Smoking into your grave: 7.36 million deaths caused by tobacco in 2023, Global Burden of Disease Study shows

 

Smoking into your grave: 7.36 million deaths caused by tobacco in 2023, Global Burden of Disease Study shows

By Hope Mafaranga

New research presented at the World Conference on Tobacco Control, hosted by the International Union Against Tuberculosis and Lung Disease (the Union) with support from Bloomberg Philanthropies and the World Health Organization (WHO), reveals that despite decades of progress, tobacco remains a leading risk factor for death globally – reinforcing the urgency of sustained, evidence-based tobacco control as a cornerstone of global health and development.

Researchers from the Institute for Health Metrics and Evaluation at the University of Washington shared new data from the Global Burden of Disease Study, revealing the staggering and persistent toll of tobacco exposure on global health. Researchers found that tobacco use was responsible for 7.36 million deaths and over 200 million disability-adjusted life-years (DALYs) worldwide in 2023.

The study also highlighted stark disparities globally: while countries like the United Kingdom saw a 45% decline in tobacco-attributable deaths since 1990, others, such as Egypt, experienced a dramatic rise, showing that decades of control efforts, tobacco remains the leading risk factor for death among men globally and ranks seventh among women.

“Tobacco exposure is one of the most significant risk factors identified in the Global Burden of Disease Study 2023, contributing to approximately 1 in 8 deaths worldwide,” said Brooks Morgan, researcher at the Institute for Health Metrics and Evaluation.

“While some countries are seeing encouraging declines in tobacco-related deaths, others are heading in the opposite direction. These trends highlight the urgent need for accelerated implementation and stronger enforcement of strategies proven to reduce tobacco use, such as the MPOWER measures recommended by the WHO.”

The findings underscore the urgent need for intensified global action and policy implementation to curb tobacco’s deadly impact and align with the WHO Framework Convention on Tobacco Control.

Additionally, researchers from China presented promising results from an AI-driven personalised mobile health (mHealth) intervention, designed to support smoking cessation. Developed using machine learning, the system delivers tailored messages and interactive tools – such as games and peer insights – based on each user’s quitting stage and preferences.

In a randomised controlled trial involving 272 smokers, the intervention group achieved a quit rate more than double that of the control group (17.6% vs. 7.4%). Participants also reported a significant drop in daily cigarette consumption and high satisfaction with the programme.

 

“In China, over 50 million smokers want to quit, yet most lack access to effective cessation services. Our study shows the significant potential of personalized ‘mHealth’ interventions to transform smoking cessation efforts.

By combining machine learning with behavior change theory, we created an intervention that can deliver cessation messages adapted to each user’s stage of quitting, preferences and needs in real time.

The system also has some interactive features, like decision-balancing games, which help boost motivation and engagement,” said Prof. Pinpin Zheng, professor and director of the Department of Preventive Medicine and Health Education in the School of Public Health, Fudan University.

“More than 80% of participants reported being satisfied with the system. These findings highlight how theory-based, technology-driven solutions can bridge the gap in cessation services and provide cost-effective, wide-reaching strategies to empower smokers to quit.”

The AI-driven, user-centric approach was shown to offer a scalable, evidence-based model for expanding cessation support in China and globally, addressing a critical gap in access to support for smokers in China who want to quit – of which there are over 50 million.

Researchers from the German Cancer Research Center presented new evidence on the cross-border marketing of Heated Tobacco Products (HTPs) on social media, revealing stark contrasts shaped by national regulatory frameworks.

Using media monitoring tools, the study analysed public posts across five platforms in the UK, Ireland, and Germany. While no promotional content was found in Ireland - where HTPs are regulated as tobacco products - nearly half of the posts in the UK and Germany promoted HTPs, primarily through commercial accounts.

The findings showed that Germany had a notably higher proportion of youth- and female-targeted content, and that marketing strategies varied by country, from price promotions in the UK to product design features in Germany.

The research highlights the urgent need for harmonised regulation, suggesting that classifying HTPs as conventional tobacco products, as is done in Ireland, could significantly reduce their online promotion and appeal.

“Our study reveals notable differences in the social media promotion of heated tobacco products (HTPs) - differences shaped by both regulatory frameworks and market presence. In Ireland, no promotional content was identified on social media, but commercial promotion of HTPs on social media was widespread in the UK and Germany - including content that may appeal to youth and women,” said Zauraiz Lone, Doctoral Researcher at the German Cancer Research Centre (DKFZ) and Heidelberg University.

