WHO says that this year it will help governments meet targets on increasing the amount that people exercise in a bid to tackle the growing epidemic of NCDs. Diseases such as diabetes, cancer and heart disease are collectively responsible for over 70 per cent of all deaths worldwide, or 41 million people every year.
Fragile and vulnerable settings
More than 1.6 billion people – or nearly a quarter of the world’s population – live in places where crises such as drought, famine or conflict leave them without access to basic services such as health care. WHO says it will strengthen health services in these countries so that they are better able to respond to disease outbreaks and deliver essential health services such as immunisation.
Antimicrobial resistance
Thrust to the top of the domestic political agenda by England’s chief medical officer Dame Sally Davies, the growing threat of AMR is also increasingly recognised globally. A recent report warned that worldwide 10 million people will die by 2050 if no action is taken. WHO has recognised that action can only be taken on a global scale and is working with government officials from both human and animal health sectors to implement its action plan.
In 2018, the Democratic Republic of the Congo saw two separate Ebola outbreaks, both of which spread to cities of more than 1 million people. The second outbreak – recognised as the second worst in history – is also in an active conflict zone.
FAQ | Ebola
What does Ebola do?
Symptoms begin with fever, muscle pain and a sore throat and can escalate rapidly to vomiting, diarrhoea and internal and external bleeding. The average EVD case fatality rate is around 50% although they have varied from 25% to 90% in past outbreaks. Health workers are at serious risk of contracting the disease and need to wear a protective suit covering their entire body.
How is the virus transmitted?
The virus is introduced into the human population through close contact with the bodily fluids of infected animals such as fruit bats and chimpanzees.
The virus spreads through human-to-human transmission, with infection resulting from direct contact with infected indviduals, through broken skin or mucous membranes, and indirect contact with objects contaminated with bodily fluids, such as door handles and telephones. The virus cannot be spread through the air
Health workers who have close contact with infected patients are particularly at risk of contracting the disease. Burial ceremonies that involve direct contact with the body of the deceased can also lead to the spread of Ebola.
Is the disease treatable?
There is no cure for the disease and treatment involves rehydration or intravenous fluids. Early treatment improves a patient’s chances of survival. There is no cure although during the Ebola outbreak in West Africa in 2014 anti viral treatments were developed. A vaccine has also been developed and will be used in the latest outbreak to protect direct contacts of infected patients.
Last year also saw WHO publish its blueprint list of priority diseases which have the potential to cause a public health emergency but for which there are no effective treatments and vaccines. This watchlist includes Ebola, Zika and disease X – an as yet unknown pathogen which could cause a pandemic.
Weak primary health care
Many low and middle income countries lack adequate primary health care – often the first port of call for patients in developed countries. WHO says it will strengthen primary health care in many of the poorest countries of the world.
Vaccine hesitancy
Vaccine hesitancy – the reluctance or refusal to vaccinate – was seen as one of the reasons for a 30 per cent increase in the number of cases of measles globally. This was a disease that was almost consigned to history in some countries. “Anti vaxx” attitudes and social media bots spreading misinformation have encouraged vaccine scepticism.
Heidi Larson, professor of anthropology, risk and decision science, at the London School of Hygiene and Tropical Medicine, said it had taken some time for the global health community to recognise the threat, although WHO started to look into it in 2013.
She said: “In terms of antibiotic resistance we need confidence in vaccines more than ever, especially as our over-relied on antibiotics are not always working.”
Dengue
This mosquito-borne disease is spreading to more temperate regions of the world and its season is also getting longer. Now, around 40 per cent of the world’s population are at risk of contracting this debilitating flu-like illness which, in its most severe form, has a 20 per cent mortality rate. WHO’s dengue strategy aims to reduce deaths by 50 per cent by 2020.
Dr Rachel Lowe, an expert on dengue at the London School of Hygiene & Tropical Medicine, welcomed dengue’s inclusion on the list. She said: “Changes in temperature and rainfall regimes across the globe are making it more difficult to predict the onset of the dengue season in countries prone to dengue epidemics.
“Several factors, including climate change and human movement, have allowed dengue to spread outside of the tropics to more temperature zones, including countries with limited capacity to respond.”
HIV
Despite the huge strides made in the fight against HIV/Aids around a million people die from the disease every year and a quarter of those infected do not know their status. One in four new infections takes place among girls and young women in sub Saharan Africa – a group whose numbers are set to boom over the next few years because of population growth.
