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Sustaining the Planet or the Malnourished? Prioritizing the Needs in a Complex World

04.3.2020

There have been tremendous improvements in global health, including overall increase of life expectancy, decreased rate of new infectious disease cases, decreased maternal mortality rate, and fewer children under 5 dying. However, there are still many issues to tackle such as climate change, malnutrition, spread of infectious diseases, non-communicable diseases, and health inequality, among others. In a world with limited resources, prioritizing these global health concerns can certainly be challenging.

With recent natural disasters occurring and having a horrible impact to its community, experts have been encouraging an immediate demand to tackling solutions to climate change. While I do believe that it is a legitimate concern, I fear that prioritizing solutions to climate change over more proximate health concerns, such as malnutrition, can cause more damage then good.

Why do I have this fear? First let’s talk about what we already know. The research on exploring the impact on health and the cost-effectiveness analysis of various interventions of climate change is still lacking. To make matters more complex, climate change is unpredictable at this time. We could be potentially investing millions or billions of dollars into solutions that may no longer be appropriate solutions 10 years from now. Before making solutions a priority, we need further research, otherwise we may be creating inefficient or unsuccessful interventions, a task that we cannot afford to do.

At least in the case of other health concerns we have developed substantial evidence on effective interventions. Let’s narrow these concerns down to just focusing on malnutrition for now, which is a condition where one can either be lacking the necessary nutrients (undernutrition) or not having the correct balance of nutrients (overnutrition) needed for optimal health. An estimated 1/3 of our global population is either underweight or overweight. According to the United Nations declaration of rights, food is a basic human right. However, undernutrition is the cause of death for an estimated 45% of the world’s children under 5 years of age. These statistics are frightening and there is sufficient evidence now on how to improve these outcomes Unfortunately this evidence may not necessarily coincide with current policies but this should be the next focus.

Furthermore, climate change solutions entail also substantial amount of changes from individuals. This becomes difficult in regards to having a strong global governance in control of interventions, compared to interventions tackling other health concerns like undernourishment. At this time, international law cannot be implemented for individual behaviour changes.

Finally, solutions to climate action require stronger global governance and I do not believe we are there yet. Unlike malnourishment, the negative health impacts from climate change has not been globally distributed, which can make it difficult for regional governance to prioritize this as a concern and work together for solutions.

We need to be realistic on our current capacity for prioritization of global health issues. If we are currently having issues with this anarchy of international relations with immediate life saving decisions, how can we rely on their commitment for climate change?

Of course there is no simple answer when it comes to prioritization of global health concerns. However, by placing more emphasis on strategically reviewing and implementing appropriate interventions in response to strong evidence, versus rash decisions, the more we can create an efficient global health system.


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