HIV, Vaccine Refusal, Delays Among Greatest Threats to Global Health, Says WHO

Pollution, HIV, and vaccination hesitancy present some of the biggest threats to public health, according to the World Health Organization (WHO). The organization's list of 10 health challenges includes both environmental and medical challenges they say demand attention from WHO and health partners in 2019.

Researchers and health experts have documented links between air pollution and emergency department visits and other health problems, as well as calls for doctors and healthcare systems to act on climate change before public health consequences become too dire. According to WHO, 9 out of 10 people breathe polluted air every day and it is considered the greatest environmental risk to health, killing 7 million people prematurely every year. Already impacting people’s health, climate change is expected to worsen, causing an additional 250,000 deaths per year between 2030 and 2050.

Access to adequate care also remains a challenge for people worldwide. While primary healthcare is typically the first point of contact that people have with the healthcare system, many countries do not have adequate primary healthcare facilities, typically due to a lack of resources.

According to WHO, more than 1.6 billion people live in places where protracted crises, such as drought, famine, conflict, and population displacement, and weak health services, present barriers to access to care. Recent years have brought more attention to the idea that these factors outside of the doctor’s office—social determinants of health—play a large role in a person’s health.

While significant strides have been made in addressing diseases, many still pose a threat to public health, according to the report. In recent years, several preventable diseases have seen jumps in incidence as a result of vaccine hesitancy. For example, measles has seen a 30% increase in cases globally.

“Vaccine hesitancy threatens to reverse progress made in tackling vaccine-preventable diseases,” states the report. “Vaccination is one of the most cost-effective ways to avoiding disease—it currently prevents 2 to 3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved.”

Despite the advent of antiretroviral therapy and preventive measures like pre-exposure prophylaxis, the HIV epidemic continues to claim an estimated 1 million people every year. The healthcare system continues to face challenges with reaching vulnerable populations at greater risk of contracting HIV, including people who inject drugs, men who have sex with men, and young girls and women in sub-Saharan Africa, who account for 1 in 4 infections in the region.

Noncommunicable diseases including diabetes, heart disease, and cancer also pose a threat to public health, accounting for more than 70% of all deaths worldwide. The rising incidence of these diseases can be attributed to tobacco use, physical inactivity, alcohol use, unhealthy diets, and air pollution, which also exacerbate mental health issues. A result of these factors, obesity rates in the United States are on the rise, with 7 states having obesity rates of at least 35%; obesity is tied to diabetes and other diseases.

Other health challenges highlighted in the report include the influenza pandemic, antimicrobial resistance, Ebola and other high-threat pathogens, and dengue.