, the two accounted for about 110 million years of healthy life lost in 2023.
Dr Alain Labrique, Director of WHO’s Department of Data, Digital Health, Analytics and AI, said that “living longer is one of the great achievements of public health”, adding that the next challenge is to ensure those years “are lived in good health”.
A turning point for low-income countries
The most significant change for international development is in low-income countries. In 2023, communicable diseases such as malaria, tuberculosis, HIV and diarrhoeal disease caused less than half of all deaths there for the first time.
This is partly a story of success. WHO’s fact sheet notes that deaths from malaria, tuberculosis and HIV have all fallen significantly since 2000, and that diarrhoeal diseases dropped from the leading cause of death in low-income countries in 2000 to fifth in 2023.
It is not, however, a story of infectious disease disappearing. Seven of the ten leading causes of death in low-income countries in 2023 were still communicable diseases, and lower respiratory infections have been the leading cause there for most of the period since 2010. Low-income countries now face both burdens at once.
The funding has not followed the burden
International financing has been slow to reflect this shift. The Institute for Health Metrics and Evaluation’s Financing Global Health profile on NCDs, published in 2024, found that NCDs received less than 2.1% of total development assistance for health in 2022, and that such assistance fell by 34.4% between 2020 and 2023.
Governments have set new goals. In the political declaration on NCDs and mental health adopted at the 80th UN General Assembly and reported by WHO in December 2025, countries committed to three fast-track targets for 2030: 150 million fewer tobacco users, 150 million more people with hypertension under control, and 150 million more people with access to mental health care.
The same declaration includes a process target that is easy to overlook: at least 80% of countries with robust surveillance and monitoring systems by 2030. Without that, progress on the other targets cannot be measured.
The data gap behind the estimates
Global estimates are only as strong as the national data beneath them. WHO’s estimates draw on national vital registration, WHO technical programmes, UN inter-agency groups and other scientific studies, including the Global Burden of Disease. Where direct data are thin, figures depend more heavily on statistical modelling.
WHO’s own fact sheet acknowledges that collecting accurate and comprehensive mortality data “remains a major challenge”, with systems often fragmented, incomplete or inconsistent, especially in many low-income countries.
The scale of the gap is set out in WHO’s fact sheet on civil registration and vital statistics (February 2024). It states that nearly 40% of the world’s deaths are not registered, that only about 10% of deaths are registered in the African Region according to WHO’s SCORE assessment, and that only 8% of reported deaths in low-income countries have a documented cause.
Why this matters for the NCD transition
Infectious disease programmes have long been supported by dedicated surveillance, often funded by disease-specific donors. Chronic conditions such as hypertension, diabetes, dementia and depression are different. They are tracked through routine primary care records, cause-of-death certification and population surveys, which are the parts of the system most likely to be weak.
A country that cannot reliably record why people die, or how many people have hypertension under control, will struggle to know whether its NCD response is working. It will also struggle to make a case for domestic or external funding.
Reading the numbers with care
The new figures deserve careful interpretation. They are modelled estimates, and other research groups, notably the Global Burden of Disease collaboration, publish figures that can differ for particular causes and countries. Small changes in rank or share should not be over-read.
The trend toward NCDs is also partly a consequence of population ageing and of lower deaths from infection, both of which are signs of progress. A rising share of deaths from NCDs does not, on its own, mean NCD death rates are rising in every country.
Still, the direction of travel is consistent across sources and over two decades. The policy question is whether health information systems in low-income countries can adapt quickly enough to guide the response. Earlier Praxis analysis on the questions leaders should ask of their evidence and on building reusable public-health data sets out why definitions, documentation and routine data quality matter as much as headline estimates.
What strengthening the evidence base involves
Several practical steps follow from the evidence:
- Strengthen civil registration and cause-of-death certification, so that national figures rest on recorded deaths rather than models alone.
- Build NCD indicators into routine primary care data, including blood pressure control, diabetes management and mental health contacts.
- Align surveillance with the 2030 declaration targets, so countries can report progress against the commitments they have made.
- Invest in the people who produce and use data, from health records officers to district managers, through practical professional education.
Praxis Global Institute’s Research & Data work supports health institutions to design, clean and interpret the evidence they need, so that shifts like this one can be seen early and acted on with confidence.
Praxis Editorial Team
Perspectives from across Praxis Global Institute’s research, technology, education, and advisory work.
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