Infectious diseases Respiratory tract infections Infections of the respiratory tract and middle ear are major causes of morbidity and mortality worldwide. Some respiratory infections of global significance include
tuberculosis,
measles,
influenza,
coronaviruses and
pneumonias caused by
Mycobacterium tuberculosis,
Morbillivirus,
Haemophilus influenzae and Pneumococci respectively. The spread of respiratory infections is exacerbated by crowded conditions, and poverty is associated with more than a 20-fold increase in the relative burden of
lung infections.
Diarrheal illnesses Diarrhea is the second most common cause of child mortality worldwide, responsible for 17% of deaths of children under age 5. Poor
sanitation can increase transmission of bacteria and viruses through water, food, utensils, hands, and flies. Dehydration due to diarrhea can be effectively treated through
oral rehydration therapy with dramatic reductions in mortality. Important nutritional measures include the promotion of
breastfeeding and zinc supplementation. While hygienic measures alone may be insufficient for the prevention of
rotavirus diarrhea, it can be prevented by a safe and potentially cost-effective vaccine.
HIV/AIDS The HIV/AIDS
epidemic has highlighted the global nature of human health and welfare and globalization has given rise to a trend toward finding common solutions to global health challenges. Numerous international funds have been set up in recent times to address global health challenges such as HIV. Since the beginning of the epidemic, more than 70 million people have been infected with the HIV virus and about 35 million people have died of HIV. Globally, 36.9 million [31.1–43.9 million] people were living with HIV at the end of 2017. An estimated 0.8% [0.6–0.9%] of adults aged 15–49 years worldwide are living with HIV, although the burden of the epidemic continues to vary considerably between countries and regions. The WHO African region remains most severely affected, with nearly 1 in every 25 adults (4.1%) living with HIV and accounting for nearly two-thirds of the people living with HIV worldwide. Human immunodeficiency virus (HIV) is transmitted through unprotected sex, unclean needles,
blood transfusions, and from mother to child during birth or
lactation. Globally, HIV is primarily spread through
sexual intercourse. The risk-per-exposure with vaginal sex in low-income countries from female to male is 0.38% and male to female is 0.3%. The infection damages the immune system, leading to acquired immunodeficiency syndrome (AIDS) and eventually, death.
Antiretroviral drugs prolong life and delay the onset of AIDS by minimizing the amount of HIV in the body.
Malaria Malaria is a mosquito-borne infectious disease caused by the parasites of the genus
Plasmodium. Symptoms may include fever, headaches, chills, muscle aches and nausea. Each year, there are approximately 500 million cases of malaria worldwide, most commonly among children and pregnant women in developing countries. The WHO African Region carries a disproportionately high share of the global malaria burden. In 2016, the region was home to 90% of malaria cases and 91% of malaria deaths. The use of
insecticide-treated bed nets is a cost-effective way to reduce deaths from malaria, as is prompt
artemisinin-based combination therapy, supported by
intermittent preventive therapy in pregnancy. International travelers to
endemic zones are advised
chemoprophylaxis with
antimalarial drugs like
Atovaquone-proguanil,
doxycycline, or
mefloquine. Global consumption and international trade in deforestation-associated commodities could also indirectly influence malaria risk. Many primary commodities cause deforestation and deforestation can increase malaria transmission. Consumption of such commodities in developed nations could increase malaria risk in developing nations.
Bacterial pathogens (B), by pathogen and
GBD super-region, 2019
Neglected tropical diseases More than one billion people were treated for at least one neglected tropical disease in 2015. For instance, neglected tropical diseases are a diverse group of infectious diseases that are endemic in
tropical and
subtropical regions of 149 countries, primarily effecting low and middle income populations in Africa, Asia, and Latin America. They are variously caused by
bacteria (
trachoma,
leprosy),
viruses (
dengue,
rabies),
protozoa (
human African trypanosomiasis,
chagas), and
helminths (
schistosomiasis,
onchocerciasis,
Soil transmitted helminths). The Global Burden of Disease Study concluded that neglected tropical diseases comprehensively contributed to approximately 26.06 million
disability-adjusted life years in 2010, as well as significant deleterious economic effects. In 2011, the World Health Organization launched a 2020 Roadmap for neglected tropical diseases, aiming for the control or elimination of 10 common diseases. The 2012
London Declaration builds on this initiative, and called on endemic countries and the international community to improve access to
clean water and basic sanitation, improved living conditions,
vector control, and
health education, to reach the 2020 goals. In 2017, a WHO report cited "unprecedented progress" against neglected tropical diseases since 2007, especially due to
mass drug administration of drugs donated by pharmaceutical companies.
