Climate change, infectious diseases, anti-vaxxers and antimicrobial resistance all made their way onto the World Health Organization’s list of health challenges facing the next decade.
The list, published on Monday, was developed with input from experts around the world and presented “urgent, global health challenges,” according to WHO, the United Nations’ public health agency.
“The list reflects a deep concern that leaders are not investing enough resources in core health priorities & systems, putting lives & economies in jeopardy,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus wrote in a Tweet on Monday.
“We need to realize that health is an investment in the future. Countries invest heavily in protecting their people from terrorist attacks, but not against the attack of a virus, which could be far more deadly & far more damaging economically & socially,” he wrote. “We face shared threats & we have a shared responsibility to act.”
Last year, WHO published a list of 10 global health threats for the year 2019, which also included climate change, antimicrobial resistance, weak primary health care and vaccine hesitancy.
WHO noted that the challenges listed for the next decade are urgent, many are interlinked and none take higher priority than another.
WHO also noted that all of the challenges demand a response from not just the health sector, but governments, communities and international agencies working together.
Here is the WHO’s list of health challenges for the next decade, along with a snapshot of what each challenge involves.
Climate crisis as a health crisis
WHO called the current climate crisis “a health crisis” on its list, noting, for instance, that air pollution kills an estimated 7 million people every year.
Climate change also has been linked with more extreme weather events, malnutrition and the spread of infectious diseases, such as malaria.
“Leaders in both the public and private sectors must work together to clean up our air and mitigate the health impacts of climate change,” according to WHO.
Health care amid conflict and crisis
Meanwhile, a troubling trend continued in 2019 in which health workers responding to medical needs in areas of conflict were targeted with violence.
Last year, WHO recorded 978 such attacks on health care in 11 countries, with 193 deaths.
When an Ebola outbreak hit the Democratic Republic of Congo in 2018, conflict between militant groups and government forces made it difficult for health workers to access some of the hardest hit areas.
“Ultimately, we need political solutions to resolve protracted conflicts, stop neglecting the weakest health systems, and protect health care workers and facilities from attacks,” according to WHO.
Making access to health care fairer for everyone
The WHO list also focused on significant health disparities, including persistent and growing gaps in who has access to quality health care based on income and other socio-economic factors.
Overall, WHO noted that there is an 18-year difference between rich and poor countries in life expectancy — and, as a separate challenge, about one-third of the world’s people lack access to medicines, vaccines, diagnostic tools and other essential health products.
“Low access to quality health products threatens health and lives,” according to WHO.
The organization called for all countries to allocate 1% more of their gross domestic product to primary health care, to give more people access to services they need close to home.
Stopping infectious diseases, preparing for epidemics
Infectious diseases — such as human immunodeficiency virus or HIV, tuberculosis, viral hepatitis and malaria, among others — will kill an estimated 4 million people around the world this year, most of them poor, according to WHO.
To stop the spread of infectious diseases, WHO said that greater political will and increased funding is needed for health services, routine immunizations, improvements in the quality and availability of data and increased efforts to mitigate the effects of drug resistance.
Separately, WHO noted that the world spends more responding to disease outbreaks, natural disasters and other health emergencies, than it does preparing for and preventing them — and that needs to change.
Unsafe food and tobacco products
Lack of food, unsafe produce and unhealthy diets are responsible for nearly one-third of the current global disease burden, according to WHO, and while hunger and food insecurity pose significant health challenges, so do obesity and unhealthy diets.
WHO added to its list that “tobacco use is declining in a few but rising in most countries, and evidence is building about the health risks of e-cigarettes.”
In general, WHO said that it has been working with countries to help reshape food systems and to build political commitment and capacity to strengthen the implementation of certain tobacco control policies.
Investing in health workers and teens
The world will need 18 million additional health workers by 2030 in low- and middle-income countries — and that includes 9 million nurses and midwives, according to WHO.
WHO said that it has been working with countries to stimulate new investment to “train health workers and pay them decent salaries.”
As a separate challenge, WHO pointed to a global need to invest in the safety of teens and adolescents too.
More than 1 million adolescents ages 10 to 19 die every year, according to WHO. The leading causes of death among that age group include road injury, HIV, suicide, lower respiratory infections and violence.
This year, WHO said that it will issue new guidance for policymakers, health practitioners and educators to help promote adolescents’ mental health and prevent the use of drugs, alcohol, self-harm and interpersonal violence.
The guidance will also provide young people with information about preventing HIV and other sexually transmitted infections, as well as information about contraception use and care during pregnancy and childbirth, according to WHO.
Anti-vaxxers and new technology
The public’s trust in doctors can influence whether they follow recommendations around vaccinations, taking medicines and even using condoms, according to WHO.
WHO has worked with social media platforms, such as Facebook and others, to help ensure that social media users receive accurate health information and not misinformation.
“Public health is compromised by the uncontrolled dissemination of misinformation in social media, as well as through an erosion of trust in public institutions,” according to WHO, which noted that the anti-vaccination movement has played a role in that.
As a separate challenge, WHO also pointed to how new technologies, such as human genome editing, can be used to prevent diseases, as well as diagnose and treat many illnesses.
WHO said that it has been working with countries to help enable them to plan, adopt and benefit from new technologies while also supporting better regulation for their development and use.
Medicines and clean facilities
WHO also noted that antimicrobial resistance could reverse advancements made in medicine.
Antimicrobial resistance refers to the ability of bacteria, viruses and some parasites to develop ways to block medicines used to fight them, so that the medicines may no longer work.
Among myriad factors, sometimes that resistance can occur when antibiotics or other medicines are used unnecessarily, allowing for bacteria or other microorganisms to develop resistance.
In response, WHO said that it not only has been working with national and international authorities to reduce the threat of antimicrobial resistance but also has advocated for research and development into new antibiotics.
Separately, WHO also has advocated for improvements in water, sanitation and hygiene conditions, specifically in health facilities. Roughly one in four health facilities globally lack basic water services, according to WHO.
The health organization has set a global goal for all countries to have water, sanitation and hygiene services included in plans, budgets and implementation efforts by 2023, and, by 2030, all health care facilities around the world should have basic water, sanitation and hygiene services, the agency said.