Reflections on the Lancet Commission on Investing in Health’s Global Health 2050 report

Abstract

This letter critiques the Lancet Commission’s Global Health 2050 report for shifting timelines and goals without adequate justification, effectively sidelining the original Global Health 2035 vision of achieving a “grand convergence” in health. The authors argue that extending the target to 2050 and proposing a 50% reduction in premature death, while calling it a “realistic” pathway, contradicts global trends—especially given that many low-income countries are decreasing health spending. They express concern over the report’s technocratic, selective approach to primary health care and universal health coverage, which undermines the core tenets of primary health care providing holistic, people-centered care, and note the report’s failure to address the practical realities faced by overstretched health systems. Ultimately, the authors question who the audience of the report is and urge the global health community to focus less on crafting ideal investment strategies and more on understanding why countries still do not prioritize health—even when the evidence for doing so is clear.