The Global Health Index specifically highlights poor diet and lack of exercise as significant contributors to Sri Lanka’s low relative standing, noting that even nations often viewed as “tropical paradises” can have poor health outcomes.
Sri Lanka’s health status has drawn international concern. The island nation has been ranked among the bottom 40 countries in the world for overall health outcomes in 2025, according to the newly released Global Health Index. With a global health index score of 54.55, Sri Lanka is placed 158th out of nearly 200 countries, a position experts say reflects persistent gaps in public health, lifestyle risk factors and healthcare investment despite improvements in life expectancy.
The Global Health Index – which aggregates ten key health measures including healthy life expectancy, blood pressure and glucose levels, obesity, mental health, happiness, alcohol and tobacco use, physical activity and government health spending – labels Sri Lanka’s overall health as below average and “unhealthy.” The ranking underscores a stark reality: picturesque landscapes and a relatively high Human Development Index (HDI) do not automatically translate into strong population health.
Health Beyond Longevity: Confronting Today’s Risks
While life expectancy at birth in Sri Lanka has risen from 71.5 years in 2000 to 77.2 years in 2021, mainly due to reductions in infectious disease mortality and wider access to basic healthcare, non-communicable diseases remain a leading threat. According to the World Health Organisation (WHO), strokes and ischemic heart disease are among the leading causes of death – conditions commonly linked with aging populations, lifestyle factors and gaps in preventive care.
Public health analysts say these chronic conditions reflect broader lifestyle and environmental issues: high rates of physical inactivity, rising obesity and changes in dietary habits. The Global Health Index specifically highlights poor diet and lack of exercise as significant contributors to Sri Lanka’s low relative standing, noting that even nations often viewed as “tropical paradises” can have poor health outcomes.
Global Health Security: Preparedness and Weak Links
A related but broader measure, the Global Health Security (GHS) Index, assesses countries’ readiness to prevent, detect and respond to infectious disease threats. While Sri Lanka’s specific overall GHS score is not published in the 2025 Global Health Security Index yet, historical data show that in earlier assessments Sri Lanka faced challenges across multiple categories – including detection and surveillance, rapid response capability, and health system capacity – compared with global averages.
The GHS Index, developed by the Nuclear Threat Initiative, Johns Hopkins Center for Health Security and Economist Impact, benchmarks health security across six major categories – from prevention of pathogen emergence to compliance with international norms and risk environment – to gauge pandemic preparedness and biological threat response capacity.
According to past index documents, Sri Lanka’s scores in areas such as laboratory systems, surveillance, and emergency response planning remained modest, highlighting structural limitations in public health infrastructure that can undermine capacity to control outbreaks swiftly.
Economic Pressures and Public Health Investment
Sri Lanka’s position in global health rankings is compounded by years of economic stress. A protracted economic crisis from 2019 to 2024 – the worst since independence – eroded public finances, spiked inflation and led to shortages in essential goods including medical supplies, highlighting the interplay between economic stability and health system robustness.
Public expenditure on health, a key component of overall population well-being, has struggled under fiscal constraints. Limited government funding for preventative care and lifestyle-related interventions has hampered efforts to curb non-communicable diseases and improve broader health outcomes.
Social Determinants and Well-being Indicators
The low health index ranking echoes other indicators of strain in social well-being. Earlier in 2025, Sri Lanka slipped in the World Happiness Report, dropping to 133rd place – a signal that subjective well-being may be lagging alongside objective health outcomes.
Despite these challenges, Sri Lanka still maintains comparatively strong human development measures within South Asia, with a High Human Development Index (HDI) among regional peers. However, analysts caution that gains in education and life expectancy – drivers of HDI – may mask deeper health system vulnerabilities and growing lifestyle health risks.
Policy Response and Health Priorities
Public health experts and government officials have acknowledged these challenges. Strengthening surveillance and response infrastructure, expanding preventive healthcare, and tackling lifestyle risk factors are increasingly viewed as priority areas. Moreover, Sri Lanka has engaged with global frameworks such as the National Action Plan for Health Security, aiming to reinforce capacities to handle epidemics and health emergencies – a move supported by technical partners including the World Health Organization (WHO).
Policy advocates argue that improving Sri Lanka’s health outcomes will require coordinated investment in non-communicable disease prevention, stronger health system financing, and policies addressing social determinants of health such as nutrition, physical activity and tobacco and alcohol use.
The 2025 rankings serve as an important – if sobering – reminder that life expectancy and development metrics alone do not capture the full picture of national health. For Sri Lanka to climb out of the bottom tier of global health standings, experts say it must broaden its focus from merely surviving disease to promoting long-term, resilient health across all segments of society.
