The world is undergoing a significant demographic transformation, with a rapidly aging population in many countries presenting both opportunities and challenges. Encouragingly, there has been remarkable progress, with the global mortality risk of death before the age of 80 dropping from about four in five in 1970 to just over half in 2023. Child mortality has seen remarkable declines worldwide. This positive trend, marked by longer and healthier lives, more women working, and smaller families as countries prosper, has contributed substantially to economic growth.

However, these favorable trends bring with them a set of challenges. The growing adult population, encompassing both the elderly and middle-aged individuals, has impacts that reverberate across societal organization, education, work dynamics, and health care services. The global population is projected to reach 9.7 billion by 2050, stabilizing thereafter. Some nations already grapple with declines in total population; and the majority of countries are experiencing significant declines in the rate of growth of the population, and so in the growth of the labor force. These shifts result from falling fertility rates and reduced premature mortality. The one area still experiencing marked population growth is Sub-Saharan Africa.

Many nations are ill-prepared for the magnitude and pace of these demographic shifts, which will ripple through labor markets, immigration, and social policies. Retirement ages and other institutional responses to changes in the age structure are lagging behind the rapid increase in adult populations. To navigate this evolving landscape, investing in the health and well-being of the working-age population is imperative. Early and effective control of Non-communicable diseases (NCDs), the primary cause of adult deaths, is crucial.

The key lesson from centuries of demography and epidemiology is clear: while death in old age is inevitable, death early in life should be rare and death in middle age need not be common anywhere. These demographic changes intersect with the challenges posed by climate stress and pandemic vulnerability. Approximately 40 percent of the global population—around 3.5 billion people—live in areas vulnerable to adverse climate effects that exacerbate poverty, especially among marginalized groups. There is also a reasonable probability of another global pandemic in the medium term. Pandemics of respiratory pathogens, like COVID, will disproportionally harm the elderly and people with NCDs. These intersections could markedly amplify intergenerational suffering and economic stagnation.

Governments cannot afford to delay addressing these interconnected challenges. Proactive measures and country-driven strategic planning are essential to build resilience. While altering the population structure significantly by 2050 might be challenging, sustaining success in reducing premature deaths and disabilities and enhancing overall well-being is achievable. These are potent yet underused tools to alleviate poverty.