8.1 Major global health issues and challenges

Global health faces numerous challenges, from leading causes of death like heart disease and cancer to emerging threats like antimicrobial resistance and zoonotic diseases. These issues affect both developed and developing nations, but with stark disparities in healthcare access, life expectancy, and disease burden.

Environmental factors play a crucial role in health outcomes worldwide. Air and water pollution, climate change, and occupational hazards contribute to various health risks. Neglected tropical diseases pose unique challenges, particularly in poorer regions, due to limited research funding and healthcare access.

Global Health Challenges

Leading Causes of Mortality and Morbidity

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• Cardiovascular diseases account for approximately 31% of all deaths worldwide (heart disease and stroke)
• Cancer ranks as the second leading cause of death globally (lung, breast, colorectal, and liver cancers)
• Respiratory diseases contribute significantly to global mortality rates (chronic obstructive pulmonary disease and lower respiratory infections)
• Dementia represents a rapidly growing cause of death and disability, especially in aging populations (Alzheimer's disease)
• Diabetes mellitus causes major morbidity and mortality, with type 2 diabetes comprising the majority of cases
• Infectious diseases remain significant causes of death, particularly in low- and middle-income countries (HIV/AIDS, tuberculosis, and malaria)
• Neonatal disorders and maternal complications during pregnancy and childbirth contribute heavily to mortality rates in developing regions
  • Premature birth complications
  • Birth asphyxia
  • Neonatal sepsis

Emerging Health Threats

• Antimicrobial resistance threatens the effectiveness of antibiotics and other antimicrobial medicines
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • Multi-drug resistant tuberculosis
• Zoonotic diseases pose increasing risks as human-animal contact intensifies
  • COVID-19
  • Ebola
  • Avian influenza
• Mental health disorders are becoming more prevalent globally
  • Depression
  • Anxiety disorders
  • Substance abuse

Health Disparities: Developed vs Developing

Life Expectancy and Mortality Rates

• Life expectancy at birth varies significantly between developed and developing countries, with gaps up to 20 years
  • Japan: 84.3 years
  • Sierra Leone: 54.7 years
• Infant and maternal mortality rates remain substantially higher in developing countries
  • Limited access to quality healthcare
  • Poor nutrition
  • Lack of skilled birth attendants
• Communicable diseases prevalence stands disproportionately higher in developing countries
  • HIV/AIDS
  • Tuberculosis
  • Malaria

Healthcare Access and Resources

• Access to essential medicines and vaccines remains limited in many developing countries
  • Contributes to higher morbidity and mortality rates
  • Affects treatment of both communicable and non-communicable diseases
• Availability of trained healthcare professionals varies greatly between developed and developing nations
  • Developed countries have significantly higher ratios of doctors and nurses per capita
  • Brain drain exacerbates shortages in developing countries
• Health expenditure per capita in developed countries far exceeds that of developing countries
  • Leads to disparities in healthcare infrastructure
  • Affects availability of advanced medical technologies

Disease Burden Shifts

• Non-communicable diseases increase in prevalence in developing countries
  • Creates a double burden of disease alongside existing communicable diseases
  • Cardiovascular diseases
  • Diabetes
  • Cancer
• Nutritional challenges shift from undernutrition to overnutrition in some developing regions
  • Rise in obesity rates
  • Increased prevalence of diet-related non-communicable diseases

Environmental Impact on Health

Air and Water Pollution

• Air pollution contributes to major health risks, both indoor and outdoor
  • Respiratory diseases
  • Cardiovascular problems
  • Premature deaths
  • Particulate matter (PM2.5 and PM10)
  • Ground-level ozone
• Water pollution and inadequate sanitation spread waterborne diseases
  • Cholera
  • Typhoid
  • Hepatitis A
  • Disproportionately affects developing countries

Climate Change and Extreme Weather

• Climate change impacts global health through multiple pathways
  • Increased frequency of extreme weather events (heatwaves, floods, droughts)
  • Changes in disease patterns and vector distribution
  • Food and water insecurity
• Rising temperatures expand habitats for disease-carrying insects
  • Malaria-carrying mosquitoes move to higher altitudes
  • Tick-borne diseases spread to new regions

Occupational and Environmental Hazards

• Occupational hazards impact the health of millions of workers worldwide
  • Exposure to toxic substances
  • Unsafe working conditions
  • Occupational cancers
  • Respiratory diseases from dust and fumes
• Exposure to environmental toxins leads to long-term health effects
  • Lead poisoning
  • Mercury contamination
  • Pesticide exposure
  • Particularly affects vulnerable populations (children and pregnant women)

Challenges of Neglected Tropical Diseases

Research and Funding Limitations

• Neglected tropical diseases (NTDs) primarily affect the world's poorest populations
  • Limited research funding
  • Insufficient drug development efforts
  • Lack of economic incentives for pharmaceutical companies
• Complex life cycles of many NTDs involve intermediate hosts or vectors
  • Makes control and elimination strategies challenging to implement
  • Requires multifaceted approaches (vector control, mass drug administration, improved sanitation)

Healthcare Access and Stigma

• Limited access to healthcare and diagnostic tools in endemic areas hinders NTD management
  • Delays early detection
  • Impedes timely treatment
  • Contributes to disease spread
• Stigma associated with some NTDs prevents individuals from seeking treatment
  • Leprosy
  • Lymphatic filariasis
  • Leads to social isolation and mental health issues

Surveillance and Environmental Factors

• Inadequate surveillance systems and underreporting of cases complicate NTD management
  • Difficult to accurately assess true disease burden
  • Challenges in allocating resources effectively
  • Hampers targeted intervention strategies
• Climate change and environmental degradation alter distribution of disease vectors
  • Potentially expands range of NTDs to new areas
  • Complicates existing control efforts
  • Requires adaptive strategies in public health planning