“Promotional activity focusing on heating devices without explicitly showing tobacco sticks reveals exploitation of policy fragmentation and regulatory ambiguities. These findings highlight the importance of addressing enforcement gaps and revisiting how product categories are defined and regulated. Strengthening digital marketing regulation and closing definitional loopholes are essential for reducing exposure, limiting uptake among younger populations, and supporting public health goals.”

Academics from the Institute of Clinical and Health Effectiveness (IECS) in Argentina also unveiled new modelling data quantifying the devastating toll of tobacco use in five low- and middle-income countries: Bolivia, Honduras, Nigeria, Paraguay, and Uruguay.

They found that in 2023 alone, tobacco was responsible for 41,000 deaths, 360,000 disease events, and over 1.3 million years of healthy life lost, costing these countries a combined US$4.3 billion in medical expenses, lost productivity, and informal caregiving.

Using a microsimulation model, the study projected that full implementation of four key tobacco control strategies - tax increases, plain packaging, advertising bans, and smoke-free environments - could avert up to 234,000 deaths and save as much as US$2 billion over the next decade.

“Our research, led by IECS in Argentina, is the result of a strong collaborative effort with partners from Bolivia, Honduras, Nigeria, Paraguay, and Uruguay—countries that are deeply committed to tackling the tobacco epidemic.” Said Natalia Espinola, Coordinator of Health Economics at IECS.

“In 2023 alone, smoking caused over 41,000 deaths and generated nearly 4.3 billion dollars in direct and indirect costs—equivalent to around 1% of the countries' combined GDP. The message is clear: countries must fully implement proven tobacco control policies. Our findings confirm that raising tobacco taxes, enforcing smoke-free spaces, banning advertising, and mandating plain packaging are not only effective—they save lives and bring major economic benefits.”

The findings demonstrate the urgent need for data-driven policy action to reduce the health and economic burden of tobacco in LMICs and accelerate progress toward global development goals.

Cassandra Kelly-Cirino, Executive Director of the Union, said: “The research showcased today at the World Conference on Tobacco Control is a powerful reminder that tobacco remains one of the most devastating public health threats of our time – there is no such thing as a healthy tobacco product, and reduced risk all too often just means increased profit for industry. We must take a zero-tolerance approach.

“The evidence presented at this conference demonstrates that when we invest in data-driven, locally tailored interventions, we save lives. The Union is very proud to support and amplify this work which strengthens the global case for urgent, sustained tobacco control.”

World leaders recommit to immunisation amid global funding shortfall

World leaders recommit to immunisation amid global funding shortfall

By Hope Mafaranga

 World leaders who are meeting in Brussels have pledged support for Gavi, the Vaccine Alliance, leading to a total of more than US$ 9 billion secured against a targeted US$ 11.9 billion budget for its next five-year strategic period from 2026 to 2030.

 Additional donor commitments are expected in the coming months. 

 The Summit also resulted in US$ 4.5 billion in complementary financing unlocked from development finance institutions, up to US$ 200 million in cost savings for Gavi-supported programmes announced by vaccine manufacturers alongside other innovation and supply commitments that will further boost equitable access to critical vaccines, and a range of private sector partnerships aimed at transforming immunisation systems in lower income countries including a US$ 40 million anchor commitment towards a new Innovation Scale-Up Fund.

 June 26, 2025’s commitments bring Gavi a major step closer to securing the resources it needs for Gavi 6.0, in which it hopes to protect 500 million children from preventable disease, averting between 8-9 million future deaths, protecting the world from deadly outbreaks of diseases such as cholera, mpox and Ebola through its vaccine stockpiles and unlocking US$ 100 billion in economic benefits for countries. 

 The Summit, co-hosted by the European Union, Gates Foundation, and Gavi, in partnership with Global Citizen, was attended by representatives of 55 donor and implementing countries including 10 heads of state and government and 24 ministers as well as leaders from multilateral institutions, civil society, private sector and vaccine industry.

 Co-hosts the European Union and the Gates Foundation reaffirmed their leadership in global health by making strong commitments to Gavi.

 The Gates Foundation announced a commitment of US$ 1.6 billion, underscoring its enduring partnership in Gavi’s efforts to ensure child survival. 