Pandemic prevention and preparedness Pandemics have an impact on global health.
Health research and development The global health approach could foster international collaboration in medical research and development and share of its results such as vaccines, optimizing overall global health for citizens. The
U.S. Agency for International Development's new Global Health Research and Development Strategy 2023–2028 includes plans to coordinate with such stakeholders in support of innovative global health product development and work with other agencies like the
CDC and National Institutes of Health. Another approach to health would be the innovation of
vaccines. The
Washington Post reported the US government's new five billion dollar budget on vaccines to prevent Covid variants because the Vaccines' access and public-private partnerships are important. Often the relevance of mechanisms to stimulate research and development is limited by national scopes and "by the transnational nature of the problem which asks for an international approach". Financing models, creation of evidence-based recommendations, and logistics may be part of that. A seminal article by
Thomas Pogge, published in
Metaphilosophy in 2005, addresses the global
health crisis, in which one-third of all human deaths are due to poverty-related causes, the majority of which are preventable. Pogge critiques the existing patent regime, particularly the
TRIPS agreement, for its role in limiting access to essential medicines and violating human rights. Pogge proposes a reform of the global health system with the objective of making medical knowledge freely available as a
global public good. The reform includes providing the results of successful drug development as public goods, rewarding inventor firms based on the impact of their inventions on the global disease burden, and ensuring a fair and feasible allocation of costs. The article argues that this reform would align the interests of pharmaceutical companies with those of patients and generic drug producers, incentivize research into neglected diseases, and be cost-effective. It also discusses the moral urgency of addressing the global health crisis and the responsibility of high-income countries to support reforms that benefit the global poor. It concludes by emphasizing the feasibility and political realism of the proposed reform, which aims to extend the benefits of medical advancements to the poor and realize human rights more fully.
Maternal health Complications of pregnancy and
childbirth are the leading causes of
death among women of reproductive age. In many developing countries, a woman dies from complications from childbirth approximately every minute. According to the World Health Organization's 2005
World Health Report, poor maternal conditions are the fourth leading cause of death for women worldwide, after
HIV/AIDS, malaria, and tuberculosis. Most maternal deaths and injuries can be prevented, and such deaths have been largely eradicated in the
developed world. Targets for improving maternal health include increasing and assisting the number of deliveries accompanied by skilled
birth attendants.
Nutrition In 2010, about 104 million children were
underweight, and undernutrition contributes to about one third of child deaths around the world. (Undernutrition is not to be confused with
malnutrition, which refers to poor
proportion of food intake and can thus refer to
obesity.) Undernutrition impairs the
immune system, increasing the frequency, severity, and duration of infections (including
measles,
pneumonia, and
diarrhea). Infection can further contribute to malnutrition.
Deficiencies of
micronutrients, such as
vitamin A,
iron,
iodine, and
zinc, are common worldwide and can compromise intellectual potential, growth, development, and adult productivity. Interventions to prevent malnutrition include micronutrient supplementation,
fortification of basic grocery foods, dietary diversification, hygienic measures to reduce spread of infections, and the promotion of
breastfeeding.
Non-communicable diseases Approximately 80% of deaths linked to
non-communicable diseases occur in developing countries. For instance,
urbanization and
aging have led to increasing poor health conditions related to non-communicable diseases in India. Similarly, China's rapid urbanization and modernization have been associated with increased sedentary lifestyles, contributing to the rise in NCDs in the region. The fastest-growing causes of disease burden over the last 26 years were
diabetes (rate increased by 80%) and
ischemic heart disease (up 34%). More than 60% of deaths, about 6.1 million, in 2016 were due to NCDs, up from about 38% in 1990. Increases in
refugee urbanization, has led to a growing number of people diagnosed with chronic non-communicable diseases. In September 2011, the United Nations is hosting its first General Assembly Special Summit on the issue of non-communicable diseases. Noting that non-communicable diseases are the cause of some 35 million deaths each year, the international community is being increasingly called to take measures for the prevention and control of chronic diseases and mitigate their impacts on the world population, especially on women, who are usually the
primary caregivers. For example, the rate of
type 2 diabetes, associated with
obesity, has been on the rise in countries previously troubled by hunger. In low-income countries, the number of individuals with diabetes is expected to increase from 84 million to 228 million by 2030. Obesity, a preventable condition, is associated with numerous chronic diseases, including
cardiovascular conditions,
stroke, certain
cancers, and
respiratory disease. About 16% of the global burden of disease, measured as DALYs, has been accounted for by obesity. A World Report on Hearing (WRH) was published in response to the resolution (WHA70.13), to provide guidance for Member States to integrate ear and hearing care into their national health plans.
