A Year in Global Health: A Less Turbulent but More Worrisome 2017

The WHO elected its new leader: Tedros Adhanom Ghebreyesus, the organisation’s first African director

This was an important year for the global health community, since the WHO elected its new leader: Tedros Adhanom Ghebreyesus, the organisation’s first African director, who has put universal health coverage at the centre of his priorities. 

it has been an ominous year that started with a new US administration whose ideologies and political decisions are a threat to health

But for the world at large it has been an ominous year that started with a new US administration whose ideologies and political decisions are a threat to health at many different levels. The dismantling of “Obamacare”, the budget cuts to development aid (particularly for USAID), the return to the “global gag rule” that threatens progress in reproductive health across the world, the withdrawal from the Paris agreement on climate change, and the lack of commitment to renew funding for the ‘Global Health Security Agenda’  are only some examples. These decisions will have an impact on the health of many future generations, within and without the USA.  

1. Lower profile of emerging infectious diseases 

Regarding emerging disease outbreaks, this year was certainly less eventful than previous ones

Regarding emerging disease outbreaks, this year was certainly less eventful than previous ones. An Ebola outbreak in the Democratic Republic of Congo and a Marburg outbreak in Uganda were quickly and efficiently stopped. After making the headlines in 2016, Zika virus became one more on the list of mosquito-borne diseases, together with chikungunya, dengue and yellow fever. However, a study in which ISGlobal participated warns of the long-term socioeconomic impact of the epidemic in Latin America, particularly on the most vulnerable families and the poorest countries. As shown by a chikungunya outbreak in Italy last summer and as highlighted at the B-debate organised by ISGlobal, Europe is also at risk and should improve its preparedness to Zika and other diseases transmitted by the Aedes mosquito.   

In China, the H7N9 bird-flu virus started killing birds for the first time and infected (and killed) more people than the previous four years put together. The virus has not yet acquired mutations that facilitate its transmission between humans, but it could happen and experts warn that the world is ill-prepared to tackle an influenza pandemic.      

2. Rebounds in known infectious diseases

In fact, “old” infectious diseases against which we have treatment and/or vaccines caused the most alarm this year

In fact, “old” infectious diseases against which we have treatment and/or vaccines caused the most alarm this year: 

In Madagascar, a plague outbreak (yes, the same plague that decimated the population in the Middle Ages) caused more than 1,500 cases and 110 deaths despite the existence of rapid diagnosis tests and effective treatments. 

After two years of fighting and the collapse of its health care system, Yemen has experienced the worst cholera epidemic in recent history, with almost 1 million cases and more than 2,000 deaths, 25% of which were children. 

Regarding malaria, for the first time in the last two decades the WHO 2017 report confirmed an increase in the total number of cases. Progress in reducing cases and deaths has stalled over the last five years, mainly due to stagnation in funding but also to the need of new tools and strategies to progress towards elimination. In this context, the publication of the new research agenda for malaria elimination (malERA Refresh) and the launch of the TIPTOP project that seeks to increase access to preventive treatment among pregnant women – two initiatives in which ISGlobal plays a leading role- are particularly relevant.

3. An alarming increase in obesity

The number of obese children has increased more than ten-fold over the last four decades

The largest analysis performed to date, in which ISGlobal participated and recently published in The Lancet, gives disturbing figures on the rise of obesity: the number of obese children has increased more than ten-fold over the last four decades. The global cost of this epidemic is estimated at 1.2 trillion USD for 2025. 

4. And in extreme weather events

This year saw six major hurricanes (...). Scientists firmly believe that these events are made worse by climate change

This year saw six major hurricanes, of which two -Irma and Maria- reached the top of the scale before hitting land. Scientists firmly believe that these events are made worse by climate change, and the 2017 US Climate Science Special Report, gives, for the first time, a 95 to 100% confidence level that global warming is driven by human activity.

5. Encouraging initiatives 

The good news is that several potent initiatives were launched this year, with the goal of addressing major global health challenges. An important example announced at the World Economic Forum 2017 is CEPI, an initiative that seeks to galvanise the development of new vaccines against emerging disease such as Lassa fever or MERS through an alliance between public and private institutions, philanthropy and civil society.  In turn, RESOLVE seeks to implement solutions to prevent cardiovascular disease and detect infectious disease epidemics, and is supported by the Chan- Zuckerberg Initiative, the Bill & Melinda Gates Foundation and Bloomberg Philanthropies.

Despite the enthusiasm generated by last year’s launch of the Sustainable Development Goals, the global indicators to monitor progress were only approved this year

Despite the enthusiasm generated by last year’s launch of the Sustainable Development Goals, the global indicators to monitor progress were only approved this year. Few countries have submitted their plans on how they will be achieved, and poor data availability and quality remains a serious obstacle for the application of the 2030 Agenda. However, the SDGs remain a driver for change at the local, national and regional level, and for the first time this year, the Bill & Melinda Gates Foundation published Goalkeepers, a report that will monitor progress towards the goals, every year until 2030. 

In November, Paris announced the official launch of the Global Urban Air Pollution Observatory, whose goal is to reduce the impact of air pollution in cities through the exchange of good practices, something that our Urban Planning, Environment and Health Initiative is actively working on (according to the latest Global Burden of Disease study, in which ISGlobal participated, at least 15,000 deaths per year in Spain can be attributed to air pollution!). This month, also in Paris, president Macron organised a summit meeting to boost commitment to and funding of the fight against climate change.   

Let’s hope that these powerful initiatives manage to compensate for the cold wind of isolationism, intolerance and “alternative facts” that blows over the world; and that, in next year’s post, consternation has given way to optimism.