Global Health Challenges
“The world is facing multiple health challenges. These range from outbreaks of vaccine-preventable diseases like measles and diphtheria, increasing reports of drug-resistant pathogens, growing rates of obesity and physical inactivity to the health impacts of environmental pollution and climate change and multiple humanitarian crises.”
This was the statement of the World Health Organization (WHO) in 2019. In addition, WHO warned: “The world will face another influenza pandemic — the only thing we don’t know is when it will hit and how severe it will be.” A few months later the pandemic was there, but COVID-19 hit us with a so far unknown virus, the SARS-CoV-2.
Five years later, the WHO gives us an update on the major challenges our health and well-beeing is facing currently — and for what wen will need to prepare.
WHO Statistics on Mortality
The World health statistics report is the annual compilation of health and health-related indicators, which has been published by the World Health Organization (WHO) since 2005. In the 2024 edition, the first chapter contains updated worldwide and regional figures of life expectancy, healthy life expectancy, and mortality from particular causes.
What do you think were the 2021 top three causes of mortality globally?
You are correct in putting cardiovascular disease first. Atherosclerosis narrows the arteries and obstructs the blood flow to the heart or brain, resulting in a fatal myocardial infarction, heart failure, or stroke. Cardiovascular events claim the lives of around one in every four individuals.
Your next likely assumption may also be correct. Cancer accounted for around 14.6% of all deaths worldwide in 2021.
Number 3 Comes as a Surprise
At least for those who are fortunate enough to live in nations where strict safety regulations and an effective vaccination campaign have helped to mitigate this surge. Covid-19 infection and its associated complications were responsible for more than every one in ten deaths globally within the year 2021.
COVID-19 Erased a Decade of Healthy Life Expectancy
According to the WHO health statistics report, in just two years, the COVID-19 pandemic erased nearly a decade of gains in both life expectancy at birth and healthy life expectancy (HALE). This migth not meet everyones obeservation in their own Region. However, according to the WHO, areas most affected were the Americas and South-East Asia, with life expectancy decreases of almost 3 years between 2019 and 2021.
The Last Pandemic — Just an Example of 21st Century Threats
Globally, noncommunicable diseases (NCDs) such as cardiovascular disease, chronic respiratory disorders mostly caused by smoking, most forms of cancer, diabetes, and dementia accounted for 73.9% of all deaths in 2019. Concurrently, the percentage of “communicable diseases” (CDs) caused by pathogens such as viral or bacterial infections decreased to 18.2%. With the emergence of COVID-19, all communicable diseases combined climbed back to 23.0% of all fatalities in 2020 and 28.1% in 2021, returning to 2005 levels. COVID-19 alone was responsible for 4.1 million (2021) and 8.8 million (2022) deaths worldwide.
However, Covid-19 is not a single event, bad luck, something we experienced once and which will never come back. The twenty-first century has witnessed a wave of severe infectious disease outbreaks. The
- 2003 “Severe Acute Respiratory Syndrome CoronaVirus (SARS-CoV-1) outbreak,
- 2009 “swine flu” (Influenza A(H1N1)) pandemic,
- 2012 Middle East Respiratory Syndrome (MERS) coronavirus outbreak,
- 2013–2016 Ebola virus disease epidemic in West Africa,
- 2015 Zika virus disease epidemic, and the
- since 2022 ongoing Mpox (formerly named “monkey pox”) epidemic outbreaks
all resulted in substantial morbidity and mortality while spreading across borders to infect people in multiple countries.
A Connected World — For Man and Microbes
At the same time, the past few decades have ushered in an unprecedented era of technological, demographic, and climatic change. Since 2000, airline flights have doubled. Since 2007, more people live in urban areas than rural areas. Climatic changes also lead to the spread of the habitat of subtropical or tropical carriers of viruses. All these recent global changes have increased the risk of infectious disease outbreaks, even as improved sanitation and access to health care have resulted in considerable progress worldwide.
Animal Trade and Outbreaks
Animal trade has contributed to multiple outbreaks and emergence events globally and pose substantial risk for animal and public health. Large numbers of livestock are traded annually between countries and may facilitate the spread of pathogens. Rift Valley fever, for example, is a zoonotic vector-borne viral disease causing abortion and high neonatal mortality in domestic ruminants. The disease is widespread on the African continent and has recently been detected in Saudi Arabia and Yemen. Live cattle movement between East Africa and the Arabian Peninsula or from the Union of Comoros to Madagascar is thought to have contributed to the introduction of Rift Valley fever virus and caused outbreaks in these locations in 2000 (Arabian Peninsula) and 2008 (Madagascar).
Large livestock is one of the reason for another global threat: antimicrobial resistence (AMR) is a complex problem evolving from (too) high and inapproriate use of antibiotics in human health, food production, animal and environmental sectors. It affects countries in all regions and at all income levels, and requires a coordinated action plan across these sectors.
SARS-CoV-2. Monkeypox. Polio. Marburg. These viruses are no longer familiar just to public-health experts, but household names around the world, thanks to their recent incursions into human populations. People have always confronted pathogens of all sorts, but the attacks are becoming more commonplace, and more intense, than they ever have before.
“We are going through an era of epidemics and pandemics,…
…and they are going to be more complex and more frequent,” says Jeremy Farrar, director of Wellcome, a global health charitable foundation that addresses health challenges.
The world has seen polio outbreaks before, for instance, as well as monkeypox clusters and cases of Marburg, a cousin of the deadly Ebola virus. We’ve even seen earlier versions of SARS-CoV-2 in the coronavirus outbreaks of 2002 and 2012. So why are these outbreaks piling up, seemingly all of sudden, and at the same time?
The explanation lies in the way we live our contemporary lives — from the ubiquity of worldwide travel to humans’ deeper encroachment into previously untouched natural habitats and the modernization that has led to climate change, urbanization, and overcrowding. Even the instantaneous and unfiltered way we communicate on social media is contributing, since misinformation is often shared, believed, and elevated to the same degree as trustworthy messages.
Then there is the increasingly unstable balance of geopolitics driving millions from their homes and into refugee camps and migrant housing, which are fertile grounds for infectious diseases to spread.
In addition, viruses and other microbes live in a dynamic and ever-evolving community. Every encounter with a human is a chance for pathogens like viruses, but also bacteria, to become fitter and more adept at infecting and causing disease in people.
Simply put, the multitude of infectious diseases facing the world today is “just the evolution of microbes and humans coming to a collision course,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
Do Humans Have a Chance Against Microbes?
COVID-19 and the other ongoing outbreaks may have finally awakened a global awareness of need for international collaboration. The World Bank recently mobilized a $10 billion annual fund dedicated to helping countries in the developing world improve their surveillance methods for detecting and — most importantly — sharing information about unusual cases of infectious diseases that could represent new public-health threats.
In addition, each region needs to establish national measures to combat the spread to infections diseases. The UAE works on disease prevention and control through several measures which include implementing laws and resolutions on combatting communicable diseases, reporting communicable diseases, setting a national policy for disease prevention and introducing health and vaccination programmes.
Stay Informed!
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Your Health Matters!
a contribution of Dr. Gabriele Stumm
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