Online treatment of eruption dynamics improves the volcanic ash and SO₂ dispersion forecast: case of the 2019 Raikoke eruption

In June 2019, the Raikoke volcano, Kuril Islands, emitted 0.4–1.8×109 kg of very fine ash and 1–2×109 kg of SO2 up to 14 km into the atmosphere. The eruption was characterized by several eruption phases of different duration and height summing up to a total eruption length of about 5.5 h. Resolving such complex eruption dynamics is required for precise volcanic plume dispersion forecasts. To address this issue, we coupled the atmospheric model system ICON-ART (ICOsahedral Nonhydrostatic with the Aerosols and Reactive Trace gases module) with the 1D plume model FPlume to calculate the eruption source parameters (ESPs) online. The main inputs are the plume heights for the different eruption phases that are geometrically derived from satellite data. An empirical relationship is used to derive the amount of very fine ash (particles <32 µm), which is relevant for long-range transport in the atmosphere. On the first day after the onset of the eruption, the modeled ash loading agrees very well with the ash loading estimated from AHI (Advanced Himawari Imager) observations due to the resolution of the eruption phases and the online treatment of the ESPs. In later hours, aerosol dynamical processes (nucleation, condensation, and coagulation) explain the loss of ash in the atmosphere in agreement with the observations. However, a direct comparison is partly hampered by water and ice clouds overlapping the ash cloud in the observations. We compared 6-hourly means of model and AHI data with respect to the structure, amplitude, and location (SAL method) to further validate the simulated dispersion of SO2 and ash. In the beginning, the structure and amplitude values for SO2 differed largely because the dense ash cloud leads to an underestimation of the SO2 amount in the satellite data. On the second and third day, the SAL values are close to zero for all parameters (except for the structure value of ash), indicating a very good agreement of the model and observations. Furthermore, we found a separation of the ash and SO2 plume after 1 d due to particle sedimentation, chemistry, and aerosol–radiation interaction. The results confirm that coupling the atmospheric model system and plume model enables detailed treatment of the plume dynamics (phases and ESPs) and leads to significant improvement of the ash and SO2 dispersion forecast. This approach can benefit the operational forecast of ash and SO2 especially in the case of complex and noncontinuous volcanic eruptions like that of Raikoke in 2019

Particle aging and aerosol–radiation interaction affect volcanic plume dispersion: evidence from the Raikoke 2019 eruption

A correct and reliable forecast of volcanic plume dispersion is vital for aviation safety. This can only be achieved by representing all responsible physical and chemical processes (sources, sinks, and interactions) in the forecast models. The representation of the sources has been enhanced over the last decade, while the sinks and interactions have received less attention. In particular, aerosol dynamic processes and aerosol–radiation interaction are neglected so far. Here we address this gap by further developing the ICON-ART (ICOsahedral Nonhydrostatic – Aerosols and Reactive Trace gases) global modeling system to account for these processes. We use this extended model for the simulation of volcanic aerosol dispersion after the Raikoke eruption in June 2019. Additionally, we validate the simulation results with measurements from AHI (Advanced Himawari Imager), CALIOP (Cloud-Aerosol Lidar with Orthogonal Polarization), and OMPS-LP (Ozone Mapping and Profiling Suite-Limb Profiler). Our results show that around 50 % of very fine volcanic ash mass (particles with diameter d<30 µm) is removed due to particle growth and aging. Furthermore, the maximum volcanic cloud top height rises more than 6 km over the course of 4 d after the eruption due to aerosol–radiation interaction. This is the first direct evidence that shows how cumulative effects of aerosol dynamics and aerosol–radiation interaction lead to a more precise forecast of very fine ash lifetime in volcanic clouds

Field test of available methods to measure remotely SO2 and NOx emissions from ships

Methods for the determination of ship fuel sulphur content and NOx emission factors based on remote measurements have been compared in the harbour of Rotterdam and compared to direct stack emission measurements on the ferry Stena Hollandica. The methods were selected based on a review of the available literature on ship emission measurements. They were either optical (LIDAR, DOAS, UV camera), combined with model based estimates of fuel consumption, or based on the so called ‘sniffer’ principle, where SO2 or NOx emission factors are determined from simultaneous measurement of the increase of CO2 and SO2 or NOx concentrations in the plume of the ship compared to the background. The measurements were performed from stations at land, from a boat and from a helicopter. Mobile measurement platforms were found to have important advantages compared to the landbased ones because they allow to optimize the sampling conditions and to sample from ships on the open sea. Although optical methods can provide reliable results it was found that at the state of the art, the “sniffer” approach is the most convenient technique for determining both SO2 and NOx emission factors remotely. The average random error on the determination of SO2 emission factors comparing two identical instrumental set-ups was 6%. However, it was found that apparently minor differences in the instrumental characteristics, such as response time, could cause significant differences between the emission factors determined. Direct stack measurements showed that about 14% of the fuel sulphur content was not emitted as SO2. This was supported by the remote measurements and is in agreement with the results of other field studies.JRC.H.2-Air and Climat

