Poverty, inequality and weak governance: People’s health is undermined if they do not have reliable access to adequate income, nutritious food, water, sanitation and shelter. These factors are further exacerbated when there is conflict, political instability, fragility, abuse of human rights, and inequitable economic growth. In combination, these factors contribute to the breakdown of basic health systems, a lack of basic needs, inadequate financial protection and – inevitably - a further spiral of ill health and poverty

Existing and emerging infections: Outbreaks of infectious disease undermine economies, society and stability: hence the need to promote health security, and reduce risks due to HIV/AIDS, Malaria, Tuberculosis, diarrheal diseases and other existing infections. With hotter temperatures, heavier rainfall, increased urbanization and changes in livestock production, patterns of disease incidence alter. This results in increased risks of people being affected by vector-borne and zoonotic diseases with epidemic potential.

Low priority for health and health care: If health not given sufficient attention in global, national and local governance and policy making, people are more likely to face serious illness and to become poorer as a result. This can be the case when levels of investment in health are low or inequitable; when competing economic interests undermine health; when there is no cross-sectoral action for health or when there is insufficient investment in opportunities for physical activity and nutrition among young people. Such policy deficits can increase risks of illness arising from climate change and undermine efforts to address NCD risk factors. Challenges will be even greater if there is insufficient attention to the growing threat of anti-microbial resistance