MONTHLY DEVELOPMENTS Global Health and Disease: Progress Worth Celebrating?

June 2012 Health has long been recognized as one of the most objective measures of human well-being and one of the issues most deserving of international attention. Four of the Millennium Development Goals address health issues: ending hunger, improving child and maternal health, and combating HIV/AIDS. In lowincome countries it is disease, not conflict, that claims millions of lives each year. More than any other issue, health highlights the drastic disparity between the worlds rich and poor and calls our attention to the reality faced by women and children. The challenges of global health have galvanized a large movement that has demonstrated the capacity to make major, measurable strides in improving specific health indicators. A revolution in child survival has dramatically reduced the number of under-five deaths from more than 12 million in 1990 to 7.6 million in 2010 according to UNICEF. Yet the challenge remains daunting. USAIDs new Child Survival Call to Action is founded on the vision of ending preventable childhood deaths altogether and is an important initiative.

Samuel A. Worthington Picture | Bio

Health and disease are not intractable issues; the challenge in many cases is not finding new solutions, but rather improving and finding creative ways to access basic care. Malaria, which causes nearly one million deaths each year, is largely preventable with relatively cheap bednets, while diarrheawhich killed 1.5 million in 2009is often effectively treated with a simple mixture of water, salt and sugar. Improving access to clean drinking water and encouraging healthy practices such as hand-washing can dramatically improve health outcomes, particularly among children. Significant gains can also be made against HIV/AIDS, which is responsible for nearly two million deaths annually, by increasing prevention education and the prevalence of male circumcision. This is not to deny the difficulty of addressing our global health challenges. Disease prevention brings up important questions about building health systems, including best practices, logistics, innovation and general effectiveness. However, because so many deaths result from preventable diseases, progress in global health is both real and possible. In addition, good public health policy has a significant impact on a countrys overall wellness. Health directly contributes to a countrys economic development, with low life expectancy and high rates of disease dragging down economic growth. Wealthy countries should play an active

role in promoting global health, because a healthier world is more politically stable and because pandemics know no borders. Improving health conditions in low-income countries saves lives and is in our national interest. Knowing all this, how have low- to middle-income countries and the international community as a whole performed? Have we seen progress worth celebrating? According to UNAIDS, new HIV infections have declined by almost 20 percent since the UN General Assembly Special Session on HIV/AIDS ten years ago. Statistics also indicate that infant and maternal mortality have each decreased by over one third since 1990, with the rate of decline in infant mortality increasing in recent yearssizeable improvements, to be sure. Access to safe drinking water increased from 77 percent to 87 percent of the world. We have seen marked improvements in tuberculosis, measles, malaria and many other diseases, with malaria prevention becoming a global success story. Yet in judging progress, international actors must look beyond health improvements and assess the impact of their own actions. We in the development community must evaluate our own work and the work of the worlds wealthiest economies. Most health indicators will continue their steady, positive gains as economic growth in developing countries continues. Whether the international health community celebrates these improvements should depend on what role it plays in their achievement. The initial prognosis is good, but as resources become scarcer we may still falter at just the wrong time.