Global health

Global health is about the health of people all around the world. It focuses on improving health for everyone and making sure that health chances are fair for all people, no matter where they live. It looks at problems that affect many countries and need worldwide attention to solve.

Global health is different from international health, which mainly looks at helping poorer countries with support from richer ones. Global health looks at many kinds of health issues, like diseases that can affect anyone, no matter what country they are in.

One way to understand global health is by looking at how common diseases are around the world and how they might shorten people's lives. In the past, before modern medicine, people often did not live very long because many babies did not survive their first years. Today, groups like the World Health Organization, UNICEF, and the World Food Programme work to improve health for everyone. They help countries work together to solve health problems and make life better for all.

Definition

Global health looks at how to keep people healthy all around the world. It uses many different ideas and ways to understand and improve health for everyone.

• Medicine talks about diseases and how to stop, find, and treat them.
• Public health focuses on keeping groups of people healthy.
• Epidemiology helps find out what causes health problems.
• Demography gives information to help make good rules about health.
• Economics looks at the best ways to use money for health.
• Other subjects like sociology, development studies, psychology, anthropology, cultural studies, and law help us understand why health is different in different places.

People and groups working on global health also think about fair treatment and rights for everyone. They talk about these important topics at meetings twice a year.

History

Important steps toward working together around the world for better health began after World War II. In 1945, the United Nations and the World Bank Group were formed. In 1948, countries created the World Health Organization to help improve health worldwide. A big cholera outbreak in Egypt helped push the world to work together on health issues.

In 2000, world leaders set eight important goals called the Millennium Development Goals to improve life for everyone by 2015. These goals led to big efforts to help people stay healthy. Later, in 2015, these goals were replaced by new ones called the Sustainable Development Goals, which include ending poverty and improving health for all.

Many important health programs started in the 2000s, like the vaccine group GAVI and groups to fight diseases like AIDS, tuberculosis, and malaria. These programs have helped save many lives around the world.

Measures

Measures of global health include disability-adjusted life year (DALY), quality-adjusted life years (QALYs), and mortality rate.

Disability-adjusted life years

Main article: Disability-adjusted life year

The DALY is a way to measure the impact of illness, disability, and death. It looks at how much time is lost because of early death and how much time is lived with disability. One DALY equals one year of healthy life that is lost.

Quality-adjusted life years

Main article: Quality-adjusted life year

QALYs combine how long a person might live with how good their health is. A year of healthy life is worth one point. If someone’s health is not perfect, that year is worth less than one point. QALYs help us understand how much value people place on living longer versus living in better health.

Infant and child mortality

Main articles: Infant mortality and Child mortality

Infant and child mortality, especially for children under age 5, show the health of the poorest groups in a population. These measures are very useful when we want to focus on health equity.

Morbidity

Main article: Morbidity

Morbidity measures include incidence rate, prevalence, and cumulative incidence. Incidence rate shows the chance of someone getting a new health problem in a certain time. It is more than just counting new cases; it is about showing how common the problem is.

Health topics

Infectious diseases

Respiratory tract infections

Infections of the respiratory tract and middle ear are major causes of illness and death worldwide. Some respiratory infections of global significance include tuberculosis, measles, influenza, coronaviruses and pneumonias caused by certain bacteria and viruses. The spread of respiratory infections is made worse by crowded living conditions, and poverty increases the burden of lung infections.

Diarrheal illnesses

Diarrhea is the second most common cause of child deaths worldwide, responsible for 17% of deaths of children under age 5. Poor sanitation can spread germs through water, food, and hands. Dehydration from diarrhea can be treated with oral rehydration therapy, which greatly reduces deaths. Important steps include promoting breastfeeding and giving zinc supplements. While good hygiene may not be enough to stop rotavirus diarrhea, a vaccine can prevent it.

HIV/AIDS

The HIV/AIDS situation has shown the global nature of health issues. Many international funds have been created to address challenges like HIV. Since the start of the epidemic, millions have been infected with HIV and millions have died. Today, millions of people worldwide are living with HIV. HIV is spread through certain activities and can damage the immune system, leading to serious health problems. Medicines can help people with HIV live longer and healthier lives.

Malaria

Malaria is a disease spread by mosquitoes, causing symptoms like fever and chills. It affects millions each year, especially children and pregnant women in developing countries. Using bed nets and taking medicine can help prevent and treat malaria. Deforestation can also increase malaria risk in some areas.

Bacterial pathogens

Studies show that bacterial infections are a major cause of death worldwide, contributing to many fatalities each year.

Neglected tropical diseases

More than one billion people were treated for at least one neglected tropical disease in 2015. These diseases are common in tropical and subtropical regions, mainly affecting poor populations in Africa, Asia, and Latin America. They are caused by bacteria, viruses, protozoa, and parasites. Efforts are ongoing to control or eliminate these diseases through better access to clean water, improved living conditions, and medicine.

Pandemic prevention and preparedness

Pandemics affect global health.

Health research and development

The global health approach encourages countries to work together in medical research and share results like vaccines. The U.S. Agency for International Development has plans to support global health product development. Creating new vaccines is another way to improve health. Financing, evidence-based recommendations, and logistics are important parts of this effort.

A paper discussed the global health crisis, where many deaths are due to poverty-related causes. It suggested making medical knowledge freely available and rewarding inventors based on the impact of their work. This approach could help pharmaceutical companies, patients, and generic drug producers work together.

Maternal health

Complications during pregnancy and childbirth are leading causes of death among women of childbearing age. In many developing countries, a woman dies from childbirth complications about every minute. Most of these deaths can be prevented, and they have been mostly eliminated in developed countries. Goals to improve maternal health include having skilled birth attendants present during deliveries.

