Commentaries

The gravest health threats facing low- and middle-income countries are not the plagues, parasites, and blights that dominate the news cycle and international relief efforts. They are the everyday diseases the international community understands and could address, but fails to take action against. Once thought to be challenges for affluent countries alone, cardiovascular diseases, cancer, diabetes, and other noncommunicable diseases (NCDs) have emerged as the leading cause of death and disability in developing countries.

In 1990, life expectancy for female Maldivians was 64.8 years, three years shorter than the global average. By 2010, female life expectancy exceeded the global average by over seven years.

The rapid scale-up of antiretroviral therapy (ART) has been one of the great achievements of global health in the last decade. But the efficiency and quality of ART programs in developing countries must improve to have maximum benefit for those in need.

While many communicable diseases have been shrinking in terms of the number of people they affect over the last two decades, the global burden of mental illness has largely remained the same. All forms of mental illness – including depression, anxiety and schizophrenia – account for nearly a quarter of all disability worldwide, and cause the most disability for those in the most productive age demographic, from 15 to 39 years old.

There appears to be a disconnect between the global burden of pneumonia and how much money is spent on attempting to reduce this burden, which Humanosphere recently summed up as: Pneumonia leads in killing children, but not in global health financing.

“We should declare the goal of eradicating malaria because we can eradicate malaria,” Gates said, to some consternation among the malaria experts. He challenged the audience to wipe out malaria for good, as the world did with smallpox in 1980, rather than continuing to simply contain the disease.

The rallying cry at this year’s meeting for the American Society of Tropical Medicine & Hygiene (ASTMH), which ended yesterday, was “Accelerating to Zero,” the Gates Foundation’s vision to eradicate malaria. Many places are nearly there: China is closing in on zero malaria and Saudi Arabia is within a few cases of ending malaria for good.

Measles is another infectious disease that can very rapidly upend and ravage any place where people lack exposure or protection against the virus.

En 1992 fui elegido alcalde de Cali, una ciudad de Colombia con 2.3 millones de habitantes. Soy epidemiólogo por formación, pero me siento atraído a ayudar a las personas, y Cali necesitaba ayuda. La tasa de homicidios era alarmante, más de 100 por cada 100.000 (las estadísticas del FBI del mismo año indican que esta tasa en Nueva York era de 27.1 por 100.000), y los homicidios eran la principal causa de fallecimiento en la ciudad.

Before the civil war started the spring of 2011, Syria was among the most impressive health success stories in the Arab world. Out of all the countries in this region, Syria ranked third for gains in female life expectancy and fourth for gains in male life expectancy between 1990 and 2010.

My advice to leaders: Skip the pronouncements and dig into the data.

The health systems in these poor countries are overwhelmed by this outbreak and the progress that’s been made in fighting these diseases, or in improving services like maternal and child care, is under threat. High-quality, timely data are urgently needed to understand how the Ebola epidemic is affecting other health issues in these three nations.

The War on Drugs has failed, a blue-ribbon panel of experts has concluded, and has actually made things worse.

A 2010 study found that the screening and treatment of infected mothers (thus preventing mother-to-child transmission of syphilis) is “among the most cost-effective public health interventions in existence.”

As global leaders repeatedly fail to reach agreements on setting emissions targets to slow the rate of global warming, local communities are taking action to protect themselves from a leading driver of climate change: the burning of fossil fuels.

In the US and globally, ALS certainly claims fewer lives each year than more common diseases. Cancer, for example, caused 204 deaths per 100,000 in the US in 2010. At the same time, these more common diseases generally have much better treatment options and longer-term prognoses – and many of them can even be prevented.

The myriad of challenges contributing to the persisting spread of Ebola in West Africa – the biggest Ebola outbreak since the viral haemorrhagic fever was discovered in 1976 – echo some of the biggest obstacles which continue to challenge the global efforts to eradicate polio.