The coronavirus pandemic threatens to throw advances in health off the track, according to a new report by the World Health Organization released on Wednesday.
"All over the world the COVID-19 pandemic is causing significant loss of life, disrupting livelihoods, and threatening recent advances in health and progress," said the 2020 World Health Statistics, an annual check-up on health with a series of key indicators.
"The good news is that people around the world are living longer and healthier lives," said Tedros Adhanom Ghebreyesus, the WHO chief.
"The bad news is the rate of progress is too slow to meet the Sustainable Development Goals and will be further thrown off track by COVID-19."
In some areas, according to the report, progress has stalled, and immunization coverage has barely increased in recent years, with fears that malaria gains may be reversed.
And there is an overall shortage of services within and outside the health system to prevent and treat noncommunicable diseases such as cancer, diabetes, heart and lung disease, and stroke.
Service coverage in low- and middle-income countries remains well below coverage than in wealthier ones, as do health workforce densities.
In more than 40% of all countries, there are fewer than 10 medical doctors per 10,000 people.
Similarly, over 55% of countries have fewer than 40 nursing and midwifery personnel per 10,000 people.
Tedros said that the pandemic highlights the urgent need for all countries to invest in robust health systems and primary health care as the best defense against outbreaks like COVID-19.
"Health systems and health security are two sides of the same coin," he said.
The biggest gains were reported in low-income countries, which saw life expectancy rise 21% or 11 years between 2000 and 2016 (compared with an increase of 4% or three years in higher-income countries).
One driver of progress in lower-income countries was improved access to services to prevent and treat HIV, malaria, and tuberculosis, as well as some neglected tropical diseases such as guinea worm.
Another was better maternal and child healthcare, which led to a halving of child mortality between 2000 and 2018.