Nutrition

In 2010, about 104 million children were underweight, and poor nutrition contributes to about one third of child deaths worldwide. Poor nutrition weakens the immune system and makes infections worse. Deficiencies in vitamins and minerals like vitamin A, iron, iodine, and zinc are common and can affect growth and development. Ways to prevent poor nutrition include giving supplements, fortifying foods, promoting breastfeeding, and improving hygiene.

Non-communicable diseases

About 80% of deaths from non-communicable diseases happen in developing countries. Urbanization and aging populations have increased health problems related to these diseases. Diabetes and heart disease have been growing faster in recent years. Over 60% of deaths in 2016 were due to non-communicable diseases. Increases in refugee urbanization have also led to more people diagnosed with chronic diseases.

In September 2011, the United Nations held its first General Assembly Special Summit on non-communicable diseases. These diseases cause many deaths each year, and the world is being asked to take steps to prevent and control them, especially for women who often care for others.

Obesity, linked to conditions like heart disease, stroke, certain cancers, and breathing problems, is a major concern. About 16% of the global disease burden is due to obesity.

Lifestyle diseases

Activities by companies can affect health, including ads for unhealthy food.

Health-related largest causes of death

Violence against women

Violence against women includes physical, emotional, and other harmful actions in families and communities. It can cause long-term health problems for women, such as pain, disability, substance use, and depression. One in five women experiences some form of violence during their lifetime. Preventing this violence is important for public health. Efforts include education, changing societal norms, and supporting women’s economic empowerment.

Global surgery

The provision of surgery and surgical care in poor countries has not kept up with other areas of global health. About five billion people lack access to safe and affordable surgery. Up to 30% of the global burden of disease could be treated with surgery. The Lancet Commission on Global Surgery highlighted the need for more surgical care and defined goals to improve access by 2030. Meeting these goals would require more surgeons, nurses, and facilities.

Multimorbidity, age-related diseases and aging

Multimorbidity is a growing health issue worldwide, likely due to aging populations and other factors. With aging populations, age-related diseases are increasing, putting pressure on healthcare systems. Research aims to extend healthy living years and slow aging. By 2050, over two billion people will be over 60 years old, making this a major global health challenge.

Infertility crisis

A scientific review found that human sperm counts have fallen by 62% in the last 50 years and are decreasing worldwide, likely due to factors like poor diets, certain chemicals in products, unhealthy lifestyles, and toxic substances in air and water.

Health interventions

See also: Health human resources

Global efforts to help children stay healthy and survive include encouraging breastfeeding, giving zinc and vitamin A supplements, adding iodine to salt, teaching good hygiene like hand-washing, giving vaccinations, and treating serious cases of malnutrition. The Global Health Council lists 32 treatments and health actions that could save many lives each year.

Some places have an "outcome gap," meaning not everyone can get the medical help they need. For example, in Guatemala, some medicines were very hard to find and very expensive. In Pakistan, medicines were cheaper than in many places but still hard to get.

Writer Laurie Garrett says that global health isn’t mainly about lacking money. Even with money, results aren’t always good because funds are often spent on just one disease instead of many needs.

Labor shortages

In 2006, the World Health Organization estimated a shortage of nearly 4.3 million doctors, nurses, midwives, and other health workers around the world, especially in sub-Saharan Africa. A 2022 study found that in 2019, the world had about 104 million health workers, including nearly 13 million doctors and almost 30 million nurses and midwives. However, many areas, like sub-Saharan Africa, south Asia, and north Africa and the Middle East, still had too few health workers. Even with today’s technology, like telehealth, the way health workers are spread out can make a big difference in care.

Global health security

The COVID-19 pandemic showed that keeping everyone healthy around the world depends on all countries, including those with fewer resources, having good health systems and some ability to study health problems. In 2020, a group called the ESSENCE group suggested a way to check how much money and help these countries get for health research. This will help find where support is needed most and allow countries to work together. The goal is to give more help for important health issues in each country, get ready for future health emergencies better, and make sure more countries can do their own health research.

Global factors impacting health

Climate change

Climate change affects health all around the world. It makes it harder for doctors to keep everyone healthy. Hot weather and dirty air can cause problems like lung disease and asthma.

Antimicrobial resistance

Antimicrobial resistance is a big problem for health worldwide. In 2019, it helped cause many deaths, including some of young children.

Organization

Global health is helped by many groups and governments around the world. Some important groups include:

• The United Nations, which has groups like the World Health Organization, United Nations Children's Fund (UNICEF), and the World Food Programme (WFP).
• Other groups like the Pan American Health Organization (PAHO), International Committee of the Red Cross, and the Centers for Disease Control and Prevention (CDC).
• Special plans such as The Global Fund to Fight AIDS, Tuberculosis and Malaria and President's Emergency Plan for AIDS Relief (PEPFAR).
• Non-governmental groups like Médecins Sans Frontières (Doctors Without Borders, MSF) and the Bill & Melinda Gates Foundation.

These groups work together to improve health for everyone, especially in places that need help the most. They focus on stopping diseases, helping people stay healthy, and making sure everyone has access to medical care.

The Global Health Security Agenda (GHSA) is a team of countries and organizations working together to prepare for and stop the spread of diseases. In March 2018, they met in Georgia to discuss how to better watch for and respond to diseases like HIV/AIDS, severe acute respiratory syndrome (SARS), H1N1 influenza, and multi-drug resistant tuberculosis. They have action plans to help countries get ready for health emergencies and work together to keep people safe.