Addressing the Global Disease Burden: Innovation, Equity, and Prevention.

The global health disease burden landscape is at an inflexion point. Non-communicable diseases (NCDs) account for more than 70% of global deaths annually, with cardiovascular disease alone responsible for nearly 18 million deaths (WHO, 2022). Meanwhile, infectious diseases continue to resurface, whether through pandemic threats like COVID-19, the expansion of vector-borne illnesses such as dengue, or the persistence of tuberculosis and HIV in low-resource settings (The Lancet, 2021).

This multiple burden, combined with the rise of new diseases linked to climate change, antimicrobial resistance, and zoonotic spillovers, has intensified calls for stronger integration of science, innovation, and policy towards a safer world.

This commentary argues that addressing the global disease burden requires a three-pronged strategy: (i) advancing biomarker-driven diagnostics and therapeutic innovations, (ii) prioritising prevention through region-specific strategies, and (iii) embedding these efforts within universal health coverage frameworks to ensure equity and cost-effectiveness.

Emerging Disease Trends and the Case for Biomarker Innovation

The frequency of novel and re-emerging diseases has accelerated in recent decades, overloading global disease burden. Drivers include rapid urbanisation, environmental disruption, increased human–animal contact, and globalisation of trade and travel (Morens et al., Nature, 2020). These conditions create fertile ground for outbreaks of zoonotic diseases and vector-borne illnesses, which now account for over 60% of emerging infections (WHO, 2021).

In this context, biomarkers, biological indicators of normal or pathogenic processes, are indispensable tools. Early identification of disease biomarkers has transformed oncology (e.g., HER2 in breast cancer, PD-L1 in immunotherapy), and is increasingly critical in infectious disease detection (e.g., host-response biomarkers for sepsis or viral infections).

Biomarkers enable timely diagnosis, reducing delays that worsen outcomes. They also aid Personalised medicine, aligning therapies to molecular signatures, and promote epidemiological surveillance, identifying at-risk populations and disease patterns.

However, major gaps remain. Translational pipelines from biomarker discovery to clinical use are slow, and the cost of biomarker-based tests often restricts access in LMICs (Low- and Middle-Income Countries) (Vasan et al., The Lancet Global Health, 2021). Investment in regional research hubs, simplified diagnostic platforms, and harmonised regulatory frameworks is essential to ensure that biomarker advances do not become yet another domain of inequity.

Therapeutic Innovation and the Equity Imperative

Advances in molecular medicine and biotechnology are reshaping the therapeutic landscape with immunotherapies, such as checkpoint inhibitors, revolutionising cancer treatment. Gene-editing tools like CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) show promise in correcting genetic disorders, while nanomedicine platforms enhance targeted drug delivery.

For infectious diseases, mRNA-based vaccines, successfully deployed during the COVID-19 pandemic, demonstrated how novel platforms can be adapted rapidly to emerging threats (Nature Medicine, 2021).

Yet these breakthroughs come with challenges. The high cost of therapies, complex delivery systems, and dependence on specialised infrastructure mean that most patients in LMICs cannot access them. For instance, CAR-T cell therapies exceed USD 350,000 per patient in high-income countries, a cost structure impossible to scale globally (WHO, 2022). CAR-T cell therapies modify patients’ T-cells to recognise and attack cancer cells.

Without deliberate policy interventions, advanced therapeutics risk deepening global health inequities.

Policy responses must focus on cost-effectiveness frameworks that ensure pricing models align with public health goals, local manufacturing and technology transfer that reduce dependence on high-income supply chains, and public–private partnerships where industry innovation aligns with public health mandates.

Embedding these considerations into global health governance is critical to ensuring that therapeutic innovation translates into population-wide benefits rather than widening disparities.

Global Diseases Burden Prevention and Region-Specific Priorities

Despite the allure of high-tech solutions, prevention remains the most cost-effective strategy in reducing the global disease burden. Historically, preventive measures such as vaccination, sanitation, and nutrition programs have saved millions of lives and generated significant economic returns (WHO, 2022).

However, prevention must increasingly be tailored to regional disease ecologies:

• Sub-Saharan Africa: Malaria prevention remains paramount, with insecticide-treated bed nets, vector control, and novel malaria vaccines (RTS,S/AS01 and R21/Matrix-M) offering new opportunities.
• South Asia: Rising diabetes prevalence demands community-based lifestyle interventions and strengthened screening programs.
• Eastern Europe and Central Asia: Tuberculosis, particularly multidrug-resistant TB, necessitates robust diagnostic networks and access to new drug regimens.
• Latin America: Climate-driven expansion of dengue and chikungunya requires integrated vector management and regional surveillance systems.

Preventive health is not merely about cost savings; it also builds societal resilience. For LMICs, every dollar invested in prevention reduces future treatment costs, protects productivity, and enhances economic stability (Bloom et al., World Economic Forum Report, 2020).

Universal Health Coverage as a Policy Anchor

Universal health coverage (UHC) represents the central policy framework for integrating innovation, prevention, and equity. Defined by the World Health Organisation as ensuring access to essential health services without financial hardship, UHC is both a moral imperative and an economic strategy.

Currently, nearly half the global population lacks access to basic health services, and 930 million people spend more than 10% of their household income on health care (WHO, 2022).

In LMICs, out-of-pocket health expenditures are a primary driver of poverty. Embedding advanced diagnostics and therapeutics within UHC frameworks can help countries mitigate catastrophic health spending and build public trust in health systems.

However, achieving UHC requires more than financing. Critical elements include primary healthcare strengthening by ensuring enough trained health workers and community outreach. Also, robust health information systems for data-driven decision-making, and regional and cross-border collaborations enabling shared procurement, surveillance, and technology transfer are a must.

The political will to invest in UHC is increasingly tied to broader development agendas, with evidence showing that healthier populations contribute to sustained economic growth (The Lancet Commission on Investing in Health, 2013).

Towards a Synthesis of Science and Policy

The path forward demands synergy between scientific innovation and inclusive policy frameworks. Governments, research institutions, and industry must align on strategies that promote open science, equitable intellectual property arrangements, and localised production of diagnostics and therapeutics. At the same time, international organisations must coordinate funding mechanisms that prioritise affordability and accessibility in LMICs.

Disease prevention, region-specific strategies, biomarker innovation, and therapeutic advancement cannot be pursued in isolation. Together, they form an interdependent strategy for building resilient health systems. Importantly, UHC serves as the anchor that integrates these components, ensuring equity in both access and outcomes.

The trajectory of global health will be determined not solely by scientific progress, but by the political and policy frameworks that shape its distribution. Without equity, innovation risks reinforcing disparities. With robust prevention, biomarker-driven diagnostics, accessible therapeutics, and universal health coverage, the global community can transition from reactive crisis management to proactive, sustainable health governance.

The imperative is clear: to ensure that the benefits of modern science are shared universally, and to advance the collective goal of health for all.

References

• WHO. (2022). “Global Health Estimates 2022.” Geneva: World Health Organisation.
• The Lancet. (2021). Global Burden of Disease Study 2021.
• Morens, DM., Daszak, P., Taubenberger, JK. (2020). “Emerging pandemic diseases: How we got to COVID-19.” Nature.
• Vasan A, et al. (2021). “Translating biomarker research for low-resource settings.” The Lancet Global Health.
• Bloom DE, et al. (2020). “The Global Economic Impact of Non-Communicable Diseases”. World Economic Forum Report.
• The Lancet Commission on Investing in Health. (2013). “Global Health 2035: A world converging within a generation.” Nat Med, (2021). “The promise of mRNA vaccines.” The Lancet.