Dr. Chris Murray, IHME, co-chairs the Lancet Commission on 21st Century Global Threats to Health, which will launch its report in February at the Munich Security Conference. It is the “Commission of Commissions,” a novel, highly ambitious three-year effort to forecast what are to be the biggest, most costly problems by taking a broadened non-traditional view. It focuses on 16 factors plus hypertension, each forecast to exact over one billion life years over the next 75 years. These include the familiar big three – pandemics, climate, and conflicts – but includes other factors that rank surprisingly high: education, inequality and low economic growth, obesity, tobacco, and AMR. A wildcard such as malicious use of AI has to be taken into account. “We excluded meteors” and mirror life, the latter too early to include. The Commission calls for a rolling, annualized review, and for higher investment by governments in both promising innovative technological solutions and building better threat-ready health systems.