The 2019 Raikoke eruption as a testbed used by the Volcano Response group for rapid assessment of volcanic atmospheric impacts

The 21 June 2019 Raikoke eruption (48° N, 153° E) generated one of the largest amounts of sulfur emission to the stratosphere since the 1991 Mt. Pinatubo eruption. Satellite measurements indicate a consensus best estimate of 1.5 Tg for the sulfur dioxide (SO2) injected at an altitude of around 14–15 km. The peak Northern Hemisphere (NH) mean 525 nm stratospheric aerosol optical depth (SAOD) increased to 0.025, a factor of 3 higher than background levels. The Volcano Response (VolRes) initiative provided a platform for the community to share information about this eruption which significantly enhanced coordination efforts in the days after the eruption. A multi-platform satellite observation subgroup formed to prepare an initial report to present eruption parameters including SO2 emissions and their vertical distribution for the modeling community. It allowed us to make the first estimate of what would be the peak in SAOD 1 week after the eruption using a simple volcanic aerosol model. In this retrospective analysis, we show that revised volcanic SO2 injection profiles yield a higher peak injection of the SO2 mass. This highlights difficulties in accurately representing the vertical distribution for moderate SO2 explosive eruptions in the lowermost stratosphere due to limited vertical sensitivity of the current satellite sensors (±2 km accuracy) and low horizontal resolution of lidar observations. We also show that the SO2 lifetime initially assumed in the simple aerosol model was overestimated by 66 %, pointing to challenges for simple models to capture how the life cycle of volcanic gases and aerosols depends on the SO2 injection magnitude, latitude, and height. Using a revised injection profile, modeling results indicate a peak NH monthly mean SAOD at 525 nm of 0.024, in excellent agreement with observations, associated with a global monthly mean radiative forcing of −0.17 W m−2 resulting in an annual global mean surface temperature anomaly of −0.028 K. Given the relatively small magnitude of the forcing, it is unlikely that the surface response can be dissociated from surface temperature variability

The 2019 Raikoke eruption as a testbed used by the Volcano Response group for rapid assessment of volcanic atmospheric impacts

The 2019 Raikoke eruption (Kamchatka, Russia) generated one of the largest emissions of particles and gases into the stratosphere since the 1991 Mt. Pinatubo eruption. The Volcano Response (VolRes) initiative, an international effort, provided a platform for the community to share information about this eruption and assess its climate impact. The eruption led to a minor global surface cooling of 0.02 C in 2020 which is negligible relative to warming induced by human greenhouse gas emissions

Toward an Integrated Solution to Mitigate the Impact of Volcanic Ash to Aviation

The science community is making a concerted effort to improve the reliability of dispersion models for the forecasting of volcanic ash plumes. Toward this end, it has been observed that the assimilation of diverse, accurate and frequent surface, airborne and satellite observations of the source and distal ash plumes may hold the key. Various international research organizations and operational agencies make these observations using a variety of active and passive remote sensing systems and use them to initialize atmospheric trajectory and dispersion models. These observation systems range from surface LIDAR and ceilometers, to airborne radiometers and nephelometers, to satellite radiometers, multi-spectral imagers, LIDAR and UV-photometers. None of these systems alone is a panacea, however, their synergistic application holds great promise toward solving this complex problem. Additionally, the aeronautical and science communities are working to better understand the quantitative thresholds and tolerances of aviation systems to volcanic ash to better inform scientists of the accuracy requirements for dispersion model forecasts. A number of the most recent and promising efforts in all of these area are discussed in this presentation

Stratospheric aerosol - Observations, processes, and impact on climate

Interest in stratospheric aerosol and its role in climate have increased over the last decade due to the observed increase in stratospheric aerosol since 2000 and the potential for changes in the sulfur cycle induced by climate change. This review provides an overview about the advances in stratospheric aerosol research since the last comprehensive assessment of stratospheric aerosol was published in 2006. A crucial development since 2006 is the substantial improvement in the agreement between in situ and space-based inferences of stratospheric aerosol properties during volcanically quiescent periods. Furthermore, new measurement systems and techniques, both in situ and space based, have been developed for measuring physical aerosol properties with greater accuracy and for characterizing aerosol composition. However, these changes induce challenges to constructing a long-term stratospheric aerosol climatology. Currently, changes in stratospheric aerosol levels less than 20% cannot be confidently quantified. The volcanic signals tend to mask any nonvolcanically driven change, making them difficult to understand. While the role of carbonyl sulfide as a substantial and relatively constant source of stratospheric sulfur has been confirmed by new observations and model simulations, large uncertainties remain with respect to the contribution from anthropogenic sulfur dioxide emissions. New evidence has been provided that stratospheric aerosol can also contain small amounts of nonsulfate matter such as black carbon and organics. Chemistry-climate models have substantially increased in quantity and sophistication. In many models the implementation of stratospheric aerosol processes is coupled to radiation and/or stratospheric chemistry modules to account for relevant feedback processes

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic