Top 10 Threats to Global Health Include Flu Pandemic, Air Pollution

The world is facing multiple health challenges, and the World Health Organization (WHO) has published its list of the top 10 threats to global health in 2019 that will require attention from the agency and its partners.



Topping the list is air pollution and climate change. According to the WHO, 9 of 10 people breathe polluted air every day, and air pollution kills 7 million people prematurely every year from diseases such as cancer, stroke, heart disease, and lung disease. Most of these deaths occur in low- and middle-income countries that have high volumes of emissions from industry, transportation, and agriculture. In addition, in these countries, dirty cookstoves and fuels are often used in homes.

The chief cause of air pollution (the burning of fossil fuels) is a major contributor to climate change and also affects health. Between 2030 and 2050, climate change is expected to cause 250,000 additional deaths per year from malnutrition, malaria, diarrhea, and heat stress.

Taking the number 2 spot on the list of global health threats is noncommunicable diseases, such as diabetes, cancer, and heart disease, which together are to blame for 41 million deaths, or more than 70% of all deaths worldwide, the WHO says. These include 15 million people who die prematurely between the ages of 30 and 69 years.

Tobacco use, physical inactivity, the harmful use of alcohol, unhealthy diets, and air pollution are the key drivers of the increase in the incidence of noncommunicable disease. These risk factors also contribute to mental health problems.

The threat of a global influenza pandemic takes the number 3 spot on the list. "The world will face another influenza pandemic — the only thing we don't know is when it will hit and how severe it will be. Global defenses are only as effective as the weakest link in any country's health emergency preparednessand response system," the WHO said in a news release. The agency is constantly monitoring the circulation of influenza viruses to detect potential pandemic strains: 153 institutions in 114 countries are involved in global flu surveillance and response.

Number 4 on the list is fragile and vulnerable settings, such as regions suffering from drought, famine, conflict, or population displacement. According to the WHO, more than 1.6 billion people (22% of the global population) live in places where protracted crises and weak health services leave them without access to basic care. "Fragile settings exist in almost all regions of the world, and these are where half of the key targets in the sustainable development goals, including on child and maternal health, remains unmet," the WHO says.

The Final Five

Rounding out the WHO's top 10 global threats for 2019 are the following:

5. Antimicrobial resistance: Time is "running out," the WHO says. "Antimicrobial resistance threatens to send us back to a time when we were unable to easily treat infections such as pneumonia, tuberculosis, gonorrhea, and salmonellosis. The inability to prevent infections could seriously compromise surgery and procedures such as chemotherapy."

6. Ebola and other high-threat pathogens: In 2018, the Democratic Republic of the Congo saw two separate Ebola outbreaks, both of which spread to cities of more than 1 million people. One of the affected provinces is also in an active conflict zone.

7. Weak primary healthcare: Primary healthcare can meet the majority of a person's health needs over the course of their life. Yet many countries do not have adequate primary healthcare facilities. The WHO says that this year, it will work with partners to revitalize and strengthen countries' primary healthcare.

8. Vaccine hesitancy: The reluctance or refusal to vaccinate despite the availability of vaccines threatens to reverse progress made in combating vaccine-preventable diseases. Vaccination currently prevents 2 to 3 million deaths each year, and a further 1.5 million could be avoided if global coverage of vaccinations improved, the WHO says.

9. Dengue: This potentially deadly mosquito-borne disease has been a growing threat for decades. An estimated 40% of the world is at risk for dengue fever, and around 390 million infections occur each year. The WHO's dengue control strategy aims to reduce deaths by 50% by 2020.

10. HIV: Although "enormous" progress has been made against HIV by having people tested for the virus, providing them with antiretrovirals (22 million are on treatment), and providing access to preventive measures, such as preexposure prophylaxis, the epidemic continues, with nearly 1 million people every year dying of HIV/AIDS. The WHO says it will work with countries to support the introduction of self-testing so that more people living with HIV know their status and can receive treatment or preventive measures.

To address these and other threats, 2019 sees the start of the WHO's 5-year strategic plan — the 13th General Programme of Work. The plan focuses on a triple-billion target: ensuring 1 billion more people benefit from access to universal health coverage, 1 billion more people are protected from health emergencies, and 1 billion more people enjoy better health and well-being.

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