The World Health Organisation (WHO) has recently outlined a list of serious threats that could potentially have a disastrous impact on global health throughout 2019. This comprehensive list includes ten key areas, each posing unique challenges to health officials worldwide. Of particular concern is the situation in India, whose large population and specific health issues contribute significantly to many of these global health threats.
Air Pollution and Climate Change
Air pollution continues to be an issue worldwide. The WHO reports that approximately nine out of ten people globally are breathing polluted air. This problem is particularly acute in India, which with 18% of the global population, experiences 26% of the premature deaths and disease burden due to air pollution.
Non-communicable Diseases
Non-communicable diseases – which include diabetes, cancer, and heart disease – cause over 70% of all deaths worldwide, or 41 million people. Such statistics include the premature death of 15 million people aged between 30 and 69. India bears a significant brunt of these diseases, being labeled as the “diabetes capital of the world”. Furthermore, India’s current estimated cancer burden of over 1.5 million new cases is expected to double within the next 20 years.
The Threat of a Global Influenza Pandemic
The WHO has warned that the world may face another influenza pandemic, the severity and timeline of which remains uncertain. India, in particular, has already suffered from swine flu, reporting 1,694 cases and 49 deaths until January 13 this year. In comparison to 2018, when 14,992 cases and 1,103 deaths were reported country-wide, the need for increased vigilance and preparedness is evident.
Fragile, Vulnerable Settings and The Impact on Health
Over 1.6 billion people, or 22% of the global population, live in areas where drought, famine, conflict, population displacement, and weak health services leave them without access to basic care. India is unfortunately at the forefront of these issues with its large migrant population often living in unhygienic conditions with minimal access to basic care. Natural disasters, such as the Kerala floods last year, bring subsequent health crises like outbreaks of leptospirosis.
Antimicrobial Resistance (AMR)
The fact that bacteria, parasites, viruses, and fungi are becoming increasingly resistant to antibiotics threatens our ability to effectively combat them. AMR is driven by various factors, include overuse of antimicrobials in people and animals, and rampant over-the-counter sale of medications without prescription, found throughout much of the world, including India. In 2016, India, China, and the Russian Federation accounted for 47% of the global incidence of MDR-TB (Multidrug-Resistant Tuberculosis).
| Threat | Global Impact | Impact in India |
|---|---|---|
| Air Pollution | 9 out of 10 people breath polluted air | 26% of premature deaths and disease burden |
| Non-communicable diseases | Cause over 70% of all deaths worldwide | Diabetes capital of the world |
| Influenza pandemic | Potential global threat | 1,694 cases of swine flu to date in current year |
Weak Primary Healthcare
Primary healthcare facilities, often the first point of contact people have with their health care system, are lacking in many countries. In India, the primary care arm of Ayushman Bharat, with a proposed 1,53,000 health and wellness centers, has received less attention than the insurance aspect of Ayushman Bharat (Pradhan Mantri Jan Arogya Yojana). Statistics for 2017 show that around 8,000 posts of doctors in primary health centers in India are vacant, and almost 2000 of the total 25,000 Primary Health Centres’ have no doctors at all.
Vaccine Hesitancy
The reluctance or refusal to vaccinate despite vaccine availability presents a global health threat. Vaccination prevents 2-3 million deaths a year, and another 1.5 million could be avoided if global vaccine coverage improves.
The Prevalence of Dengue
Dengue, a mosquito-borne disease, poses a significant global health risk. Approximately 40% of the world is at risk of dengue with nearly 390 million infections annually. India is particularly affected, reporting 89,974 dengue cases and 144 deaths until November 25, 2018.
HIV and AIDS
HIV/AIDS still claims nearly a million lives each year according to the WHO. Since the epidemic’s beginning, over 70 million people have contracted the infection, with about 35 million deaths reported. Currently, around 37 million people worldwide live with HIV. Despite these alarming numbers, India has made strides against the disease, having enacted the HIV/AIDS Act, 2018 which makes anti-retroviral therapy a legal right for Indians with HIV/AIDS.
Ebola and Other High Threat Pathogens
The WHO also identifies diseases and pathogens, such as Ebola, Zika, Nipah, MERS-CoV, SARS, and disease X that have the potential to cause a public health emergency owing to the lack of effective treatments and vaccines. While India has yet to see an Ebola case, several Indian states battled Zika in 2018, and at least 17 people died of Nipah infection over the months of April and May.