Happy World Health Day 2008 - Are We Getting Healthier?

Today is World Health Day, a time to step back and ask if the world is becoming healthier.  On some areas such as HIV/AIDS and malaria we are making progress.  Yet we are falling behind in other areas such as maternal and child health.  We are also ill prepared to deal with the negative health consequences of climate change - the theme for this year's World Health Day.   Though it will be an issue for all of us, it will most severely affect the poorest of the poor.  When it comes to public health, however, we are all in it together.

The World Health Organization released a bulletin which stated that climate change is causing an increase in diseases like malaria and dengue fever, both of which Haiti has aplenty.   Climate change could also increse the number of natural disasters each year in the form of floods and mudslides.  Disasters, emergencies, and disease go hand in hand.  At least 150,000 more people are dying each year of malaria, diarrhea, malnutrition and floods, all of which can be (at least partially) traced to climate change.

Asia is an interesting example as more than half of new deaths are taking place there.  A WHO spokeperson stated that malaria-carrying mosquitos are now found in parts of Asia where there was no malaria before.  In other words, as cooler areas heat up the mosquitos are able to move in which is especially dangerous given the populations in these areas will have little resistance.  

The WHO estimates malaria kills 100,000 people each year.  Those who are most vulnerable are young, malnourished, and/or already affected by other diseases.  Pregnant women, children under five, and conflict victims are espcially vulnerable.   Considering the negative health consequences of climate change, the WHO will set aside $10 million for advocacy to inform people and governments about the health dangers of climate change - to prevent when possible and to respond when we must.

There are agricultural consequences as well.  Too much rain or too little are both disasters in Haiti.  Too much results in the aforementioned floods and mudslides.  Too little will result in a bad harvest - and the malnutrition which undermines health and the hunger which undermines stability.   Either undermines development.

The WHO is advising governments to strengthen health systems, invest in clean water, immunize their populations, improve disease surveillance systems, control mosquito populations (this will be especially important) and to prepare for disasters before they happen.  These steps make sense for any country.

Click here to see a slide show and basic facts about the relationship between climate change and health.   Click here for a tip sheet about specific health threats associated with warmer weather.  Finally, click here to see the leading causes of sickness and death worldwide.

On a related note, I attended an interesting presentation today by Dr. Tadataka (Tachi) Yamada, who oversees the health programs of the Bill and Melinda Gates Foundation.   In the struggle for global health, this foundation is a force to be reckoned with.  Only ten years old, the Foundation will invest 10 billion dollars in health programs over the next five years.  It is a rare and perhaps even unique in that it has the resources of a government agency and the efficiency of a corporation.  

Dr. Yamada opened by asking the audience to remember a time when they had lost someone.  Each of us has experienced grief and a single loss is enormous.  But we are losing 10,000,000 children each year and 4,000,000 of those in their first month of live.   It is a moral failure so vast that it is hard to even comprehened.  We know what  works in maternal and child health.   The failue is that we have not translated this knowledge into action though.   We have not delivered. 

Dr. Yamada emphasized that when it comes to fighting a disease such as malaria, a government must first make a committment.  Then it must set national policies.  Third, the government and all of its partners must apply known interventions with a sense of urgency.  One known interventions are being applied, novel interventions can be explored and added once known to be effective.  It is a simple model but one that remains to be applied to developmental issues in Haiti including deforestation and malaria.

The Bill and Melinda Gates Foundation thinks big.  They are the first high profile organization to argue that we should be thinking not only of controlling malaria but of eradicating it.   He also noted the importance of working with the private sector to develop solutions given that in Africa, Asia, and many parts of Haiti the majority of people are paying for the clear majority of health services via the private sector.  If you saw the public clinics, you would understand.  

He also stressed the importance of measuring what we are doing in health.  It is not enough to say we are doing good.  We have a responsibility to measure the impact of our health interventions so we know if we are doing the best we can for beneficiaries.  If we are not measuring then we cannot change course - this could cost lives.  Using a tennis analogy, he said "if you are not keeping score, then you are just practicing." 

The Bill and Melinda Gates Foundation highly values innnovation.  In order to encourage novel solutions to health problems, they have started a call for Proposals on Grand Challenges in Health.  Applicants send in a two page proposal stating a problem, how they will address it, and how they will measure it.  Applicants do not need to have data before hand.  The intent is to encourage novel approaches.  Many of the funded projects will be failures but we can learn from failures.  Some will be great successes.  

We have major challenges facing us in promoting global health, but we are making some progress.  The trick will be to accelerate progress, especially for the poorest of the poor.  I hope that when World Health Day 2009 comes around, I can tell you that we have continued to build on successes for the betterment of all humanity - not just a part of it.  

Finally, consider signing up for "Alert Net Daily Espresso" - A listserv for humanitarian news.  If you join, you will be sent daily a list of recent articles pertaining to health, climate change, and other development related issues.

Bryan