 The European Commission pledged EUR 360 million, as part of a total pledge of more than EUR 2 billion from Team Europe  which includes the EU and its Member States collectively the largest donor to Gavi. At the Summit, the European Investment Bank (EIB) announced an extension of its EUR 1 billion liquidity facility that can be accessed by any donor to facilitate their pledge, while Team Europe has already pledged nearly EUR 800 million for Gavi’s African Vaccine Manufacturing Accelerator (AVMA) to support local vaccine manufacturing. 

 Record number of donors

In addition to the co-hosts, the Summit saw a record number of new donors step forward to support Gavi’s next strategic cycle (2026-2030). With some of Gavi’s existing donors unable to announce commitments due to a need to align pledging with their own domestic budgetary cycles, this broad base of support will provide critical momentum for Gavi as it continues to mobilise resources in pursuit of its US$ 11.9 billion fundraising target.

 With Gavi’s implementing countries expected to invest a record US$ 4 billion towards their immunisation programmes over the coming five years, the Summit had strong representation from leaders pledging support and political commitment towards Gavi’s model of sustainable co-financing and secure supply through a diversified manufacturing base, including increased manufacturing capacity in Africa.

The Summit also saw enthusiastic engagement in discussions on reform of the global health architecture. Gavi, which is implementing its own transformative reform programme called the Gavi Leap, has offered to play a lead role in shaping a dialogue on how to evolve the current landscape so that it better serves countries, and to take proactive steps in forging closer collaboration with its partner agencies.  

 Call to action

Leaders from all co-hosts of the Summit urged existing donors unable to pledge today as well as potential new donors to step forward to help Gavi reach its target of US$ 11.9 billion.

 Failure to fully fund Gavi will have significant consequences on the health and well-being of children in lower-income countries, as well as on global health security.

 

Ursula von der Leyen, President of the European Commission said: "Investing in health is investing in our shared future. Our work with Gavi saves lives. For over 20 years, we have stood side by side, with the European Union contributing over EUR 3.2 billion to vaccinate more than 1 billion children against deadly diseases. But millions still need this vital protection.

Today, Team Europe is pledging more than EUR 2 billion. The EU remains committed to this mission so that children across the world are safer, healthier and stronger. This is global solidarity in action.”

 António Costa, President of the European Council said: “Today’s summit is a powerful reminder that global health security is a shared responsibility. Immunisation is one of its strongest foundations. We have to ensure that every person, everywhere, has access to vaccines. The European Union is proud to stand at the forefront of this global effort, helping raise resources and forging innovative partnerships that will save lives, protect communities and promote prosperity. Through Gavi, we are investing not just in vaccines, but in the preparedness and resilience of health systems worldwide.  Together with our partners, we are building a more secure and equitable global health architecture. The EU remains firm in its commitment to leaving no one behind.”

 

Bill Gates, chair of the Gates Foundation said: “In a constrained budget environment, it’s even more important to focus aid funding on the investments that really work. And Gavi is exactly that. I don’t know of anything with a higher impact per dollar in terms of saving and improving lives. Gavi is one of the best investments I’ve ever made and one of the best investments countries can make today in the world’s future.”

 

José Manuel Barroso, Board Chair, Gavi said: “Today is a good day for immunisation and a good day for global health. We have made impressive progress towards fully funding our next strategic period, secured vital access to finance for health systems investment and seen important progress that will shape vaccine markets and revolutionize last mile delivery. I want to thank all our donors and stakeholders that have stepped up to pledge towards a successful Gavi 2026-2030 period.”

 Dr Sania Nishtar, CEO, Gavi said: “I have been humbled by the support shown to Gavi today. As Gavi enters a new strategic period, a period which will see radical change to the way we support countries and converge with our partners at the last mile, we can do so with the confidence that not only our donors, but Gavi countries, the private sector and all other stakeholders stand with us as we build a healthier, more prosperous future."

 

 

Unitaid commits $50M to eliminate cervical cancer by 2030

Unitaid commits $50M to eliminate cervical cancer by 2030 

By Hope Mafaranga 

With just five years left to meet global 2030 targets for cervical cancer elimination, Unitaid is launching a new phase of work to help countries accelerate progress. 

Announced at the Global Forum on Cervical Cancer Elimination, held in Indonesia yesterday, Unitaid will commit an immediate $18m part of a broader $50m package through 2026 to support countries across four continents scale up life-saving screening and early treatment.  

This comes at a critical moment. While human papillomavirus (HPV) vaccination protects younger generations who have not yet been exposed to the virus, hundreds of millions of women worldwide are at risk and need timely access to screening and treatment. 

