In two days’ time (April 7) the world will collectively focus attention on global health. The theme this year, “Universal Health Coverage” carries a simple message : the urgent need to raise awareness to improve global health the world over- whatever nationality or culture.
The message is simple. And for many countries like Sri Lanka it is not new. After all, did we not face formidable and daunting issues concerning public health before, and did we not also overcome them without the hi tech aids and advanced knowledge we now have? Take the 1950’s high maternal morbidity and mortality, measles, mumps, polio, malaria . To doctors battling these diseases in that past era they were undoubtedly formidable and challenging. But the point is, they were overcome. The development of vaccines and the immunisation program implemented island wide, the spread of education and literacy among the communities, and acceptance of family planning or spaced families using scientific methods to lower the incidence of women having too many babies too soon compromising their health resulted in an overall improvement in the quality of health among Lankans.
These advances notwithstanding many critical health issues still remain unresolved prompting the WHO to launch a new 5 Year strategic Plan which focuses on an ambitious target of ensuring one billion more persons worldwide are protected from health emergencies, and one billion more with improved quality of life and well being.
The WHO listed ten major health challenges for this Year’s World Day in its latest report. Not all of them are new. Some of them have existed for several years, albeit with negligible forward strides. Others are new. Like the COVID-19, which has affected almost all countries around the world and claimed the lives of millions, leaving a trail of morbidity and mortality in its wake. Still others are emerging or re-emerging after years of having seemingly disappeared into oblivion. In some relatively new diseases such as chronic kidney disease of unknown origin (CKDU) the source of the disease is still a subject of controversial theories. So are the many non scientifically proven cures being offered by so called experts on the subject. The good news is that due to global pressure virologists and scientists have now developed vaccines to fight these emerging diseases like COVID-19 for example. It is encouraging to note that a vaccine developed by a multi country team is now being tested on a limited number of patients which is an encouraging breakthrough. Four persons reportedly have been given the vaccine at a hospital in Seattle US which is said to increase the immunity against the disease with no harm to the recipients. However, US health authorities have also said that it will be several months for the vaccine to be used on a wider population.
[Challenges]
1. Air pollution
Heading the list of major challenges by the WHO is air pollution. While air pollution is not a new problem, the WHO has noted that there was now a sharp rise in air pollution, spurred by the increasing number of vehicles using petrol, burning fossil fuels, cooking on open stoves and fires, and tobacco smoking . All of which have made air pollution the greatest environmental risk to health.
Health impacts
Commenting on the adverse impacts of air pollution on human health, the WHO has warned that microscopic pollutants in air can penetrate respiratory and circulatory systems damaging lungs, heart and brain causing millions of people to die prematurely from diseases like cancer, stroke, heart attack and respiratory problems. Tragically, most of these deaths and adverse impacts are in middle level countries and low income countries, where industry, transport, agriculture and fossil fuels are on the rise. Recent statistics bear this out.
2. Non Communicable diseases
A second major issue the health officials would have to face this year and the years ahead, is the surge of non communicable disease (NCDs) that have swept like a tidal wave across the world including Sri Lanka. Diabetes, cancer, hypertension and heart disease are reportedly collectively responsible for over 70% of preventable and premature deaths worldwide. Tobacco use, obesity resulting from physical inactivity, unhealthy diets, and unhealthy lifestyles have been cited as the main trigger factors for this unprecedented surge. In the present society where internet, computers, smart phones, have led to addiction problems and pornography the tragic fact is that those affected are mostly young people between15 to25 years.
These risks are exacerbated by mental illness which reportedly affects one in two persons in every country including Sri Lanka.
3. Global Influenza pandemic
This seasonal flu continues to afflict thousands of persons both young and old as well as children in most countries. Although a regular occurrence, triggered by climatic changes the need for taking precautions to enable high risk populations to protect themselves with the flu vaccine now available for them and follow the simple hygienic rules spelled out by the WHO, cannot thus be brushed aside lightly.
4. Anti Microbial resistance
With the increasing number of patients now resorting to popping pills for even a simple cold, doctors fear that patients using such tablets for a long period could develop anti microbial resistance – i.e the ability of bacteria, parasites, viruses and fungi to resist these medicines. This could result in effective treatment of infections like salmonellosis, gonorrhoea, diarrhoea and even seriously compromise surgery and procedures like chemotherapy, posing a major health challenge. .
5. Vaccine resistance
Despite vaccines now being available to fight main preventable diseases, health authorities are concerned that many persons are reluctant to access these services due to various reasons. The refusal to do so could range from fears, myths and stigma surrounding certain diseases like sexually transmitted diseases (STI). The key to overcoming this obstacle lies in educating the public and potential victims. Mothers should make it a point to ensure their children are fully protected against old and emerging preventable diseases by immunising them, while vulnerable communities sidelined by society must be included into the vaccination program.
Our health and well being concerns all of us. Safeguarding it by using the services and resources available to us is the key to ensuring a healthy future generation.