Global health is experiencing a paradoxical transformation characterized by simultaneous convergence between nations and divergence within them. Developing regions are achieving improvements in basic health metrics driven by expanding vaccination coverage, improved sanitation infrastructure and more effective infectious disease control – narrowing the gap with advanced economies on foundational health indicators.

In stark contrast, health disparities within countries are reaching unprecedented levels, creating what epidemiologists describe as “health micro-geographies”1 where life expectancy can vary significantly across neighborhoods in the same city. These intra-national divides are increasingly driven by socioeconomic determinants rather than healthcare access alone, with disparities in environmental quality, food systems, built environments and digital health literacy creating fundamentally different risk profiles across population groups.

The most pronounced divergence is occurring in advanced economies, where sophisticated medical technologies and precision health approaches disproportionately benefit advantaged populations while resource-constrained communities experience stagnating or declining health outcomes.