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Global Health

An Overview - The main health-related antagonists of the world

Despite substantial developments in the world of medicine and health care, there are one billion people in the world who still lack access to health care systems. Out of 56 million deaths each year worldwide, 36 million deaths are due to non-infectious chronic diseases, such as cardiovascular disease, cancer, diabetes and chronic lung diseases. Other diseases that are considered significant include lower back pain and major depression. These ranked amongst the top ten greatest contributors to disability in every country, causing more health loss than diabetes, chronic obstructive pulmonary disease, and asthma combined in 2013. The load of major depression is likely to rise to be the second chief cause of loss of ‘disability-adjusted life years’ in 2030.

Most of the deaths caused by debilitating diseases such as cardiovascular disease (over 80%) occur in low- and middle-income countries. HIV/AIDS is another marring disease of the modern world that is roughly estimated to take over the lives of 33.4 million people, with 2 million people dying yearly, based on an evaluation from UNAIDS. Similarly, Tuberculosis presents itself as 9.4 million cases each year.

Children are one of the most vulnerable groups getting affected by preventable diseases; children make up half of the 1.6 million deaths caused by pneumococcal diseases, making pneumococcal diseases the number one vaccine-preventable cause of death worldwide. Vaccination against these diseases is vitally important. In developing countries, half of the children who receive medical treatment against pneumococcal diseases still die.

Other diseases, such as Malaria are almost non-existent in Europe and North America but are very prevalent in the tropical and subtropical regions that exist in a broad band around the equator, that includes much of sub-Saharan Africa, Asia and Latin America. These diseases cause some 225 million acute illnesses annually.

Although the statistics above make for ill reading, an important fundamental link to these deaths is poverty. The World Health Organization (WHO) and others repeatedly point out that many of these diseases are “diseases of poverty.” Health services were either reduced or removed, and now health care is either unavailable for the poor in many parts of the world, or is too expensive. The WHO provides a useful diagram to show this in effect:

However, even though today we are continuing to develop more effective drugs to treat diseases, global health is still at risk from drug-resistant pathogens. Bacteria and other pathogens have continually evolved to resist drugs that modern medicine uses to combat them. In recent years the increase in drug resistance has been a particular worry, specifically due to the advent of antibiotic resistant superbugs. Unless steps are taken to tackle this significant global issue, one conventional estimate is that it will cost the world an additional 10 million lives a year by 2050. It will also have an aggregate cost of 100 trillion USD, which is more than 1.5 times the annual world GDP today, or approximately the equivalent to losing the UK economy from global output annually.

On the high pricing for drugs, it has been noted, Big pharma generally defends high prices for new drugs … to cover costs for researching and developing new drugs. But in fact, most new drugs launched are just slight variations of existing medicines
Nathan Ford, of Médicins Sans Frontiéres said, At the moment we are getting more and more drugs of less and less use. The tenth headache pills; the 15th Viagra. There are currently eight drugs in development at the moment for erectile dysfunction. Do we need 8 more drugs for erectile dysfunction? I don’t think we do. Meanwhile diseases like Malaria, TB that kill 6 million people every a year, are neglected—no new medicines are coming out and we are left treating people with old drugs that increasingly don’t work

Current situation and measures taken to deal with health related problems:

Most of the world’s health-care systems continue to depend on the most discriminatory method for funding health-care services: out-of-pocket payments by the sick or their families at the point of service. This robs many families of much needed care because they cannot afford it. Moreover, a tumultuous cycle is generated as more than 100 million people around the world are pushed into poverty each year because of catastrophic health-care expenditures (Primary Health Care, Now More Than Ever, WHO World Report 2008). To combat diseases on a global scale, the World Health Organisation (WHO) is the main organisation whose interventions cover all areas of the global health-care spectrum, including response to humanitarian emergencies and crisis intervention; preventing chronic diseases; establishing International Health Regulations, which countries must follow to recognise disease outbreaks and stop them from spreading; and working to achieve the health-related Millennium Development Goals (MDGs).

Global Health works conjointly with the World Health Organization, UNICEF and other UN agencies to improve and develop major initiatives to help families survive and thrive. Other organisations are also at work to reduce the global disease burden for specific groups. An example is of ‘Every Woman Every Child’, which aims to save the lives of 16 million women and children by 2015. It is a global effort that assembles and intensifies international and national action by governments, the private sector and civil society to tackle with the major health challenges facing women and children around the world.

Currently, the top strategies employed by various organisations can be summarised as follows:

1) RAISE PUBLIC AWARENESS:

• Endorse healthy lifestyle choices through effectual education and public engagement.
• Bring up the political concern of non-communicable diseases.
• Assemble persuasive and usable information to help with widespread and accurate media coverage and thus, improve economic and social health impacts.

2) ENHANCE ECONOMIC, LEGAL AND ENVIRONMENTAL POLICIES

• Address the impact of government taxation on health
• Develop and implement national and international policies as well as regulatory restraints, to discourage the consumption of alcohol, tobacco and unhealthy foods
• Address the impacts of poor health on economic output and productivity

3) ENGAGE BUSINESS AND COMMUNITY

• Make business a key partner in promoting health and preventing disease.
• Develop and monitor codes of responsible conduct with the food, beverage and restaurant industries.
• Empower community resources such as voluntary and faith-based organizations.

4) DIMINISH HEALTH IMPACTS OF POVERTY AND URBANIZATION

• Study how poverty increases risk factors
• Focus on the links between the built environment, urbanization and chronic non-communicable diseases.

5) HEALTH SYSTEM REORIENTATION

• Assign resources within health systems based on burden of disease.
• Increase number and skills of professionals who prevent, treat and manage chronic diseases, especially in developing countries.
• Move health professional training towards proper use of antibiotics (e.g. limit use of antibiotics until sure the patient needs it; limit antibiotic distribution over counters; emphasize on completion on course of antibiotic etc.)
• Increase access to medications to prevent complications of diseases.

Since 2000, large Global Health Initiatives (GHIs) have stemmed a rigorous response to the aforementioned diseases with effective health interventions and technologies (e.g, short-course chemotherapy for tuberculosis, vaccines, antiretroviral drugs for HIV/AIDS, and insecticide-treated bed-nets and artemisinin in combination with other treatments for the prevention and treatment of Malaria). About 100 GHIs now exist. A few of these are: Tuberculosis and Malaria (Global Fund); the Global Fund to Fight AIDS, the Global Alliance for Vaccines and Immunization (GAVI) and the World Bank Multi-Country AIDS Program (MAP).

General issues with the data gathered and effectiveness of such implementations:

No rigorous studies exist in which the effect of GHIs on health systems has been prospectively examined. In view of the amounts of resources that are being invested in health systems, new efforts are needed to improve data gathering, and new methods should be designed to specifically measure and investigate health systems.
Correlations with other sectors, such as nutrition, education, housing, and labour also have an effect on the general population health. Moreover, a country’s ability to invest in health is controlled by a plethora of factors such as national wealth, economic performance, economic policy, and governance.
In short, some major reasons for unnecessary deaths around the world are due to human decisions and politics, not just natural outcomes. Tackling systemic problems is paramount for effective, universal health care that all are entitled to.

References:

http://www.globalissues.org/issue/587/health-issues
http://content.time.com/time/health/article/0,8599,1687159,00.html
http://www.who.int/features/factfiles/global_burden/en/
http://www.un.org/en/globalissues/health/