At its 70th U.N. World Health Assembly in Geneva in late May, the World Health Organization (WHO) made history with the election of a new Director-General: Tedros Adhanom Ghebreyesus of Ethiopia – the first African to lead the organization. He now takes on the challenge of combating both infectious and noncommunicable diseases and other health challenges around the world. To succeed, he must convince the world to see health as a global public good—something in which we all have a stake.
An announcement by the WHO on May 12 underscores this point. A new Ebola outbreak was declared in the Democratic Republic of Congo after three people died. According to the WHO, the outbreak is “in a remote and hard to reach area and appears to be geographically relatively limited.” It reminds us that the world is vulnerable to infectious disease epidemics like the 2014 Ebola crisis that killed more than 11,300 people, largely in three countries in West Africa.
That earlier Ebola outbreak was contained, but with a seriously delayed and uncoordinated response. While we have learned much since then, each year there are many infectious outbreaks that could become epidemics and need to be contained. And one of the most profound lessons from the 2014 outbreak was that we all have a stake in the public health, health care and prevention systems of other countries and in their capacity to respond effectively to infectious disease. Further, we all benefit when other countries are healthy and stable.
Ebola brought front and center the concept of health as a global public good that requires investment by all nations. We invested in HIV care and prevention globally, through the president’s “PEPFAR” program, for similar reasons and to great benefit for all. In these contexts, it was easy to see that a threat to the health of people in one region is a threat to all of us. Health has no borders and can only be assured on a global basis.
Yet now we have other emergent issues that threaten all of our health. Noncommunicable diseases (NCDs) are the leading cause of death and disability worldwide and were, therefore, a major focus of attention at the World Health Assembly. NCDs—especially cardiovascular and lung diseases, diabetes and cancers—kill 40 million people each year, equivalent to 70 percent of all deaths globally, according to the WHO. Half are preventable.
The vast majority (87 percent) of “premature” deaths from NCDs (before the age of 70) occur in low- and middle-income countries. And the problem there is growing. In developing countries, NCDs are increasing faster, in younger people, and with worse outcomes than in wealthier countries, according to the NCD Alliance.
In addition, the cost of failing to act on NCDs far outweighs the cost of action. The cost of inaction in developing countries is $7 trillion over the next 20 years, the NCD Alliance calculates, while the annual cost of implementing a set of high-impact interventions is $11 billion. Yet NCDs still receive less than 2 percent of Development Assistance for Health.
It’s time for the world community to support health as a global public good, for we will all bear the consequences of inaction. In the case of infectious disease, we must prevent outbreaks through stronger health and disease-prevention systems around the world. In the case of noncommunicable diseases, we must prevent unnecessary suffering and economic loss that exacerbates poverty and increases instability, and invest in the approach with the highest return: prevention.
We know what’s needed. We must support quality health care, effective treatment, and population-wide disease prevention. We must promote healthy living—combatting tobacco use and moderating alcohol use—and support exercise and healthy eating and the availability of healthy water and food that people can afford.
Seeing health as a global public good is vital. Not only does it underscore our shared future but it shifts the focus to prevention. And as outgoing WHO Director-General Margaret Chan said in Geneva, we must “move to a mindset of prevention.”
Peace is often discussed as a global public good. Climate is increasingly considered one. Isn’t health of equivalent importance? Health of a population is the basis of a successful and productive society, in an interdependent world.
The Italian G7 Presidency recently listed “security as a ‘global public good,’ which includes issues related to anti-terrorism financing, remittances, and cyber security.” If remittances are to be considered a global public good, how can health not be?
Health is key to the aspirations of individuals, nations, and regions of the world. If we approach it from a global standpoint, we have a far greater chance of success.
The UN World Health Assembly reflects a shared global aspiration. It’s time to strengthen that commitment and fund it sufficiently, so that preventable deaths and years lived on ill health—no matter where they occur—become a thing of the past.