Without it, cervical cancer will remain one of the leading though most preventable causes of cancer death for women in low- and middle-income countries.  

Marisol Touraine, Chair of Unitaid’s Executive Board, said the new investments are designed to fast-track elimination efforts in a subset of countries, while supporting solutions that are country-owned, regionally tailored, and globally relevant. 

Touraine said a strong learning agenda and a focus on health financing challenges will ensure that progress goes beyond small-scale implementation and individual countries, benefiting systems, communities and regions.  

Building on more than six years of experience, Unitaid and its partners will support governments to expand access to affordable HPV testing and portable treatment devices, develop national strategies, and bring services closer to women whether in remote villages, island states, or urban clinics.   

“This is more than a financial commitment. It is a strategic response to what countries have told us they need: affordable diagnostics, decentralized treatment, and support for solutions designed and led at the national level. With this new phase of work, we are reaffirming our commitment to equity, innovation, and women’s health. The tools exist, the will is growing and what’s needed now is aligned, concrete action,” he said.  

Programmes are now launching across Africa, Asia, the Pacific, Latin America and the Caribbean.  

One of the programmes is the Clinton Health Access Initiative (CHAI) that will enhance support in Rwanda and South Africa, where governments are putting forward ambitious plans to meet 2030 elimination targets, while progress in India, Kenya, Malawi, Nigeria, Zambia, and Zimbabwe, have also prioritized elimination.  

Expertise France will help build resilient secondary prevention services for cervical cancer in Myanmar, support the Government of the Philippines in its elimination efforts by exploring effective delivery models in geographically isolated and disadvantaged areas, and strengthen regional advocacy and cancer treatment capacity through collaboration with the National Cancer Center of Japan.  

In Latin America and the Caribbean, the Pan American Health Organization (PAHO) will aid efforts to scale up services and lower the cost of HPV tests by leveraging the PAHO Regional Revolving Fund, a regional procurement mechanism accessible to all countries. 

In Asia and the Pacific, the Regional Office of the World Health Organization (WHO) will offer targeted technical assistance to Lao, Mongolia, and Papua New Guinea. Additionally, access will be expanded via catalytic donations of thermal ablation devices used for removing precancerous lesions across several Pacific Island countries. 

“In South Africa, we are committed to scaling up access to screening and treatment through our public health system alongside HPV vaccination efforts which have benefitted over 4 million girls,” said Dr. Lesley Bamford, National Department of Health, South Africa. 

“As a country, we welcome Unitaid’s continued support in bringing these tools closer to the women who need them. Eliminating cervical cancer is not only possible – it is essential to advancing health equity and strengthening our broader goal of universal health coverage.” 

In parallel to country-level support, Unitaid will address some of the greatest barriers to scale: fragmented markets, uneven pricing and constrained financing, while enabling South-South collaboration and community voices to ensure countries have the tools, evidence and support needed to deliver at speed and scale.  

These efforts are designed to help countries reach the WHO’s 90-70-90 targets for elimination – 90% of girls vaccinated, 70% of women screened, and 90% of those in need receiving treatment – to make cervical cancer the first cancer ever eliminated. 

Dr Jarbas Barbosa, Director of PAHO said through PAHO’s Regional Revolving Funds, HPV vaccines, HPV tests and ablative treatment devices are available to our Member States at one unique price regardless of the purchase size. 

“PAHO’s commitment to support Member States in reaching the elimination targets for 90% HPV vaccine coverage, 70% screening coverage and 90% treatment coverage is reinforced by the PAHO Disease Elimination Initiative,” he Barbosa.

Jeremie Pellet, CEO of expertise France said: “We are proud to continue this crucial work on cervical cancer prevention with Unitaid, whose trust since 2020 has been key. By scaling up a proven model in Myanmar and the Philippines, Expertise France is deepening its impact, contributing to the global elimination goal, and affirming its role as a leading force in the fight against cervical cancer.” 

Jeremy Farrar, ADG, Division of Health Promotion, Disease Prevention and Control at the WHO   said no woman should be left behind in accessing life-saving tools to prevent and treat cervical cancer. Achieving this goal requires collective action. 

“WHO welcomes Unitaid’s continued leadership and investment helping countries turn innovation into impact, faster. With governments, civil society, and partners like Unitaid, we can save lives faster and make cervical cancer elimination a reality,” he said.