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The 13 biggest threats to global health, according to WHO

The World Health Organization (WHO) recently released a list of 13 urgent health challenges the world will face over next decade, which highlights a range of issues including climate change and health care equity.

About the list

According to WHO, the list provides an overview of "urgent, global health challenges" that WHO developed with help from experts around the world. WHO said the challenges included on the list "demand a response from more than just the health sector," adding, "Governments, communities, and international agencies must work together" to address these "critical" issues.

WHO said all of the challenges included on the list are urgent, and several are interlinked. As such, WHO did not list the challenges in any particular order.

The 13 biggest health challenges for the next decade

1. Climate crisis

The world's climate crisis has major health implications, according to WHO, with air pollution alone killing an estimated seven million people annually. In addition, more than 25% of deaths from chronic respiratory disease, heart attack, lung cancer, and stroke are attributed to the same emissions responsible for global warming, WHO said. Climate change also worsens malnutrition and promotes the spread of infectious diseases, according to WHO.

To address the issue, WHO said it is working toward creating "a set of policy options for governments" that aim to lower the health risks associated with air pollution. The organization said, "Leaders in both the public and private sectors must work together to clean up our air and mitigate the health impacts of climate change."

2. Health care delivery in areas of conflict and crisis

WHO noted that, in 2019, most of the disease outbreaks that required the organization's "highest level of … response occurred in countries with protracted conflicts."  WHO said it recorded a total of 978 attacks against health care workers or facilities in 11 countries last year, which resulted in 193 deaths. The conflicts also forced a record number of people to leave their homes, resulting in limited health care access for tens of millions of people, WHO said.

WHO noted that it is "working with countries and partners to strengthen health systems, improve preparedness, and expand the availability of long-term contingency financing for complex health emergencies." However, the group said "political solutions" are need "to resolve protracted conflicts, stop neglecting the weakest health systems, and protect health care workers and facilities from attacks."

3. Health care equity

There are major discrepancies in the quality of people's health across socio-economic groups, WHO said. For example, WHO noted that there is an 18-year difference between the life expectancy of people in low- and high-income countries, as well as significant differences in life expectancies among people living within the same countries and cities. In addition, low- and middle-income countries face a disproportionately large burden of cancer, diabetes, and other noncommunicable diseases, which can quickly put a strain on the resources of low-income households.

WHO said it is working to address disparities in health equity by improving "child and maternal care, nutrition, gender equality, mental health, and access to adequate water and sanitation" and providing guidance on how countries can work to improve health care equity.

4. Access to treatments

According to WHO, about one-third of people across the world lack access to essential health products such as diagnostic tools, medicines, and vaccines. Limited access to these products fuel drug resistance and threaten people's lives and health, according to WHO.

To address the issue, WHO said it will "sharpen its focus" on efforts to combat "substandard and falsified medical products; enhance[e] the capacity of low-income countries to assure the quality of medical products throughout the supply chain; and improve[e] access to diagnosis and treatment for noncommunicable diseases."

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5. Infectious disease prevention

HIV, sexually transmitted infections, viral hepatitis and other infectious diseases will kill an estimated four million people this year, accord to WHO. Vaccine-preventable diseases also are expected to kill thousands of people over the next decade.

Part of the reason why infectious diseases continue to spread is because of weak health systems in endemic countries and insufficient levels of financing, WHO said. As such, WHO said there is "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."

6. Epidemic preparedness

An airborne and highly infectious virus pandemic "is inevitable," WHO said, but countries around the world continue to spend more on responding to these emergencies than preparing for them. This leaves countries  unprepared for when another pandemic strikes and potentially threatens the lives of millions of people, according to WHO.

WHO said countries should invest in evidence-based practices to strengthen their health systems and protect populations from disease outbreaks, natural disasters, and other health emergencies.

7. Unsafe products

Nearly one-third of today's global disease burden is attributed to a lack of food, unsafe food, and unhealthy diets, according to WHO. WHO said while food insecurity and hunger continue to be an issue, there also is a growing number of people who have diets that are high in fat or sugar, leading to a rise in weight- and diet-related diseases. Further, there's been an increase in tobacco and e-cigarette use in most countries, raising additional health concerns.

WHO said it is looking to combat health risks related to unsafe foods and other products by "working with countries to develop evidence-based public policies, investments, and private sector reforms to reshape food systems and provide healthy and sustainable diets," and "to build political commitment and capacity to strengthen implementation of evidence-based tobacco control policies."

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8. Underinvestment in health workers

There is a shortage of health workers around the world because of low pay and chronic underinvestment in health workers' education and employment, WHO said. According to WHO, the shortages negatively affect health systems' sustainability and jeopardize health and social care services. An additional 18 million health workers, including nine million nurses and midwives, will be needed across the world by 2030, according to WHO.

WHO said the World Health Assembly has designated 2020 as the "Year of the Nurse and the Midwife" in an effort to spur "action and encourage investment in education, skills, and jobs" for health care workers. In addition, WHO said it is working with countries to generate new investments to ensure health care workers are trained and paid "decent salaries."

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9. Adolescent safety

Each year, more than one million adolescents ages 10 to 19 die, with road injuries, HIV, suicide, lower respiratory infections, and interpersonal violence leading as causes of death among teens. According to WHO, a number of factors—including harmful alcohol use, unprotected sex, and lack of physical activity—increase the risks of these types of death.

WHO said it will aim to promote mental health and curb harmful behaviors among adolescents in 2020 by issuing new guidance and working to bolster emergency trauma care.

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10. Improving public trust of health care workers

The spread of misinformation, coupled with weakening trust of public institutions, is playing an increasing role in the health decisions patients make, according to WHO. But when patients trust health care systems, they are more likely to follow a health care workers' advice on how to stay healthy and are more likely to rely on health services, WHO said.

In order to bolster public trust in health care workers and systems, WHO said it is working to help countries "strengthen primary care" and to combat misinformation on social media platforms. Further, WHO added that "scientists and the public health community need to do a better job of listening to the communities they serve," and there is a need for investments "in better public health data information systems."

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11. Capitalizing on technological advancements

Breakthroughs in technology have revolutionized disease diagnosis, prevention, and treatment, WHO said, and genome editing, digital health technologies, and synthetic biology have the potential to solve a number of health problems.

However, WHO also noted that these technologies raise a number of questions regarding how they should be regulated and monitored. WHO cautioned that without the appropriate guardrails, these technological advancements have the potential to create new organisms and harm people, and said it is setting up new advisory committees to review evidence and provide guidance on the technologies.

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12. Threat of anti-microbial resistance and other medicines

Anti-microbial resistance (AMR) has the potential to undo decades of medical advancements and has increased due to a number of factors, including limited access to quality and low-cost medications, the unregulated prescription and use of antibiotics, poor infection control, and more, WHO said.

The organization said it is working to combat AMR "by addressing its root causes, while advocating for research and development into new antibiotics."

13. Health care sanitation

Billions of people across the world live in communities without adequate sanitation services or potable water, which are major causes of disease. And about one-fourth of health care facilities across the world lack basic water services, which are critical to health systems, WHO said. A lack of water and other basic resources results in poor-quality care and increases the likelihood of infections, according to WHO.

To address the issue, WHO and its partners are working with low- and middle-income countries to improve hygiene, sanitation, and water conditions at the countries' health care facilities. WHO also is calling on all countries to ensure all health care facilities have basic hygiene, sanitation, and water services by 2030 (WHO, "Urgent health challenges for the next decade," 1/13).

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