Lifestyle diseases Commercial determinants of health refers to private sector activities that affect people's health positively or negatively such as advertisements for
unhealthy food.
Health-related largest causes of death Violence against women Violence against women has been defined as: "physical, sexual and psychological violence occurring in the family and in the general community, including
battering,
sexual abuse,
dowry-related violence,
rape,
female genital mutilation and other traditional practices harmful to women, non-spousal violence and violence related to exploitation,
sexual harassment and
intimidation at work, in educational institutions and elsewhere,
trafficking in women, forced
prostitution and violence perpetrated or condoned by the state." In addition to causing injury, violence may increase "women's long-term risk of a number of other health problems, including
chronic pain,
physical disability,
drug and alcohol abuse, and
depression". The WHO Report on global and regional estimates on violence against women found that partner abuse causes women to have 16% more chances of suffering
miscarriages, 41% more occurrences of
pre-term birth babies and twice the likeliness of having
abortions and acquiring HIV or other
STDs Although statistics can be difficult to obtain as many cases go unreported, it is estimated that one in every five women faces some form of violence during her lifetime, in some cases leading to serious injury or even death. Risk factors for being an offender include low education, past exposure to
child maltreatment or witnessing violence between parents, harmful use of alcohol, attitudes accepting of violence, and
gender inequality. Equality of women has been addressed in the
Millennium Development Goals. Now,
gender equality is
Sustainable Development Goal 5. Preventing the violence against women needs to form an essential part of the public health reforms in the form of
advocation and
evidence gathering.
Primary prevention in the form of raising
women economic empowerment facilities,
microfinance and skills training social projects related to gender equality should be conducted. Activities promoting relationship and communication skills among couples, reducing alcohol access and altering societal ideologies should be organized. Childhood interventions, community and school-based education, raising media-oriented awareness and other approaches should be carried out to challenge social norms and
stereotypical thought processes to promote
behavioral change among men and raise gender equality. Trained health care providers would play a vital role in secondary and tertiary prevention of abuse by performing early identification of women suffering from violence and contributing to the addressing of their health and psychological needs. They could be highly important in prevention of the recurrence of violence and the mitigation of its effects on the health of the abused women and their children. The Member States of the World Health Assembly endorsed a plan in 2016 for reinforcing the health system's role in addressing the global phenomenon of violence against women and girls and working towards their health and protection.
Global surgery Halfdan T. Mahler, the 3rd Director-General of the
World Health Organization (WHO), first brought attention to the disparities in surgery and surgical care when he stated, "the vast majority of the world's population has no access whatsoever to skilled surgical care and little is being done to find a solution". While significant progresses have been made in fields within global health such as
infectious diseases,
maternal and child health, and even other
non-communicable diseases over the past several decades, the provision of
surgery and surgical care in resource-limited settings have largely remained unmet with about 5 billion people lacking access to safe and affordable surgical and anesthesia care. In fact, it has been estimated that up to 30% of the total
global burden of disease (GBD) could be attributable to surgical conditions, which include a mix of
injuries,
malignancies,
congenital anomalies, and
complications of pregnancy. As a result, global surgery has become an emerging field within global health as "the
multidisciplinary enterprise of providing improved and equitable surgical care to the world's population, with its core belief as the issues of need, access and quality" and has often been described as the "neglected stepchild of global health", a term coined by
Dr. Paul Farmer to highlight the urgent need for further work in this area. Furthermore,
Jim Young Kim, the former President of the
World Bank, proclaimed in 2014 that "surgery is an indivisible, indispensable part of health care and of progress towards universal health coverage." In 2015, the Lancet Commission on Global Surgery (LCoGS) published the landmark report titled "Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development", describing the large, pre-existing burden of surgical diseases in low- and middle-income countries (LMICs) and future directions for increasing universal access to safe surgery by the year 2030. The Commission highlighted that 143 million additional procedures were needed every year to prevent further
morbidity and
