Urgent health challenges for the next decade 2030: World Health Organization

As a new year and a new decade kickoff, WHO has released a list of urgent, global health challenges in January 2020. This list, developed with input from WHO experts around the world, reflects a deep concern that leaders are failing to invest enough resources in core health priorities and systems. This puts lives, livelihoods, and economies in jeopardy. None of these issues are simple to address, but they are within reach. Public health is ultimately a political choice. All the challenges in this list demand a response from more than just the health sector. With the deadline for the 2030 Sustainable Development Goals quickly approaching, the United Nations General Assembly has underscored that the next 10 years must be the "decade of action". -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------According to WHO Director-General, we need to realize that health is an investment in the future. Countries invest heavily in protecting their people from terrorist attacks, but not against the attack of a virus, which could be far more deadly, and far more damaging economically and socially. A pandemic could bring economies and nations to their knees. Which is why health security cannot be a matter for ministries of health alone. Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus, SARS-CoV-2, that was first recognized in Wuhan, China, in December 2019. Genetic sequencing of the virus suggests that SARS-CoV-2 is a betacoronavirus closely linked to the SARS virus. The World Health Organization (WHO) has declared the COVID-19 outbreak a pandemic on 11 March 2020 and till the 19th April 2020 WHO reports the 2,241,359 confirmed cases, 152,551 deaths and more than 168 countries, areas or territories with cases worldwide affected.1,2 Stopping infectious diseases What’s the challenge? Infectious diseases like HIV, tuberculosis, viral hepatitis, malaria, neglected tropical diseases and sexually-transmitted infections will kill an estimated 4 million people in 2020, most of them 114 NEUROPHARMAC JOURNAL 5 (2020) 113-117 poor. Meanwhile, vaccine-preventable diseases continue to kill, such as measles, which took 140,000 lives in 2019, many of them children. Although polio has been driven to the brink of eradication, there were 156 cases of wild poliovirus last year, the most since 2014. The root causes are insufficient levels of financing and the weakness of health systems in endemic countries, coupled with a lack of commitment from wealthy countries. What’s WHO doing? There’s an urgent need for greater political will and increased funding for essential health services; strengthening routine immunization; improving the quality and availability of data to inform planning, and more efforts to mitigate the effects of drug resistance. There’s also a need to invest in research and development of new diagnostics, medicines and vaccines. Together with partners, WHO is working to end polio as soon as possible. Preparing for epidemics What’s the challenge? Every year, the world spends far more responding to disease outbreaks, natural disasters and other health emergencies than it does preparing for and preventing them. A pandemic of a new, highly infectious, airborne virus most likely a strain of influenza to which most people lack immunity is inevitable. It is not a matter of if another pandemic will strike, but when, and when it strikes it will spread fast, potentially threatening millions of lives. Meanwhile, vector-borne diseases like dengue, malaria, Zika, chikungunya, and yellow fever are spreading as mosquito populations move into new areas, fanned by climate change. What is WHO doing? WHO is advising countries on evidence-based investments to strengthen health systems and infrastructure to keep populations safe when health emergencies strike. The 2019 Global Preparedness Monitoring Board report identified seven concrete steps that countries and multilateral institutions should adopt, including more international cooperation, greater domestic focus on preparedness and increased funding. Protecting the medicines that protect us What’s the challenge? Anti-microbial resistance (AMR) threatens to send modern medicine back decades to the preantibiotic era, when even routine surgeries were hazardous. The rise of AMR stems from myriad factors that have come together to create a terrifying brew, including unregulated prescription and use of antibiotics, lack of access to quality and affordable medicines, and lack of clean water, sanitation, hygiene and infection prevention and control. What is WHO doing? WHO is working with national and international authorities in the environment, agriculture and animal sectors to reduce the threat of AMR by addressing its root causes, while advocating for research and development into new antibiotics. Protecting people from dangerous products What’s the challenge? Lack of food, unsafe food and unhealthy diets are responsible for almost one-third of today’s global disease burden. Hunger and food insecurity continue to plague millions, with food shortages being perniciously exploited as weapons of war. At the same time, as people consume foods and drinks high in sugar, saturated fat, trans fat and salt, overweight, obesity and diet-related diseases are on the rise globally. Meanwhile, tobacco use is declining in a few but rising in most countries, and evidence is building about the health risks of ecigarettes. What is WHO doing? WHO is working with countries to develop evidence-based public policies, investments and private sector reforms to reshape food systems, and provide healthy and sustainable diets. In 2019 the food industry committed to eliminating trans fat by 2023, but more is needed. WHO is working with countries to build political commitment and capacity to strengthen the implementation of evidence-based tobacco control policies. Investing in the people who defend our health What’s the challenge? 115 NEUROPHARMAC JOURNAL 5 (2020) 113-117 Chronic under-investment in the education and employment of health workers, coupled with a failure to ensure decent pay, has led to health worker shortages all over the world. This jeopardizes the health and social care services and sustainable health systems. The world will need 18 million additional health workers by 2030, primarily in lowand middle-income countries, including 9 million nurses and midwives. What is WHO doing? To trigger action and encourage investment in education, skills and jobs, the World Health Assembly has designated 2020 the Year of the Nurse and the Midwife. WHO, with partners, will issue a comprehensive State of the World’s Nursing report on World Health Day in April. We’re working with countries to stimulate new investment to train health workers and pay them decent salaries. Keeping adolescents safe What’s the challenge? More than 1 million adolescents aged 10-19 years die every year. The leading causes of death in this age group are road injury, HIV, suicide, lower respiratory infections, and interpersonal violence. Harmful use of alcohol, tobacco and drug use, lack of physical activity, unprotected sex, and previous exposure to child maltreatment all increase the risks for these causes of death. What is WHO doing? In 2020, WHO will issue new guidance for policymakers, health practitioners and educators, called Helping Adolescents Thrive. The aim is to promote adolescents’ mental health and prevent the use of drugs, alcohol, self-harm and interpersonal violence, as well as provide young people with information on preventing HIV and other sexually transmitted infections, contraception, and care during pregnancy and childbirth. WHO will continue to work with governments on improving emergency trauma care following severe injuries (e.g. due to gunshots and road traffic crashes). Earning public trust What’s the challenge? Trust helps to shape whether patients are likely to rely on health services and follow a health worker’s advice around vaccinations, taking medicines, or using condoms. Public health is compromised by the uncontrolled dissemination of misinformation in social media, as well as through the erosion of trust in public institutions. The anti-vaccination movement has been a significant factor in the rise of deaths in preventable diseases. What is WHO doing? WHO is working with countries to strengthen primary health care, so people can access effective and affordable services easily, from people they know and trust, in their communities. We're working with Facebook, Pinterest and other social media platforms to ensure their users receive reliable information about vaccines and other health issues. Building scientific literacy and health education is vital. There’s a need, too, for self-reflection: scientists and the public health community need to do a better job of listening to the communities they serve. Finally, we must invest in better public health data information systems. Harnessing new technologies What’s the challenge? New technologies are revolutionizing our ability to prevent, diagnose and treat many diseases. Genome editing, synthetic biology, and digital health technologies such as artificial intelligence can solve many problems, but also raise new questions and challenges for monitoring and regulation. Without a deeper understanding of their ethical and social implications, these new technologies, which include the capacity to create new organisms, could harm the people they are intended to help. What is WHO doing? In 2019 WHO set up new advisory committees for human genome editing and digital health, bringing together the world’s leading experts to review the evidence and provide guidance. WHO is also working with countries to enable them to plan, adapt, and benefit from new tools that provide clinical and public health solu