With the commencement of new year and a new decade kick-off, World Health Organisation, WHO has released a list of urgent, global health challenges. The list is a sign that global health is changing and environmental threats pose just as great a risk as infectious diseases such as Ebola and HIV. It also shows that threats to health can come from any quarter.
This list, developed with input from experts around the world, reflects a deep concern that leaders are failing to invest enough resources in core health priorities and systems. This puts lives, livelihoods and economies in jeopardy. None of these issues are simple to address, but they are within reach. Public health is ultimately a political choice.
Climate change, conflict and the gap between rich and poor are among the top threats to global health, the WHO has said.
In a new year resolution WHO has set out how it will tackle the 13 greatest threats to the world’s health over the next decade.
Climate change and air pollution
WHO says the “climate crisis is a health crisis”, with rising temperatures estimated to kill an additional 250,000 people between 2030 and 2050, mainly due to malnutrition, malaria, diarrhoea and heat stress. Air pollution meanwhile kills an estimated seven million people every year.
Conflict and crisis
In 2019 the most complex disease outbreaks took place in countries witnessing protracted conflict – such as the Ebola outbreak in Democratic Republic of Congo where violence has hampered control efforts in this long-running outbreak.
At the same time, health workers and facilities continue to be targeted – last year WHO recorded 978 attacks on health care in 11 countries last year, with 193 deaths.
Conflict in countries such as Yemen and Syria is also displacing record numbers of people, leaving tens of millions of people with little access to health care.
Unequal access to health care
There is an 18-year difference in life expectancy between the richest and poorest countries, but also a marked gap within countries.
The global rise in non-communicable diseases, such as cancer, chronic respiratory disease and diabetes, has a disproportionately large impact on low and middle-income countries. WHO says improving access to primary care is an important way of reducing inequalities
Expanding access to medicines
About a third of the world’s population lack access to medicines, vaccines, diagnostics and other essential health products. And those products that are available are often substandard or fake, putting people’s lives at risk and fuelling drug resistance.
Despite great strides in fighting diseases such as HIV and malaria infectious diseases are expected to kill four million people this year. Meanwhile, vaccine-preventable diseases such as measles, which killed 140,000 people in 2018, are on the rise.
There has also been an upsurge in the number of cases of polio – there were 156 cases of the disease last year, mainly in Pakistan, the biggest number since 2014.
Preparing for epidemics
Dr Tedros said that last year a global flu pandemic was the one thing that scared him more than anything else. He said countries were “investing in panic”, for example spending billions of dollars on the 2014-15 West Africa outbreak, rather than investing in preparedness and disease surveillance.
Lack of food, unsafe food and unhealthy diets are responsible for almost one-third of today’s global disease burden. Hunger and food insecurity continue to plague millions, with food shortages being “perniciously exploited” as weapons of war, says WHO.
At the same time, as people consume foods and drinks high in sugar, saturated fat, trans fat and salt, overweight, obesity and diet-related diseases are on the rise globally.
Investment in health workers
Underinvestment in the education of health workers and poor pay has led to health worker shortages all over the world. An additional 18 million health workers will be needed by 2030, primarily in low and middle-income countries, WHO warns.
Keeping adolescents safe
More than a million young people aged 10 to 19 die every year with the leading causes of death road injury, HIV, suicide and lower respiratory infections. Teenagers are also risking their lives and health through harmful use of alcohol, tobacco and drug use, lack of physical activity and unprotected sex.
Earning public trust
One reason for the global resurgence of measles is that the public has lost faith in health professionals and is ignoring messages around the importance of vaccination. Social media has served to fuel this mistrust with many people unsure what to believe.
Harnessing new technologies
Genome editing, synthetic biology and artificial intelligence have the potential to revolutionise health care but also raise questions about regulation and monitoring.
A recent report warned that worldwide 10 million people will die by 2050 if no action is taken. WHO is working with government officials from both human and animal health sectors to implement its action plan.
Hygiene and sanitation in health care facilities
Roughly one in four health facilities globally lack basic water services, leading to increased chance of infection for patients and health workers.
We need to realize that health is an investment in the future. Countries invest heavily in protecting their people from terrorist attacks, but not against the attack of a virus, which could be far more deadly, and far more damaging economically and socially. A pandemic could bring economies and nations to their knees. Which is why health security cannot be a matter for ministries of health alone.
All the challenges in this list demand a response from more than just the health sector. We face shared threats and we have a shared responsibility to act. With the deadline for the 2030 Sustainable Development Goals quickly approaching, the United Nations General Assembly has underscored that the next 10 years must be the “decade of action”.
Dr Tedros Adhanom Ghebreyesus, WHO Director-General
Elevating health in the climate debate
What’s the challenge?
The climate crisis is a health crisis. Air pollution kills an estimated 7 million people every year, while climate change causes more extreme weather events, exacerbates malnutrition and fuels the spread of infectious diseases such as malaria. The same emissions that cause global warming are responsible for more than one-quarter of deaths from heart attack, stroke, lung cancer and chronic respiratory disease. Leaders in both the public and private sectors must work together to clean up our air and mitigate the health impacts of climate change.
What is WHO doing?
In 2019, over 80 cities in more than 50 countries committed to WHO’s air quality guidelines, agreeing to align their air pollution and climate policies. This year, WHO will work towards developing a set of policy options for governments to prevent or reduce the health risks of air pollution.