Top 10 threats to global health in 2019

The World Health Organization (WHO) recently came out with a list of the top 10 threats to global health that will demand attention from WHO and its health partners in 2019.
These threats, that are also affecting us in the country, include the following:
Vaccine hesitancy, or the reluctance or refusal to vaccinate despite the availability of vaccines, threatens to reverse progress made in tackling vaccine-preventable diseases. Vaccination is one of the most cost-effective ways of avoiding disease — it currently prevents two to three million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved. Vaccine hesitancy is an urgent issue in the Philippines following a drop in vaccine confidence and coverage.
Dengue remains a global health threat. Dengue cases in the country also increased by 21% in January to October 2018 compared to the same period in 2017. The WHO explains that dengue is a mosquito-borne disease that causes flu-like symptoms. Dengue may be lethal, killing up to 20% of those who contract its severe form.
Meanwhile, the world will face another global influenza pandemic — the only thing we don’t know is when it will hit and how severe it will be. WHO warns that global defenses against this threat are only as effective as the weakest link in any country’s health emergency preparedness and response system.
Every year, WHO recommends which strains should be included in the flu vaccine to protect people from seasonal flu. If a strain develops into one which could cause pandemic, the WHO will activate mechanisms that it has put in place in partnership with major players.
The HIV epidemic continues to rage with nearly a million people every year dying of HIV/AIDS. The 6,532 new HIV infections reported by the DoH from January to July 2018 is the highest recorded so far. The average number of Filipinos newly diagnosed with HIV per day has steadily increased: 2 in 2009, 7 in 2011, 13 in 2013, 22 in 2015. and 31 in 2018.
Noncommunicable diseases (NCDs), such as diabetes, cancer and heart disease, are collectively responsible for over 70% of all deaths worldwide. These three NCDs are among the leading causes of death in the Philippines. The rise of NCDs has been driven by five major risk factors: tobacco use, physical inactivity, the harmful use of alcohol, unhealthy diets and air pollution.
Air pollution and climate change: Nine out of ten people breathe polluted air every day. In 2019, air pollution is considered by WHO as the greatest environmental risk to health. Microscopic pollutants in the air can penetrate respiratory and circulatory systems, damaging the lungs, heart and brain, killing 7 million people prematurely every year from diseases such as cancer, stroke, heart and lung disease. The primary cause of air pollution (burning fossil fuels) is also a major contributor to climate change, which impacts people’s health in different ways. Between 2030 and 2050, climate change is expected to cause 250,000 additional deaths per year, from malnutrition, malaria, diarrhea and heat stress. As an archipelago, the Philippines is highly vulnerable to the impacts of climate change.
Fragile and vulnerable settings: More than 1.6 billion people (22% of the global population) live in places where protracted crises (through a combination of challenges such as drought, famine, conflict, and population displacement) and weak health services leave them without access to basic care. Fragile settings exist in almost all regions of the world, and these are where half of the key targets in the sustainable development goals, including on child and maternal health, remain unmet.
Antimicrobial resistance is the ability of bacteria, parasites, viruses and fungi to resist these medicines. Drug resistance is driven by the overuse of antimicrobials in people, but also in animals, especially those used for food production, as well as in the environment.
Ebola and other high-threat pathogens: In 2018, the Democratic Republic of the Congo saw two separate Ebola outbreaks, both of which spread to cities of more than 1 million people. WHO has come up with a watchlist for priority research and development. This includes Ebola, several other hemorrhagic fevers, Zika, Nipah, Middle East respiratory syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS) and disease X, which represents the need to prepare for an unknown pathogen that could cause a serious epidemic.
Weak primary health care: Primary health care can meet the majority of a person’s health needs of the course of their life. Health systems with strong primary health care are needed to achieve universal health coverage. Yet many countries do not have adequate primary health care facilities. This neglect may be a lack of resources in low- or middle-income countries, but possibly also a focus in the past few decades on single disease programs, the WHO concludes.
 
References:
1. https://www.who.int/emergencies/ten-threats-to-global-health-in-2019
2. https://news.mb.com.ph/2018/10/24/dengue-cases-up/
3. https://www.doh.gov.ph/node/1058
 
Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines (PHAP). Medicine Cabinet is a column that aims to promote awareness on public health and health care-related issues. PHAP and its member companies represent the research-based pharmaceutical and health care sector in the Philippines.
medicinecabinet@phap.org.ph.