This year marks two significant milestones in public health: the 70th anniversary of both the World Health Organization (WHO) and the Universal Declaration of Human Rights.
Both WHO’s constitution and the declaration assert that health is a human right, rather than a privilege for those who can afford it.
In the past 70 years, the world has made significant progress in safeguarding that right and improving the health of the world’s people.
Life expectancy has increased by 25 years. Maternal and childhood mortality has plummeted. Smallpox has been eradicated and polio is on the brink. We have turned the tide on the HIV/AIDS epidemic and deaths from malaria have dropped dramatically. Innovative partnerships have produced effective vaccines against meningitis and the world’s first malaria vaccine. There are many other causes for celebration.
But even as we continue to struggle with old threats, new ones have arisen.
The impact of climate change
Climate change will have profound effects on health. Antimicrobial resistance has the potential to destroy the gains of modern medicine. Non-communicable diseases, including heart disease, stroke, cancer, diabetes, hypertension, lung diseases and mental illnesses, have become the major killers of our time.
This year also marks another landmark in the history of public health – the 100th anniversary of the 1918 influenza pandemic. The so-called Spanish flu remains the deadliest outbreak on record. At least 50 million people died, three times more than the death toll from the First World War, which overshadowed it.
Thankfully, we have not seen a pandemic on that scale since then. But the threat of outbreaks is ever present, and the world remains vulnerable, especially to airborne viruses.
Diseases do not respect national borders; a threat to one country is a threat to us all. The devastating West African Ebola epidemic of 2014–15 highlighted that we are only as strong as our weakest link.
At the time of writing, I am in the Democratic Republic of the Congo with Jean-Pierre Lacroix, the United Nations under secretary general for peacekeeping operations, to assess the latest Ebola outbreak and the measures we need to take to end it.
Although we have new tools, such as a vaccine and investigational therapeutics, we are also facing new challenges: the outbreak is occurring in an active conflict zone. On several occasions our operations have been in lockdown because of attacks in and around the town of Beni, the epicentre of the outbreak. But while we are in lockdown, Ebola is not.
Stronger health systems
Responding to outbreaks and other emergencies is a key part of WHO’s work. But even more important is the task of strengthening health systems to support countries on their journey towards universal health coverage.
Strong health systems are the best investment both in health security and in promoting health and preventing disease.
In the Sustainable Development Goals (SDGs), all countries have committed to universal health coverage as part of SDG 3: healthy lives and well-being for all.
Political commitment at the country level is essential for achieving that goal, with support from WHO and other partners working in an integrated and coherent way.
At the invitation of Germany, Ghana and Norway, 11 international agencies have agreed to work together on a Global Action Plan for Healthy Lives and Well-Being to get the world back on track for achieving the ambitious health targets in the SDGs.
We call on G20 leaders to support the Global Action Plan by ensuring that health remains an integral and permanent part of the G20 agenda, and to encourage its inclusion in other multilateral forums.
At a national level, we need G20 leaders to translate commitments on paper into action on the ground. In particular, we need countries to strengthen their capacities to detect and respond to outbreaks, according to the International Health Regulations; to implement national action plans against antimicrobial resistance; to develop public health policies that tackle malnutrition, with a special focus on childhood obesity, and to improve the availability of and access to healthy food; and to build an adequately trained health workforce with suitable and safe work conditions, especially as the world is facing a gap of 18 million health workers needed to achieve the health-related SDGs.
These actions need no justifications; they are ends in themselves because health is a rights issue. But the dividends they pay in terms of more stable and productive societies make investing in health a no-brainer.