Article for Global Health / Public Health

Article for Global Health / Public Health includes:

global health issues

global health learning
global health initiative
global health strategies

 

‘The first wealth is health’ is a famous quote said by Sir Emerson. We live in a super-fast age. The Internet has shrunk the world dramatically and people are connected 24×7. Multitasking is the order of the day as we struggle to fulfill our responsibilities to everyone in our lives. In this melee, too often we forget to spare time for ourselves. The stress levels continue to build up until one day a major collapse may make us aware that in all this frenzied activity, we have forgotten to take care of one important thing – our health. As we spend days shuttling between hospital and home, subjecting our body to one test after another trying to find out what has gone wrong, we are forced to remember that Health is indeed Wealth.

According to World Health Organization (WHO), health is physical, mental and social well-being and not merely the absence of disease. Health is a fundamental human right and a worldwide social goal, that it is essential to the satisfaction of basic human needs and to an improved quality of life, and that it is to be attained by all the people. “Nothing on earth is more international than disease”, said Paul Russell. Health and disease have no political or geographical boundaries. Disease in any part of the world is a constant threat to other parts. History is replete with examples of the spread of pestilences-particularly of plague and cholera, along trade routes. In the 14th century, a procedure known as “quarantine” was introduced in Europe to protect against the importation of plague. Quarantine soon became an established practice in many countries. This was the origin of international health work. It was recognized that in both developed and developing countries, the standard of health services the public expected was not being provided. The services do not cover the whole population. 

There is lack of services in some areas and unnecessary duplication in others. A very high proportion of the population in many developing countries, and especially in rural areas does not have ready access to health services. Although there was the recognition that health is a fundamental human right, there is a denial of this right to millions of people who are caught in the vicious circle of poverty and ill-health. This culminated in the international objective of ‘HEALTH FOR ALL’ as a social goal of all governments. Health for all was a holistic concept calling for efforts in agriculture, industry, education, housing and communications, just as much as in medicine and public health. But this was not implemented as expected and is the result of changing lifestyles, and demographic and epidemiological transitions that are being experienced as population’s age and countries advance in social and economic development. New global challenges result from industrial growth, globalization and increasing interdependence, such as climate change, food insecurity, epidemic levels of chronic diseases and pandemic disease impact on human health and wellbeing. Chronic threats such as tobacco addiction, obesity, environmental pollution, and lack of access to care riddle the public health landscape, exacerbated by profound health inequities has also posed a big challenge. With the increase trend in life style changes leading to sedentary habits coupled with addictions like smoking and alcohol abuse and failure to obtain preventive health services for example hypertension control, cancer detection and management of diabetes the risk for non-communicable diseases has increased. 

In 2008, more than 5 million people in the Asia-Pacific region died from tobacco use and exposure to tobacco smoke, for an average of 1 death every 6 seconds. Now the serious concern is the use of tobacco by adolescents which needs a serious attention or else the Continuation of tobacco use from such an early age puts people at a much greater risk of contracting non-communicable diseases at an earlier age. If not addressed effectively, the problem will increase pressure on healthcare systems in the future and cause health expenditures to rise in those countries. 

Today, non-communicable diseases (NCDs), mainly cardiovascular diseases, cancers, diabetes and chronic respiratory diseases, represent a leading threat to human health and development. These four diseases are the world's biggest killers, causing an estimated 35 million deaths each year -60% of all deaths globally- with 80% in low-and middle income countries. These diseases are preventable. Upto80% of heart disease, stroke, and type2diabetes and over a third of cancers could be prevented by eliminating shared risk factors, mainly tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol. Unless addressed, the mortality and disease burden from these health problems will continue to increase. WHO projects that, globally, NCD deaths will increase by 17% over the next ten years. We have the right vision and knowledge to address these problems. Proven cost effective strategies exist to prevent and control this growing burden. However, high-level commitment and concrete actions are often missing at the national level. NCD prevention and control programs remain dramatically under-funded at the national and global levels and have been left off the global development agenda. Despite impacting the poorest people in low-income parts of the world and imposing a heavy burden on socioeconomic development, NCD prevention is currently absent from the Millennium Development Goals. However, in all low- and middle-income countries and by any measure, NCDs account for a large enough share of the disease burden of the poor to merit a serious policy response, not forgetting the deaths due to accidents and injuries.

Developing and least developed Asian and Pacific countries are vulnerable to both non-communicable and communicable diseases. Since most of these countries have a relatively high proportion of deaths of young people (including children) which are often caused by communicable diseases, the figures for Years of Lost Life due to communicable diseases are higher. According to WHO, low-income countries currently have a relatively higher share of deaths from: 

(i) HIV infection, TB and malaria, 

(ii) other infectious diseases, and 

(iii) maternal, perinatal and nutritional causes compared with high- and middle-income countries.  

Although these three causes combined pose a lesser burden than non-communicable diseases, they will remain important causes of mortality in the next 25 years in low-income countries. Vaccination, use of condoms, proper use of antibiotics and better environmental conditions may help in this context.

Evidence from the World Health Organization suggests that nearly half the world's populations are affected by mental illness with an impact on their self-esteem, relationships and ability to function in everyday life. An individual's emotional health can also impact physical health and poor mental health can lead to problems such as substance abuse. The importance of maintaining good mental health is crucial to living a long and healthy life. Good mental health can enhance one’s life, while poor mental health can prevent someone from living a normal life. “There is growing evidence that is showing emotional abilities are associated with pro social behaviors such as stress management and physical health” (2010). It was also concluded in their research that people who lack emotional expression lead to misfit behaviors. These behaviors are a direct reflection of their mental health. Self-destructive acts like suicide may take place to suppress emotions. The other conditions which may affect the health and well-being of people may be disasters like earth quakes, cyclones, floods, nutritional problems, volcanic eruptions, fires, severe air pollution, epidemics, toxicological accidents, nuclear accidents and warfare. There is also a lot of resources imbalance which poses the greatest challenge to global health. 

"Global health is not just about disease based initiatives", "it's about strengthening systems and institutions for delivering health-and that don’t just refer to strengthening health systems. It's about norms and standards, it's about whole of government approaches and partnerships, it's far beyond the "North-South" mind-set-there are totally different networks at play-even the infectious/non-infectious disease agenda needs to be framed quite differently." This broader understanding of global health, demands that global health governance takes responsibility for the determinants of health.

I would hence like to conclude by saying that “The challenges ahead are great, but the world has never been in a better position to dramatically improve global health. We have the tools to prevent many of the worst diseases; we have the scientific knowledge to develop new solutions; and we have growing political commitment and resources. Working together, we can save millions of lives, and change the world's view of what's possible”.

Article by:

Zeba Unnisa