|A billboard warning about Ebola in Bamako, Mali.|
Tuesday, December 29, 2015
The biggest global health stories of 2015, and one untold story
This was originally published on Global Health TV on December 17, 2015
There seemed to be a lot of good global health news in 2015, especially when compared to 2014, when Ebola was ravaging West Africa and scaring the rest of the world. In the last 12 months, Ebola has mostly passed, progress was made against malaria and AIDS and the climate deal in Paris raised hopes that less climate change could improve global health. Here are what I consider some of the top global health stories of the year, not necessarily in order of priority:
Ebola on the Decline: A year ago, Ebola was raging. As of Dec. 16, there have been 11,315 deaths and 28,640 cases of Ebola. But Ebola has not disappeared entirely. It re-emerged in Liberia after having earlier been declared Ebola-free. Dr. David Nabarro, the UN special envoy on Ebola, said that he expects transmission in Guinea to finish before the end of 2015 and in Liberia in early 2016. Here’s an update on Ebola in an interview with Dr. Nabarro.
Climate Change Emerges as Health Issue: It is increasingly obvious that climate change is becoming the central development issue of our time. It is also a major obstacle to global health. A Journal of the American Medical Association study explained how climate change adversely affects human health, including decreased respiratory health, increases in infectious diseases, decreased food security and more mental stress. A report produced by a commission of The Lancet and University College London went further to state that climate change threatens to undermine 50 years of global health progress but, at the same time, presents the greatest global opportunity to improve people’s health. “The Paris Accord just signed is monumental in their potential to protect the health of my one-year old grandson Troy and all future generations,” said Ray Martin, long-time health officer at the U.S. Agency for International Development and executive director emeritus of Christian Connections for International Health.
Continued Progress on Malaria: In 2015, the WHO declared that the Millennium Development Goal on malaria had been met “convincingly.” The Economist declared that “the end is in sight for one of humanity’s deadliest plagues” and that Swaziland is on the brink of becoming the first malaria-free country in sub-Saharan Africa. In fact, Bill Gates says that malaria could be eradicated by 2040 even without a vaccine. Last week, the WHO released its annual World Malaria Report and reported a significant increase in the number of countries moving towards malaria elimination but with slower progress reported in Africa, which accounts for 88% of all malaria cases in the world.
Tipping Point for AIDS Proves Elusive: Last year in this space, I wrote that “we had reached the long anticipated tipping point of AIDS” – the point where more people were on AIDS treatment than the number of new infections. I wrote that based on the ONE Campaign’s “At the Tipping Point: Tracking Global Commitments on AIDS” report which was based on UNAIDS data. It now turns out that this conclusion was premature. In this year’s report, “Unfinished Business,” ONE reports that “newly remodeled estimates of the data for 2013 suggest that the world had not reached the tipping point in 2013.” Erin Hohlfelder, head of global health policy at the ONE Campaign, explained that UNAIDS revised past years’ treatment and infection projections based on better data and a revised mathematical model. However, we are tantalizingly close to the tipping point (see the graph on Page 6 of that report to see how close). The good news is that UNAIDS estimated that seven times as many people were accessing antiretroviral therapy by 2015 as had been the case in 2005 and that AIDS-related deaths have fallen by 42% since the 2004 peak.
Global Health in the Sustainability Development Goals (SDGs): On Dec. 31, the SDGs replace the Millennium Development Goals as the planet’s major way of measuring development progress. Health was very prominent in the MDGs, accounting for three of the seven MDGs. Global health is much less prominent in the SDGs (they account for only one of the 17 goals) but the SDGs cover some critical areas of global health totally ignored by the MDGs, such as non-communicable disease, substance abuse and traffic accidents. Linda Fried of Columbia University makes the case that the SDGs “offer a broader framework to address public health concerns in a more holistic way.” In a report released last week, the WHO looked back at the trends and positive forces during the MDG era and assesses the main challenges that will affect health in the next 15 years. See my September blog here on Global Health TV for more on global health and the SDGs.
Africa Defeats Meningitis: Did anyone notice that Africa wiped out meningitis between 2010 and 2015 due to a mass vaccination campaign? As recently as 1997, meningitis infected more than a quarter million people and killed 25,000 in the “meningitis belt” that stretches from Gambia to Ethiopia. But after the vaccination campaign, the number of cases dropped from 1,994 in 2009 to four in 2013. “The disease has virtually disappeared from this part of the world,” said Dr. Maire-Pierre Preziosi of the World Health Organization. But meningitis could return and the vaccination efforts must continue.
More Progress on Contraception: The world came a bit closer to its goal of reaching 120 million additional girls and women with modern contraception by 2020. In its annual progress report, FP2020 reported that the number had increased by 24.4 million since 2012. This is good news but even FP2020 admitted that “the report shows that FP2020 and its partners must take immediate action to speed up progress.” Amanda Glassman, director of global health policy of the Center for Global Development, says this is the right time for a fresh look at family planning efforts. “2016 is the midpoint of the FP2020 initiative and revisits of performance projections, funding requirements, allocation practices and incentives for alignment of effort could have an impact,” she wrote.
Mass Famine Plummets: Here’s another underreported story: Hunger has fallen 27% since 2000, according to the 2015 Global Hunger Index. However, the same report found that the state of hunger is still serious or alarming in 52 countries. Thanks to NPR’s Goats and Soda Blog for bringing this underreported piece of good news to my attention.
Surging Global Health Funding Stabilizes: During the era of the Millennium Development Goals (2000-2014), $228 billion was allocated to address the three health-related MDGs. Spending grew rapidly in the first ten years, but it was stagnant from 2010 to 2014, and actually decreased by 1.6% between 2013 and 2014, according to Financing Global Health 2014 published by the Institute for Health Metrics and Evaluation. Here’s a great visual aid for understanding the trends in global health spending since 2002. The report noted that low- and middle-income countries themselves greatly increased their spending, which reached an all-time high of $711 billion in 2012.
And finally, here’s a global health issue that wasn’t a major story but should have been:
Untold Global Health Story of 2015: Earlier this year, the Johns Hopkins University Bloomberg School of Public Health and the Consortium of Universities for Global Health announced a contest for diseases and issues that impact global health but receive little or no attention from the mainstream media. After receiving 170 nominations, they chose mycetoma, a flesh-eating, bone-destroying disease that has spread misery for centuries and commissioned a three-part series called “The Most Neglected Disease.”