Health issues

How can the threat of new and reemerging diseases and immune micro-organisms be reduced?

The health of humanity continues to improve; people are living longer—life expectancy at birth increased globally from 67 years in 2010 to 71.4 years in 2015. Although WHO has verified more than 1,100 epidemic events worldwide over the past five years, the incidence and mortality rates of infectious diseases are actually falling due to medical advances and accessibility to medical care. WHO reports that if current trends continue, the world will have met global targets for turning around the epidemics of HIV, malaria, and tuberculosis. However, the mortality rates from noncommunicable diseases continue to rise—from 60% in 2000 to 68% in 2012. Other health problems like antimicrobial resistance, malnutrition, and obesity continue to rise. Political instability is a major health concern in many countries such as South Sudan, Syria, Mali, and the Central African Republic, where rebuilding infrastructure and establishing health care will take many years. There are over 42 million refugees or displaced persons in the world (down from 50 million in 2013), who have little access to health care. The prevalence of undernourished children in fragile states is 39%, compared with 15% in the rest of the world. The spread of disease in such areas, compounded by having fewer health workers, represents a dangerous trend witnessed during the Ebola epidemic.

According to UN data, the number of deaths in children under five declined from 12.7 million in 1990 to 6.3 million in 2013. This is a reduction from an estimated 90 deaths to 46 deaths per 1000 live births. Nevertheless, less than one third of all countries have achieved or are on track to meet the MDG of reducing child mortality by two-thirds from 1990 levels by 2015. At the current rate, this goal is not expected to be achieved until 2028. About 80% of child mortality occurs in sub-Saharan Africa and Southern Asia. Rates have worsened in Syria, Iraq, some sub-Saharan African countries, and some members of the former Soviet Union since 1990. Maternal mortality fell 43% between 1990 and 2015. But this is still far short of the MDG of a 75% reduction. Maternal mortality shows very little decrease in the regions with the highest rates.

More than half the developing world at any given time is suffering from diseases associated with unsafe water and poor sanitation. Although an additional 2.5 billion people have gained access to improved drinking water since 1990, there are still over 700 million people without such safe access today. Diarrhea causes over 1.8 million deaths per year (68% of these are children under the age of five). About 25% of the world gained access to improved sanitation between 1990 and 2012, but many—possibly over 40%—do not use the available facilities, and WHO estimates that 2.5 billion people did not have access to basic sanitation in 2014 and 1.1 billion people practice open defecation, linked to 280,000 diarrheal deaths annually. It is estimated that a third of these deaths could be prevented by simple hand-washing.

With longer life expectancies, rising health care costs, and a shrinking health workforce, telemedicine and self-diagnosis via biochip sensors and online expert systems will be increasingly necessary. Better trade security is also needed to prevent food- or animal-borne diseases. Falling costs of gene sequencing and improved genomic understandings will make personalized medicine possible for the public, at least in high- and middle-income families. According to PricewaterhouseCoopers, U.S. personalized medicine is a $286 billion per year industry and growing 11% annually. IBM’s Watson is improving diagnostics; nano-medicine could one day detect and treat disease at the genetic and molecular levels, making treatments more precise; 3D bio-printing is opening a new field of tissue and organ replacements from one’s own genetic material; and longevity research has significantly extended the lives of lab animals.