In an invited commentary that appeared in the January 2026 issue of Open Access Government, International Osteoporosis Foundation (IOF) President Professor Nicholas Harvey warns of osteoporosis as a major yet overlooked global health crisis. Even though osteoporosis affects roughly 500 million people worldwide, and fragile bones cause around 70 fractures every minute in people over 55, the disease remains underdiagnosed and undertreated, leaving many vulnerable to disability or death. 

One in three women and one in five men over 50 will experience an osteoporosis-related fracture, and the problem is expected to worsen as populations age. Because bone loss is largely invisible and symptom-free until a fracture occurs, both patients and clinicians often underestimate the risk, and routine health checks rarely prioritize bone health assessment.

IOF calls for systemic change: currently, up to 80% of patients who suffer fragility fractures never receive follow-up care to prevent further injury. Barriers include limited access to bone scans, outdated treatment criteria, reimbursement restrictions, and low awareness among healthcare providers and the public. 

For those who have experienced a fragility fracture, Fracture Liaison Services (FLS) – specialized hospital-based programmes that identify fracture patients, connect them to osteoporosis care, and coordinate long-term follow-up. Although the number of FLS programmes is growing, they remain scarce in most health systems. Without such services, patients often ‘fall through the cracks,’ receiving orthopaedic repair but no treatment for the disease that caused the fracture. The result is a revolving door of repeat fractures, rising healthcare costs, and avoidable suffering.

However, FLSs do not address the prevention of a first fracture. IOF therefore also emphasises the urgent implementation of effective mechanisms worldwide to ensure that every individual at high fracture risk is appropriately assessed and treated.

Professor Harvey concludes that:

Until bone health receives the attention it deserves, the global crisis of fragility fractures will continue to grow. Early detection, equitable access to care, and coordinated follow-up could transform outcomes for millions – making this hidden crisis entirely preventable.

Read the article: Addressing a hidden crisis: the global neglect of bone health