Global Health Challenges in the 21st Century

[This interview was originally published on the Caixa Ciencia blog to mark World Health Day]

Antoni Plasència is Director of the Barcelona Institute for Global Health (ISGlobal), an internationally renowned research centre supported by ”la Caixa”. Plasència also serves as a consultant for the Department of International Health at the Hospital Clínic de Barcelona and visiting professor at the University of Barcelona. At ISGlobal, he leads a team of 385 people who are determined to improve global health and promote health equity through research and the translation and application of knowledge—goals to which ”la Caixa” is firmly committed. To mark World Health Day, we are talking to him about the problems currently facing health and the role research plays in dealing with these challenges.

What are the most urgent problems facing global health in the 21st century?

I see a number of challenges that we have to respond to simultaneously. I would not prioritise them. The first group are those related to the fight against premature mortality—the health problems that continue to affect the life expectancy of children. We're mainly talking about infectious diseases—such as malaria, tuberculosis, and respiratory and diarrhoeal diseases—but malnutrition is also a problem. If we don't solve those problems, we cannot ensure equity, because there will still be a very large part of the world where children will be born with what we might call a "postal code" that has a much greater influence on their future than their genetic code.

Antoni Plasència leads a team of 385 people who are determined to improve global health and promote health equity through research and the translation and application of knowledge

The World Health Organisation has said that, by 2020, there will be more people over 60 years of age in the world than children under 5. What about health in adults?

The challenge in adults is to combat the emergence of chronic diseases. We have to work to ensure health in middle-aged populations and to limit the impact of cancer, heart disease, mental health problems, and so on.

It is estimated that climate change will cause an additional 250,000 deaths a year between 2030 and 2050. Do environmental problems have an impact on our health?

Yes. Our health is closely linked to natural resources and affected by our access to water, climate change, temperatures that allow us to function normally, etc. One major challenge is pollution—in other words, the relationship between the abuse of natural resources and our health.

"We also have to ensure that this science is translated into action, that solutions are implemented which will contribute to the transformation and improvement of people's lives"

Any other challenges you would highlight?

We shouldn’t overlook epidemics and pandemics. Due to their rapid evolution and broad impact, these can cause considerable disruption on a global scale in the short term. And when I say disruptive, I don't mean just in terms of health; epidemics and pandemics are also disruptive in terms of the economy, geopolitics, security, etc.

What role does the scientific community play in meeting these challenges?

Research serves health. Our job is to understand the problems and to find solutions. However, while that is a significant and important task, the generation of new knowledge through science is not enough by itself, we also have to ensure that this science is translated into action, that solutions are implemented which will contribute to the transformation and improvement of people's lives. Without science, it would be difficult to discover the innovations that will make a difference for future generations.

What ISGlobal’s objective?

At ISGlobal we combine research and knowledge translation. We understand that, in an interdependent and rapidly interconnected world, a global vision is needed to promote health. To put it another way, we know that the problems of health do not respect borders and, therefore, neither do the solutions.

How important is the role of philanthropic organisations like ”la Caixa” in achieving this goal?

Good ideas can’t be developed without the necessary resources. ”la Caixa’s” commitment to knowledge as a transforming element that can improve health and equity and to the idea that good health is a determining factor in the progress of societies is a unique and valuable approach. What is more, it also highlights the contribution of public-private partnerships. As a general rule, most of the funding for scientific research comes from public agencies, which is a good thing, but without the support of the private sector we would come up short. ISGlobal is a good example of this commitment to combining public and private funding.

"Both the problems of health and their solutions transcend frontiers and, in a world without borders, problems spread very rapidly"

What conclusions would you draw from your career in public and global health?

Health doesn't respect borders. That means that both the problems of health and their solutions transcend frontiers and, in a world without borders, problems spread very rapidly. Take air pollution, for example, which travels and affects communities located at a distance from the origin of the problem. And we also still have the example of Ebola ... So, it is not a question of looking at the problems in each country in isolation, we need to look at them from a global standpoint. In today’s world, we are all neighbours. We all depend on each other. And our shared future will be very affected by health problems and their solutions.

ISGlobal’s work is focused on two broad areas: infectious diseases and noncommunicable diseases and their relationship with the environment. In both of these areas its contribution has been decisive: two areas that stand out in particular are the fight against malaria and the fight against yaws disease.