The global economic impact of the five leading non-communicable diseases (NCDs)—cardiovascular disease (CVD), chronic respiratory disease, cancer, diabetes and mental ill-health—could total $47 trillion over the next 20 years, according to a study released by the World Economic Forum.

“The Global Economic Burden of Non-communicable Diseases” report analyzes the overall costs of NCDs to the global economy. Findings show the estimated cumulative output loss over the next 20 years represents approximately 4% of annual global GDP. While mental ill-health is typically left off the list of top NCDs, it alone accounts for more than $16 trillion, or one-third, of the overall $47 trillion anticipated spend on NCDs.

“Think of what could be achieved if these resources were productively invested in an area like education,” said Professor Klaus Schwab, founder and executive chairman of the World Economic Forum. “The need for immediate action is critical to the future of the global economy.”

More than 60% of deaths worldwide are due to NCDs, killing 36 million people each year. Low- and middle-income countries are disproportionately affected. In 2010, 80% of NCD deaths occurred in those countries, many of them prematurely, at working age. Developing countries are confronted with an ever-increasing share of this financial burden, as their economies and populations grow. The global population beyond the age of 60 is expected to double between now and 2050. This development, coupled with increasing urbanization, means a sharp increase in NCD rates. The study concludes that the cumulative costs of CVD, chronic respiratory disease, cancer and diabetes in low- and middle-income countries are estimated to surpass $7 trillion between 2011 and 2025, averaging nearly $500 billion per year.

“Until now, we’ve been unable to put a figure on what the World Health Organization (WHO) calls the ‘world’s biggest killers.’ This study shows that families, countries and economies are losing people in their most productive years,” said Olivier Raynaud, senior director of health at the World Economic Forum. “The numbers indicate that non-communicable diseases have the potential to not only bankrupt health systems but to also put a brake on the global economy. Tackling this issue calls for joint action by all actors of the public and private sectors.”

Mental health concerns and CVD alone account for almost 70% of lost output. In 2010, the global direct and indirect cost of CVD was approximately $863 billion and is estimated to rise 22% to $1,044 billion by 2030. Overall, the cost for CVD alone could be as high as $20 trillion over the 20-year period. For mental health conditions, the 2010 global costs were approximately $2.5 trillion, with the cost projected to surge to $6 trillion by 2030.

Cumulative NCD losses will rise steadily over the next 20 years, but the rate of increase will pick up sharply by 2030. The value of life lost, including lost income, out-of-pocket spending related to medical care and pain and suffering due to NCDs will double between 2010 and 2030.

To a substantial degree, NCDs are caused by tobacco use, harmful use of alcohol, physical inactivity and poor diet. Strategies for targeting these risk factors are considered in a companion study released by the WHO, which analyzes the means and costs of implementing these measures in low- and middle-income countries.