mortality from treatable surgical conditions as well as a $12.3 trillion loss in economic productivity by the year 2030. In order to address these challenges and track progress, the Commission defined the following core indicators for assessing access to safe and affordable surgical d anesthesia care: This finding challenged the common misconception that surgical care is financially prohibitive endeavor not worth pursuing in LMICs. In terms of the financial impact on the patients, the lack of adequate surgical and anesthesia care has resulted in 33 million individuals every year facing catastrophic health expenditure — the out-of-pocket healthcare cost exceeding 40% of a given household's income. In alignment with the LCoGS call for action, the
World Health Assembly adopted the resolution WHA68.15 in 2015 that stated, "Strengthening emergency and essential surgical care and anesthesia as a component of universal health coverage." This not only mandated the WHO to prioritize strengthening the surgical and anesthesia care globally, but also led to governments of the member states recognizing the urgent need for increasing capacity in surgery and anesthesia. Additionally, the third edition of
Disease Control Priorities (DCP3), published in 2015 by the
World Bank, declared surgery as essential and featured an entire volume dedicated to building surgical capacity. A key policy framework that arose from this renewed global commitment towards surgical care worldwide is the National Surgical Obstetric and Anesthesia Plan (NSOAP). NSOAP focuses on policy-to-action capacity building for surgical care with tangible steps as follows: (1) analysis of baseline indicators, (2) partnership with local champions, (3) broad stakeholder engagement, (4) consensus building and synthesis of ideas, (5) language refinement, (6) costing, (7) dissemination, and (8) implementation. This approach has been widely adopted and has served as guiding principles between international collaborators and local institutions and governments. Successful implementations have allowed for sustainability in terms of longterm monitoring, quality improvement, and continued political and financial support. The NIHR Global Health Research Unit on Global Surgery is led by the
University of Birmingham which provides overall oversight in relation to the Unit strategy, infrastructure and delivery, research and finance. The network prioritized surgical topics that needed research and has performed multiple surgical studies. The network resulted in many research groups including GlobalSurg I, II, III and COVIDSurg and many other trials with worldwide collaborations as project FALCON, CHEETAH, GECKO COVID-19 and mortality.
Other global surgery collaborations More trials have emerged to assess surgical outcomes around the World using big data from thousands of centers. Other notable trials include: • Global PaedSurg; The study was published in The Lancet examined the risk of mortality for nearly 4000 babies born with birth defects in 264 hospitals around the world. The study found babies born with birth defects involving the intestinal tract have a two in five chance of dying in a low-income country compared to one in five in a middle-income country and one in twenty in a high-income country. • ASOS PaedSurg: African Pediatric postoperative outcomes are poor, with up to 4x morbidity and 11x mortality rates than high income countries. • ACCCOS: COVID-19 Mortality was higher in Africa than reported from studies done in other parts of the World. • ACIOS (African Critical Illness Outcomes Study): 1/8 patients in African hospitals are critically ill with 20% 7 day mortality rate. About 56% do not receive even the basic critical care needs. • Global Health Research Group on Children's Non-Communicable Diseases Collaborative • SnapSBO (Small Bowel Obstruction) study Group
Multimorbidity, age-related diseases and aging Multimorbidity is "a growing public health problem worldwide", "likely driven by the ageing population but also by factors such as high body-mass index, urbanisation, and the growing burden of
NCDs (such as type 2 diabetes) and tuberculosis in low- and middle-income countries (LMICs)". Around the world,
many people do not die from one isolated condition but from a multitude of factors and conditions. A study suggested there is a paucity of multimorbidity and comorbidity data globally and mapped comorbidity patterns.
With aging populations, there is a rise of
age-related diseases which puts major burdens on
healthcare systems as well as contemporary economies or contemporary economics and their appendant societal systems.
Healthspan extension and anti-aging research seek to extend the span of health in the old as well as slow aging or its negative impacts such as physical and mental decline. Modern anti-senescent and regenerative technology with augmented decision making could help "responsibly bridge the
healthspan-
lifespan gap for a future of equitable global wellbeing". Aging is "the most prevalent risk factor for chronic disease, frailty and disability, and it is estimated that there will be over 2 billion persons age > 60 by the year
2050", making it a large global health challenge that demands substantial (and well-orchestrated or efficient) efforts, including interventions that alter and target the inborn
aging process.
Infertility crisis A
scientific review found that human
sperm counts fell
by 62% in the last 50 years, are decreasing at an accelerating rate and are decreasing worldwide, likely a result of factors such as
poor diets,
endocrine disruptors in prevalent products, unhealthy lifestyles and toxic
forever chemicals in air and water. ==Health interventions==