The biggest threats to health this year

Every year, the World Health Organisation releases a list of what they believe are the top 10 threats to global health. Here are nine for in 2019:

AIR POLLUTION AND CLIMATE CHANGE

Nine out of 10 people breathe polluted air every day, and the primary cause of air pollution (burning fossil fuels) is also a major contributor to climate change, which impacts people’s health through malnutrition, malaria, diarrhoea and heat stress.

“Microscopic pollutants in the air can penetrate respiratory and circulatory systems, damaging the lungs, heart and brain, killing seven million people prematurely every year from diseases such as cancer, stroke, heart and lung disease,” WHO notes.

Ninety per cent of these deaths are in low- and middle-income countries, with high volumes of emissions from industries, transport and agriculture, and from unclean cooking fuels in homes.

NON-COMMUNICABLE DISEASES

Non-communicable diseases, such as diabetes, cancer and heart disease, are collectively responsible for over 70 per cent of all deaths worldwide, or 41 million people, including 15 million people who die prematurely, aged between 30 and 69.

These diseases are driven by five major risk factors: tobacco use, physical inactivity, harmful use of alcohol, unhealthy diets and air pollution.

These risk factors also exacerbate mental health issues.

INFLUENZA

The WHO warns that the world will face another influenza pandemic, though it is not clear when it will hit or how severe it will be.

Together with 153 institutions in 114 countries, the global health agency is monitoring the circulation of influenza viruses to detect potentially pandemic strains.

But global defences 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.

FRAGILE AND VULNERABLE SETTINGS

More than 1.6 billion people (22 per cent of the global population) live in places where protracted crises (drought, famine, conflict, and population displacement) and weak health services leave them without access to basic care.

These fragile settings exist in almost all regions of the world, and are where half of the key targets in the sustainable development goals, including on child and maternal health, remain unmet.

ANTIMICROBIAL RESISTANCE

The ability of bacteria, parasites, viruses and fungi to resist antibiotics (antimicrobial resistance) threatens to send us back to a time when we were unable to easily treat infections such as pneumonia, tuberculosis, gonorrhoea, and salmonellosis.

In 2017, around 600,000 cases of tuberculosis were resistant to rifampicin – the most effective first-line drug – and 82 per cent of these people had multidrug-resistant tuberculosis.

EBOLA AND HIGH-THREAT PATHOGENS

WHO’s Research and Development Blueprint identifies diseases and pathogens that have potential to cause a public health emergency but lack effective treatments and vaccines.

This watchlist for priority research and development includes Ebola, several other haemorrhagic 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 HEALTHCARE

Primary health care is the first point of contact people have with their healthcare system, and ideally should provide comprehensive, affordable, community-based care throughout life.

Health systems with strong primary healthcare are needed to achieve universal health coverage. Yet, many low- and middle-income countries do not have adequate primary healthcare facilities due to lack of resources.

Lack of adequate facilities can also be attributed to focus on single disease programmes in the past few decades.

DENGUE

A mosquito-borne disease that causes flu-like symptoms and can be lethal and kill up to 20 per cent of those with severe versions, dengue, has been a growing threat for decades.

A high number of cases occur during the rainy seasons of countries such as Bangladesh and India.An estimated 40 per cent of the world is at risk of dengue fever, and there are around 390 million infections a year.

HIV

Nearly a million people every year die of HIV/AIDS every year. To address this, the international health agency is supporting the introduction of self-testing to increase the number of people who know their status, so they can receive treatment (or preventive measures if the result is negative).