Last month, Jacob Coxon resigned from AI company Anthropic, stating that its researchers believe AI could lead to human extinction within ten years. Evan Hubinger, also an Anthropic employee, estimated the extinction risk at over 10 percent, though the specific mechanisms remain speculative.
Similar alarmism surrounds other global threats, including nuclear conflict, asteroid strikes, engineered pathogens, and treatment-resistant organisms. However, these long-term risks often overshadow more immediate health challenges that can be addressed through policy. The Lancet Commission on 21st Century Global Threats to Health has published a report identifying dozens of health risks, ranked using disability-adjusted life years (DALYs), which quantify healthy years lost due to illness, disability, or premature death.
The commission divides threats into categories, from existential risks like nuclear war and AI-driven biological weapons to major catastrophic events such as climate change, antimicrobial resistance, and obesity. The DALY metric evaluates both high-impact, low-probability events and more frequent but less severe dangers. For instance, unmitigated climate change, projected to reach 4.4°C without intervention, could eliminate nearly 2 billion years of healthy life compared to a 1.8°C scenario.
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Despite these warnings, the largest portion of preventable health loss over the next 70 years stems from more routine conditions. Tobacco remains the leading cause of DALYs, contributing to chronic obstructive pulmonary disease, cardiovascular disease, and lung cancer. Smoking rates are climbing in low- and middle-income nations, where enforcement of health regulations is often inadequate. High blood pressure, the top physiological risk factor for strokes, heart attacks, and kidney failure, is another area where low-cost interventions, such as reduced salt intake and medication, could have a major effect. Yet the most significant burden comes from what the commission terms the “obesity cluster”: poor nutrition, weight gain, and physical inactivity, which drive type 2 diabetes, cardiovascular disease, and multiple cancers.
This cluster is largely influenced by ultra-processed foods and sedentary habits, both of which governments can address through policy measures. The commission’s findings indicate that while existential risks dominate headlines, the most effective health strategies already exist. These include stronger public health systems, expanded prevention programs, and established tools like antibiotics, obesity treatments, and climate adaptation. The obstacle is not a lack of solutions but a shortage of political commitment and coordination.
