A Year in Global Health

A Year in Global Health

27.12.2016
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This has been an eventful year in global health. It has also been so for our institute, that enters a new phase with the merger of CREAL and the incorporation of research on non-communicable diseases and environment.

The Zika virus [...] spread from Brazil to USA in less than one year

The increasing globalization of emerging pathogens led the World Health Organization (WHO) to declare in February, for the fourth time in the entire history of the organization, a public health emergency of international concern.

Zika: a Global Emergency

It is the first mosquito-borne virus that can also be transmitted via sexual intercourse

This time, the cause of the emergency- and the focus of media attention- was the Zika virus that, thanks to the widespread distribution of the Aedes aegypti vector in the Americas, spread from Brazil to USA in less than one year. The virus causes milder symptoms than chikungunya or dengue in the vast majority of adults but, in contrast to these, it can be transmitted to the fetus, leading to a broad range of neurological birth defects (including microcephaly).

The WHO has lifted the emergency state on the basis that Zika will become endemic

In addition, it is the first mosquito-borne virus that can also be transmitted via sexual intercourse. Although the WHO has lifted the emergency state on the basis that Zika will become endemic, the social and economic impact of the epidemic is considerable, particularly for the most vulnerable populations (more than 2,300 babies with congenital Zika syndrome by now, most of them in poor zones of northeastern Brazil). It also underlines the urgent need for a coordinated response in control vector, vaccine and drug development, and access to family planning services.

Yellow Fever: a Ticking Time Bomb

The limited production of yellow fever vaccines is a proble that remains to be solved

While all eyes were on Zika, the planet narrowly escaped an even greater disaster. A yellow fever outbreak in Angola (that extended to DRC) led to the first cases in history of yellow fever in Asia (imported to China from Angola) and, with them, the threat of a large outbreak in the continent, where the vector is widespread and the population has no natural immunity to the virus.

If this had occurred, there would not have been enough vaccines to protect people living in large cities. Luckily, thanks to a massive vaccination campaign in Angola and DRC led by the WHO and the vaccine Alliance GAVI, the outbreak was controlled on time. However, the limited production of yellow fever vaccines is a problem that remains to be solved.

MERS: Another Pathogen That Jumps Across Borders

This year, the emerging pathogen MERS Coronavirus (whose distribution is currently limited to the Middle East) showed once again its capacity to travel, with one imported case in Thailand in July and another one in Austria in September. Fortunately, rapid detection and isolation measures avoided local transmission of the virus (in 2015, 186 persons were infected with MERS in South Korea as a result of one single imported case).

Antimicrobial Resistance: Time to Wake Up

Only in three previous occasions has the organization discussed health issues at a general assembly

Concerning re-emerging infectious diseases, an important milestone was the United Nations high level Summit on antimicrobial resistance, in September of this year. Only in three previous occasions has the organization discussed health issues at a general assembly (HIV, non-communicable diseases and Ebola). For the first time, Heads of State committed to encourage innovation in antibiotic development, increase public awareness of the threat, and develop surveillance and regulatory systems on the use and sales of antimicrobial medicine for humans and animals – topics we are actively working on at the Antimicrobial Resistance Initiative.

The New Urban Agenda

Another important UN meeting was the Conference on Housing and Sustainable Development (Habitat 3) in October. There, the WHO presented a report to which ISGlobal contributed and that highlights the close association between urbanism and health, particularly non-communicable diseases, prompting the new urban agenda to incorporate health as a cross-cutting criterion for sustainable urban development.

Lessons Drawn from Chernobyl and Fukushima

This year also marked the anniversaries of two catastrophes with a large health impact. The 30th anniversary of Chernobyl, the worst civilian nuclear accident in history, was commemorated in April. Its main health impact has been a considerable increase in thyroid cancer among exposed children and adolescents as well as the mental health impact on the exposed population.

The 2016-2030 agenda extends and broadens the millennium goals

March marked the 5th anniversary of the earthquake and tsunami that led to the Fukushima accident, where the amount of released radioactivity was 5-10 times lower than in Chernobyl and the main challenge has been the psychosocial impact on the more than 1,500 evacuees. Hence, the importance of a European-funded project, led by ISGlobal, that aims to establish recommendations that respond to the needs of affected populations in the case of future nuclear accidents, without generating unnecessary anxiety.

The SDG Year

The RTS,S vaccine [...] may turn out to be a powerful ally

Last, but not least, 2016 saw the launch of the 17 Sustainable Development Goals, under the theme “leaving no one behind”. The 2016-2030 agenda extends and broadens the millennium goals. On one hand, it seeks to finish the fight against infectious diseases such as malaria (in this sense, the RTS,S vaccine that received funding this year for three pilot studies in Africa may turn out to be a powerful ally), reduce child mortality (the causes of which can be better determined with a minimally invasive autopsy technique we have developed), and the improvement of maternal health (an issue where strong inequalities remain, according to a World Bank Report in which ISGlobal has participated).

The new development agenda also seeks to broaden the fight against non-communicable diseases that are mostly due to unhealthy lifestyles and environmental exposures such as air pollution, and of which the great majority of deaths occur in low and middle-income countries. Finally, the post-2015 agenda includes goals that have a direct impact on health, such as reducing inequalities, access to clean water, climate action, and peace. And when we speak of peace, we should not forget the thousands of refugees that have had to flee the Syrian conflict and that currently live under extremely precarious sanitary conditions.

It is one more reason to promote an interdisciplinary approach that integrates all aspects of health care for humans, animals and the environment

True enough, the 2030 agenda is ambitious and risks being little more than a paper exercise. However, it is one more reason to promote an interdisciplinary approach that integrates all aspects of health care for humans, animals and the environment – the best way to protect and save millions of lives in the future. If properly implemented, every year there will be less to regret and more to celebrate on this end-of-the-year post.