Heart disease, which has remained the leading cause of death at the global level for the last 20 years, is now killing more people than ever before, according to the World Health Organization.

The WHO said diabetes and dementia are also among the world's top 10 causes of death.

The WHO's 2019 Global Health Estimates, released on Wednesday, said non-communicable diseases now make up 7 of the world's top 10 causes of death, an increase from 4 of the 10 leading causes in 2000. The new data cover the period from 2000 to 2019.

“Heart disease has remained the leading cause of death at the global level for the last 20 years. However, it is now killing more people than ever before,” the organisation said.

Heart disease now represents 16 per cent of total deaths from all causes and the number of deaths from heart disease increased by more than two million since 2000 to nearly 9 million in 2019. Diabetes and dementia enter the top 10 causes of death.

Alzheimer's disease and other forms of dementia are now among the top 10 causes of death worldwide, ranking 3rd in both the Americas and Europe in 2019. Women are disproportionally affected: globally, 65 per cent of deaths from Alzheimer's and other forms of dementia are women.

Deaths from diabetes increased by 70 per cent globally between 2000 and 2019, with an 80 per cent rise in deaths among males. In the Eastern Mediterranean, deaths from diabetes have more than doubled and represent the greatest percentage increase of all WHO regions.

The WHO said the estimates reveal trends over the last 2 decades in mortality and morbidity caused by diseases and injuries, clearly highlighting the need for an intensified global focus on preventing and treating cardiovascular diseases, cancer, diabetes and chronic respiratory diseases, as well as tackling injuries, in all regions of the world, as set out in the agenda for the UN Sustainable Development Goals.

“These new estimates are another reminder that we need to rapidly step up prevention, diagnosis and treatment of non-communicable diseases,” Director-General of WHO Dr Tedros Adhanom Ghebreyesus said.

“They highlight the urgency of drastically improving primary health care equitably and holistically. Strong primary health care is clearly the foundation on which everything rests, from combatting non-communicable diseases to managing a global pandemic.”

While more non-communicable diseases are now causing deaths worldwide, there has been a global decline in deaths from communicable diseases, which however still remain a major challenge in low- and middle-income countries.

In 2019, pneumonia and other lower respiratory infections were the deadliest group of communicable diseases and together ranked as the fourth leading cause of death.

However, compared to 2000, lower respiratory infections were claiming fewer lives than in the past, with the global number of deaths decreasing by nearly half a million, WHO said adding that this reduction is in line with a general global decline in the percentage of deaths caused by communicable diseases.

HIV/AIDS dropped from the 8th leading cause of death in 2000 to the 19th in 2019, reflecting the success of efforts to prevent infection, test for the virus and treat the disease over the last two decades. While it remains the fourth leading cause of death in Africa, the number of deaths has dropped by more than half, falling from over 1 million in 2000 to 435 000 in 2019 in Africa.

WHO said Tuberculosis is also no longer in the global top 10, falling from 7th place in 2000 to 13th in 2019, with a 30% reduction in global deaths. Yet, it remains among the top 10 causes of deaths in the African and South-East Asian regions, where it is the 8th and 5th leading cause respectively.

The new estimates also emphasise the toll that communicable diseases still take in low-income countries: 6 of the top 10 causes of death in low-income countries are still communicable diseases, including malaria (6th), tuberculosis (8th) and HIV/AIDS (9th).

Meanwhile, in recent years, the WHO reports highlight an overall concerning slow-down or plateauing of progress against infectious diseases like HIV, tuberculosis and malaria.

The new projections state that people are living longer – but with more disability.

The estimates further confirm the growing trend for longevity: in 2019, people were living more than 6 years longer than in 2000, with a global average of more than 73 years in 2019 compared to nearly 67 in 2000. But on average, only 5 of those additional years were lived in good health.

Disability, however, is on the rise.

“To a large extent, the diseases and health conditions that are causing the most deaths are those that are responsible for the greatest number of healthy life-years lost. Heart disease, diabetes, stroke, lung cancer and chronic obstructive pulmonary disease were collectively responsible for nearly 100 million additional healthy life-years lost in 2019 compared to 2000,” WHO said.

Injuries are another major cause of disability and death, with the African region recording a significant rise in road traffic injuries since 2000.

Globally, deaths from road traffic injuries are 75 per cent male.

Assistant Director-General for the Division of Data, Analytics and Delivery for Impact at WHO Dr Samira Asma said robust health data are critical to address inequalities, prioritize policies and allocate resources to prevent disability and save lives.

"We call upon governments and stakeholders to urgently invest in data and health information systems to support timely and effective decision-making,” Asma said.