Global Health Problems Span a Wide Spectrum

  • Infectious and noncommunicable diseases threaten health
  • Ebola fever epidemic points to need to improve health systems
  • Health spending is moving from national to regional and local governments
  • But any look at global health must include more than diseases.

    The latest issue of F&D magazine examines a panoply of global health concerns—among them the growing importance of regional and local governments in health care delivery, the need for more efficient delivery of health services and for better functioning health systems, and the increasing number of organizations involved in the provision or health services—an area once almost solely the province of the World Health Organization (WHO).

    Progress and threats

    Harvard economist and demographer David E. Bloom, in a broad look at the status of human health, notes that although the world confronts many problems it has made great progress in the control and treatment of infectious diseases—the result of better medicine and vaccination, clean water and sanitation, and improvements in nutrition, education, and income. One of the clearest demonstrations of the advance in health is the sharp increase in life expectancy—which has increased by 23 years over the past six decades and is forecast to increase another 7 years by mid-century.

    Gains in life expectancy are a hopeful indicator of what is possible in facing both longstanding and new health threats, Bloom writes. These threats include infectious diseases like Ebola, malaria, tuberculosis, HIV, hepatitis, diarrhea, and dengue (including drug-resistant forms of these and other pathogens), as well as chronic infirmities such as cardiovascular disease, cancer, respiratory disease, diabetes, neuro-psychiatric conditions, sense organ disorders, and musculoskeletal disorders.

    In many respects, the most jarring feature of the global health scene is the massive disparity between its achievements and failings, he writes. For example, there is a 38-year gap between the country with the longest life expectancy, Japan at 83 years, and that with the lowest, Sierra Leone at 45. And 14 countries have a life expectancy at birth of less than 55 years, while 25 have one greater than 80 years.

    Lessons from Ebola

    Health was a major focus of the Millennium Development Goals established by the United Nations 15 years ago and will surely remain prominent on the development agenda, according to Bloom. But the nature, focus, and concrete indicators of any new goal (or...

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