NCDs and mental health conditions to cost South America trillions by 2050 – PAHO

Non-communicable diseases (NCDs) and mental health conditions will cost South America over US$ 7.3 trillion in lost productivity and healthcare spending between 2020 and 2050, according to estimations in a new Pan American Health Organization (PAHO) report launched on July 15, 2025. This figure—equivalent to the entire annual GDP of Latin America and the Caribbean—underscores an urgent economic and health emergency, and the need to act now to prevent disease and protect development.

“These aren’t just health statistics, they are fiscal alarm bells,” said PAHO Director, Dr Jarbas Barbosa. “The escalating burden of NCDs and mental health conditions has become an economic emergency – perhaps the worst economic disaster in health.”

The report – Major storm on the horizon: Health and macroeconomic burdens of non-communicable diseases and mental health conditions in South America – was commissioned by PAHO, and developed with the analytical support of the Harvard T.H. Chan School of Public Health. It presents detailed macroeconomic projections of NCDs and mental health for 10 countries: Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Uruguay, and Venezuela.

NCDs are already the leading cause of death in the Americas, claiming six million lives in 2021, with nearly 40% of these occurring prematurely in people under 70. Cardiovascular diseases and cancer alone account for over half of these deaths. Diabetes is also rapidly increasing, with an estimated 43 million people unable to access treatment. Mental health conditions are increasing as well, further straining already stretched health systems and productivity.

The combined economic losses from NCDs and mental health across South America are primarily driven by premature deaths, long-term disability, and lower workforce productivity. Individual country losses projected for 2020-2050 range from US$88 billion in Uruguay to US$ 3.7 trillion in Brazil, representing up to 4.5% of GDP in some countries.

“For decades, policymakers in the Americas and beyond have tended to undervalue health. But the world is increasingly recognizing that health has not only intrinsic, but also instrumental value,” said Dr David E Bloom, Professor of Economics and Demography at the Harvard T.H. Chan School of Public Health, and lead author of the report.

“A key goal of this report is to equip PAHO and South American decision-makers with evidence to advance the needle on the priority given to large, transformative increases to health sector budgets.”

The rise in these conditions is attributed to ageing populations, as well as to increased exposure to preventable risk factors such as tobacco use, unhealthy diets, sedentary behaviour, harmful alcohol use, and air pollution.

Since 2000, obesity among adults in the region has surged by 67.5%, diabetes by 53.6%, and physical inactivity by 24.1%. Notably, about 67.5% of adults in the Americas are overweight — far above the global average of 43.5%, and the region has the highest levels of physical inactivity globally at 35.6%. These trends, if left unaddressed, will lead to further economic stagnation, inequality, and healthcare system overload.

Despite the grim projections, significant progress has been made, with cardiovascular and cancer mortality declining since 2000 due to policy and intervention. PAHO’s HEARTS initiative, implemented in 33 countries, has helped over 5.7 million people manage hypertension through primary care.

However, the report urges countries to “go further” in three key areas and fully implement proven, cost-effective interventions:

Prevention: Addressing main risk factors like tobacco use, unhealthy diets and sedentary behaviour can prevent many conditions.

Early diagnosis and treatment: Health systems that detect risks early and act swiftly improve survival and economic participation.

Financing solutions and global commitment: National health budgets must prioritize NCDs and mental health. Fiscal policies, such as excise taxes on tobacco, alcohol and sugar sweetened beverages, can fund reforms while improving population health.

“Healthy diets and regular physical activity are medicine against NCDs,” said Dr Barbosa. “We can prevent up to 40% of cancers by reducing tobacco use, improving diets, and promoting active lifestyles. And we can eliminate cervical cancer with vaccines, early screening, and treatment of precancerous lesions.”

PAHO in a release of the findings noted that it works to expand access to essential medicines and diagnostics, particularly through its pooled procurement mechanism, the PAHO Revolving Funds, and is also strengthening health systems to expand coverage and integrate NCD and mental health services. Currently, only 36% of people with hypertension have it under control, and 58% of those with diabetes receive effective treatment.

A pivotal opportunity to address this challenge will be the upcoming Fourth High-Level Meeting on NCDs and Mental Health in September, 2025, during the United Nations General Assembly, where governments, civil society, academia and the private sector are expected to renew their commitments and adopt a new political declaration.

PAHO is urging all governments, partners, and communities to make health central to economic strategies, promote healthy lifestyles, strengthen fiscal and regulatory policies to address key risk factors, invest in primary care, and expand mental health services, given that “Health is the foundation of development, security, and prosperity.”