Investing in Health for an Equitable Future
Good health is a fundamental human right and a pillar of economic opportunity, yet for too many people around the world it is elusive. While significant strides have been made, such as in increasing life expectancy, progress has been unjustly uneven. Today, we are at a sticking point – those within reach have realized the benefits of evolving technologies and care in health, yet the global community is struggling to reach the most vulnerable among us.
For example, access to sexual, reproductive, and child health care services is improving and since 2000, maternal mortality has fallen by 37 per cent. However, the maternal mortality ratio, the proportion of mothers that do not survive childbirth compared to those who do, in developing regions is still 14 times higher than in the developed regions. Health service coverage is also lower among women living in poverty and in rural areas.
Meanwhile, today the world faces growing threats that could undermine hard-won gains and create additional headwinds toward achieving Sustainable Development Goal 3 (SDG 3). Evolving trends in climate, demographics, urbanization, and technology are impacting disease patterns, care, treatment, and health systems. On top of this, countries are not yet investing enough resources in core health priorities and systems, especially primary healthcare. To reach the targets of SDG 3, “ensure healthy lives and promote well-being for all at all ages” by 2030 we must all accelerate progress today.
Disease patterns are evolving with changes in climate, conflict, economics, technologies, demographics, and urbanisation. For example, climate change causes more extreme weather events, exacerbates malnutrition and fuels the spread of diseases, such as malaria, dengue, Zika, and yellow fever. Between 2030 and 2050, climate change is expected to cause approximately 250,000 additional deaths per year from malnutrition, infectious diseases, and heat stress. Not to mention, an estimated 7 million people die each year because of air pollution. Leaders in both the public and private sectors must work together to clean up our air and mitigate the health impacts of climate change.
Anti-microbial resistance (AMR) threatens to send modern medicine back decades to the pre-antibiotic era. The rise of AMR includes unregulated prescription and use of antibiotics, lack of access to quality and affordable medicines, and lack of clean water, sanitation, and infection prevention and control. Today, drug-resistant diseases cause at least 700,000 deaths globally per year, and if not action is taken, it could increase to 10 million per year, including around 2.4 million people in high-income countries between 2015 and 2050. It is key for all sectors to work together to reduce the threat of AMR by addressing its root causes, while advocating for research and development into new antibiotics.
Meanwhile, around the world, more people are moving to cities and town, putting stress on healthcare finances and systems, and significantly impacting infectious diseases with greater population density, and noncommunicable diseases. Most future urban growth will take place in developing cities, creating a unique opportunity to shape urbanization and other major urban development trends in a way that protects and promotes health.
Around 1 in 7 people globally (15 percent) have one or more mental or substance use disorders. Mental health disorders are complex, can take many forms, and have been measured inadequately in the past as “invisible” disorders. As our societies become more integrated, urban, and technological, and simultaneously face changes in demographics, climate, and conflict, burdens on our mental health are increasing. Evolving mental health prevention, treatment, and care services is critical to well-being for all.
Universal health coverage (UHC) means that all people can access quality health services they need, without risk of financial impoverishment. Still today, at least half of global population do not receive the quality health services they need and if current trends continue, some five billion people risk missing out on health care in 2030.
One of the best ways to reduce this inequality is through strengthening primary health care. Countries that aren't investing enough in primary healthcare today are holding back progress for tomorrow. It is estimated that around 60 million lives could be saved in the next decade by upping annual spending on primary health care in low and middle-income countries by some $200 billion per year (a 5 per cent increase in health spending).
The world is confronted by increasing infectious disease outbreaks. A 2019 report by the recently established Global Preparedness Monitoring Board warned that the world remains dangerously unprepared for national/regional epidemics and global pandemics. New and known infectious diseases have the potential to cause major outbreaks, as we see today with coronavirus disease (COVID-19).
Epidemic-prone diseases such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), Ebola, Zika, and others, are precursors of a new era of high-impact, potentially fast-spreading outbreaks that are more frequent and increasingly difficult to manage. Meanwhile, pandemics, such as respiratory infections like influenza, remain unpredictable but reoccurring events that can have serious consequences for human health and well-being worldwide.
Each year, the world spends more responding to disease outbreaks and health emergencies than preparing for and preventing them. To get ahead of pandemics we must break the cycle of panic and neglect. Countries invest heavily in military defense spending but not against the attack of a virus, which could be more deadly and damaging economically and socially. The estimated economic and social costs of the SARS epidemic was a loss of over $40 billion in productivity and $53 billion from the 2014-2016 West Africa Ebola outbreak. In short, we need to invest in preparedness, not panic.
Rapid changes in technologies have transformed the way we reach and treat patients in all corners of the globe. New technologies, like AI and blockchain, are revolutionizing health care – from predictive analytics and medicine, genome editing, synthetic biology, electronic medical records, vaccine delivery and storage, to training for health providers.
The real achievement will lie in the use of technological advances to reach all people equitably. These technologies have the potential to leapfrog the most vulnerable among us forward, but they can also reinforce and exacerbate the health inequalities we face today. It is up to the international community and governments to harness and manage technologies for good. Meanwhile, these developments raise challenges for monitoring and regulation that we must also tackle together.
The Decade of Action on the SDGs, calls on all sectors of societies to mobilize in order to meet the SDGs. The private sector has emerged as a key player in research, development, and deployment, making the greatest impact in low and middle-income countries. At the same time, it is the public sector’s obligation to optimize these technologies as a great equalizer, and to lead the way by taking steps to strengthen health systems. To achieve our goal of ensuring health for all, all sectors of society including the public and private sectors must collaborate.
In the 20th century, smallpox claimed more than 300 million lives and is now the only human disease to have been eradicated worldwide. The eradication of smallpox in 1980 highlights what can be achieved when nations and peoples work together. Public health is ultimately a political choice. Communities, countries, and the international system must come together to realize that investing in health is key to our shared future.