In 2017 new developments, new leaders and new threats promise to tug the reins of global health organizations and send us off in unexpected directions. In fact, we’re already feeling the road change beneath us.
This year, IntraHealth International’s annual list of global health issues to watch is filled with abundant uncertainty, and cautious hope for progress. These aren’t the only issues on our minds, of course – global migration, the refugee crisis and climate change happening now, for example, will likely affect global health for decades or even centuries to come.
Here are some of the big developments we’ll be watching and responding to in 2017:
7. Superbug: Drug-resistant bacteria are here
Last summer, a Nevada woman went to the hospital with a bacterial infection. She’d picked it up during a visit to India, where she had broken her thigh and was in and out of care. In Nevada, the hospital gave her antibiotics – it didn’t stop the infection. The doctors tried another kind of antibiotics. That didn’t work either.
In the end, researchers found that the bacteria attacking the woman couldn’t be stopped by any of the 26 antibiotics available today. The U.S. Centers for Disease Control and Prevention refers to the woman’s infection as carbapenem-resistant Enterobacteriaceae – another name for it is a superbug.
The threat of bacteria that are immune to our entire arsenal of medicines has been looming for years, and it is now a reality – superbugs kill some 700,000 people per year. At the U.N. General Assembly last September, world leaders agreed on some steps to stop superbugs from spreading. In 2017, they’ll have a chance to put their commitments into action.
6. Dangerous complacency around HIV.
If progress and fatigue had a baby, its name would be complacency.
Great strides in HIV treatment and management over the past decade, along with successes in reducing the stigma against people who live with the virus, have had some troubling side effects. In some areas, such as northern Namibia (where HIV rates among women in particular reach almost 31 percent), many have come to think of HIV as a normal part of life, a manageable issue like any other chronic condition. The results can include a loss of caution and more new infections.
“The truth is we have every tool we need to prevent the spread of HIV,” Charlize Theron said at the 2016 International AIDS Conference last July. “Every tool we need. Condoms. PrEP. PEP. ART. Awareness. Education. And yet 2.1 million people, 150,000 of them children, were infected with HIV last year.”
While UNAIDS and other major organizations have vowed to end the AIDS epidemic by 2030, we’re now at a crucial point from which it will be all too easy to backslide, including in the United States. We hope to see progress, urgency and continued global investments in 2017 as countries work toward their HIV-related targets and build the health workforces they need to achieve them. But some fear we may see stagnation instead.
5. Reproductive health care on the precipice
Abortions and teen birth rates in the U.S. are now at the lowest rates ever recorded. Two big reasons, according to the Pew Research Center: education and highly effective methods of contraception. According to the Copenhagen Consensus, making access to sexual and reproductive health services universal is one of the best, most cost-effective ways to achieve the global Sustainable Development Goals. By investing $25 per year, the consensus reports, we could see returns of up to $150 for every dollar invested.
But between 2000 and 2014, while most of the world was reducing its maternal mortality rates, pregnancy-related deaths in the U.S. went up. In Texas, for instance, where politicians have slashed funding for reproductive health care clinics, the number of maternal deaths doubled between 2010 and 2014.
Reproductive health and rights – both domestically and globally – could come under further attack in 2017 as new lawmakers arrive in Washington, D.C., and new international aid agendas are set.
4. Zika settles in
It’s been almost a year since the World Health Organization declared a state of emergency around the Zika virus. Less than 10 months later, the same organization startled public health experts by declaring the emergency over – not because Zika is no longer a threat, WHO officials said, but because the virus isn’t going away.
We know now that Zika will be an ongoing menace much like malaria and yellow fever, and that health workers will be fighting it for the foreseeable future. Two big differences that could affect U.S. action on Zika, though: the virus is a tangible threat to U.S. citizens, and there is no vaccine – yet.
3. A race for new vaccines and the struggle to uphold the ones we have
This year will see scientists hard at work on the vaccines for Zika and Ebola viruses. Already in 2017 a group of prominent donors announced that it had raised almost $500 million to develop and stockpile vaccines for new and known viral threats.
But in the U.S., some of the older vaccines we rely upon are facing challenges, too.
A researcher in Texas said the state is on the verge of a massive outbreak of measles. Seven cases cropped up in Los Angeles County last month. In Washington state, a mumps outbreak is making its way through public schools. Both measles and mumps are easily prevented with vaccines.
The small-but-vocal anti-vaccine movement in the U.S. may grow in 2017 as debates about vaccines make their way anew into the political discourse.
2. Strikes, shortages and other labor woes in the health workforce
Staff in most of Haiti’s 19 public hospitals have been on strike since Dec. 12. Jamaica is in the midst of a health care crisis as specialized nurses leave the country en masse for jobs in North America and Europe. And in Kenya, a massive strike among doctors demanding better working conditions has left millions of people without access to health care.
The global shortage of health workers is getting worse. And in many countries, it’s leaving doctors, nurses, midwives and others to burn out in bad working conditions – or leave their countries altogether – while their communities suffer under lower-quality care.
Organizations are working to change this, but it will take time, investment, and a new generation of aid.
1. The uncertain future of global health and international aid
This year the World Health Organization will elect a new director-general, who’ll be charged with moving past the WHO’s widely criticized reaction to West Africa’s Ebola outbreak two years ago and guiding a global organization that’s low on budget and high on bureaucracy. But of course, the new WHO appointment is not the only one that will shape global health this year.
No one knows yet how the incoming administration will carry on the United States’ traditional commitments to global health aid. We contribute more than any other country (though it adds up to less than 1 percent of our overall national budget), part out of do-goodery and part out of enlightened self-interest.
The U.S. government and public have long valued our investments in the future of global health, cooperation and prosperity. But changes in leadership and the rise in nationalism around the world could hurt global aid to those in need.
What other global health issues are you tracking this year?