The decisions New Zealanders make at this year’s general election will help shape health and wellbeing for decades to come.

Yet political debate is dominated by immediate concerns such as rising living costs, access to health services, and economic management.

These all matter enormously, but an equally important question is receiving far less attention: are we making the decisions needed to protect our long-term future?

A major new report from the Lancet Commission on 21st Century Global Threats to Health – from a group of 37 experts in health, economics, security and technology – provides compelling evidence that many of the greatest dangers facing our future are preventable.

It also highlights why governments must look beyond short electoral cycles and national borders.

The greatest threats are not necessarily what we expect

The Commission examined hundreds of potential threats to human health through to 2100, identifying 17 major catastrophic threats, including two with potential to cause human extinction.

Among the largest potentially preventable sources of future health loss are obesity and unhealthy diets, low educational attainment, income inequality, poor mental health, smoking and unhealthy ageing.

Other major threats include pandemics, antimicrobial resistance which makes infections harder to treat, climate change, air pollution and armed conflict.

Most alarming are the potentially “existential” dangers from nuclear conflict and malicious uses of artificial intelligence, including biological weapons.

Importantly, these findings are not a simple ranking of policy priorities based on existing health burdens. The Commission estimates potentially avoidable health losses under different scenarios of societal response, rather than........

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