Untitled Quiz

Managing Global Health Challenges

• Global health policies, healthcare disparities, and humanitarian healthcare address infectious and chronic diseases.
• Alfredo Galletti, Corporate Vice President and General Manager of Novo Nordisk Italia, presented. He has 20 years of experience in the company and is responsible for pricing and access for international operations.

Index

• What is "global Health" and the concept of health
• Key concepts in global health
• History of global health
• Global Health challenges and challenging factors
• Current & Future global health priorities
• Sustainable Development Goals
• Governance and main actors in global health
• Global Health and ethics
• Conclusions and final remarks

Global Health and the concept of Health

• WHO defines health as a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.
• Health is more than just being free of disease; it is about living well.

Life Expectancy by Continent

• Life expectancy across continents has risen over time but unevenly.
• Worldwide life expectancy has increased over time.

Key Concepts related to Global Health

• Determinants of health
• Measurement of health status
• Importance of culture to health
• Global burden of disease
• Organization and function of local health systems

Determinants of Health

• Personal/Social factors: genetic makeup, age, gender, lifestyle, community influences, income status, geographical location, culture, environment, work conditions, education, and access to health services
• Systemic factors: political stability, civil rights, environmental degradation, population growth, urbanization, and country development

Multi-cause-effect relationships

• Malnutrition leads to more susceptibility to disease.
• Cooking with wood and coal leads to respiratory diseases.
• Poor sanitation increases intestinal infections.
• Poor life circumstances correlate with STIs and HIV/AIDS.
• Advertising tobacco and alcohol relates to addiction and related diseases.
• Rapid growth in vehicular traffic, often with untrained drivers on unsafe roads, leads to road accidents.

The Measurement of Health Status

• Cause of death: data often limited and incomplete.
• Life expectancy at birth is the average lifespan expected.
• Infant mortality rate: deaths of infants under 1 per 1,000 births.
• Neonatal mortality rate: deaths among infants under 28 days per 1,000 live births.
• Child mortality rate: probability of a newborn dying before reaching age five.
• Maternal mortality rate: number of women dying during childbirth or pregnancy-related complications per 100,000 births.

Key Concepts on Global Health

• Determinants of health, Measurement of health status, Importance of culture to health, and Global burden of disease, and The organization and function of local health systems

Culture and Health

• Culture significantly impacts health perspectives and behaviors.
• Traditional health systems exist (herbal medicine, faith healers).
• Beliefs and practices (e.g., epilepsy as a possession, mental health explanations).
• Cultural diversity, marginalization, and vulnerabilities affect health.

The global burden of disease (GBD)

• GBD is a global research program that evaluates the impact of diseases, injuries, and risk factors.
• GBD involves over 12,000 researchers from 160 countries and has tracked data from 1990 onwards.

The Organization and Function of Health Systems

• Universal coverage with single-payer systems (everyone covered by national health plan).
• Universal coverage with multi-payer systems (national health systems with competing insurers).
• Multi-payer systems with no universal coverage (not everyone has coverage).
• No national healthcare infrastructure.

History of global health

• The historical exploration and tropical medicine eras highlight the devastating impact of infectious diseases.
• Global cholera pandemics occurred between 1816 and 1899.
• The 1900s saw the development of international health organizations and programs to address these global challenges.
• The 1980s saw a focus on HIV and related health issues.

Smallpox - a (once deadly) disease

• Smallpox is the first and only infectious disease to be eradicated in humans.
• The virus caused permanent health complications and high mortality rates before eradication.
• The eradication campaign used a global vaccination program.
• Jenner's observation of the resistance of milkmaids to smallpox led to the first smallpox vaccine.

The fight against Polio

• Polio is an infectious disease transmitted by the poliovirus, that can cause paralysis and death.
• The disease spreads in conditions of poor sanitation.
• A global eradication initiative helped reduce cases significantly.
• Two of three types of wild poliovirus have been eradicated worldwide.

The challenges to global health

• Increased healthcare costs
• Widening health disparities
• Macroeconomic issues
• Healthcare worker shortages
• Anti-microbial resistance
• Urbanization
• Ageing population

Scientific advancement

• FDA and NBE approvals for chemical entities and biologics over time.

Digital innovation

• Disease identification algorithms
• Personalized treatment and biomarker recognition
• Robotic surgery and clinical trial research

Macroeconomic issues

• Historical data of Health spending and GDP growth.
• Wide variation in healthcare expenditure as a percentage of GDP across countries.

Widening disparities

• Significant health disparities exist, with some countries experiencing much higher rates of mortality and poorer life expectancy than others.

Ageing of population

• Common diseases of ageing include cardiovascular, chronic respiratory, communicable, diarrhoeal, and neurodegenerative diseases.

Anti-microbial resistance

• Overuse of antimicrobial drugs leads to resistant pathogens and challenges in the management of infectious diseases.
• Global measures (e.g., antimicrobial stewardship, infection prevention), are required to address this.

The current & future priorities

• Various global health challenges are addressed.
• Future needs include the support for health systems, access to care, and mitigating risks associated with climate, environment, and urbanization.

Future health challenges on NCDs

• Burden of chronic diseases vary across income classes.

Lifestyle and communicable diseases

• Malnutrition and food insecurity
• Infection diseases
• Substance abuse

Sexual and reproductive health

• Inadequate CSE
• Adolescent pregnancies
• Unsafe abortions
• Sexually transmitted infections (STIs)

Cancer

• High incidence and mortality rates globally.
• Risk factors include lifestyle, environment, and genetic predisposition.
• Infections are frequently associated with cancer (e.g., Helicobacter pylori, Hepatitis B & C, human papillomavirus).
• Treatment access and affordability vary greatly based on geography and access to healthcare.

Diabetes

• Increasing worldwide prevalence
• Type 1 and 2 diabetes; gestational diabetes each with its own complications and risk factors .

Obesity

• Several comorbid health complications
• Risk factors linked to reduced lifespan

Sustainable Development Goals

• Global goals to address global health challenges.

Governance and main actors in global health

• Key stakeholders involved in developing and implementing global health policies and programs.

Global Health and ethics

• Ethical considerations in addressing global health crises.

Conclusions and take-home messages

• Key concepts and messages (e.g. changing definition of health, global commitment, and fragmentation of global space.)

Main actors in global health

• Organisations and stakeholders influencing and shaping global health policies and actions.

The World Health Organization (WHO)

• Functions
• Action framework

The Global Fund to Fight AIDS, Tuberculosis and Malaria

• Financing mechanism, not implementation.

Bill & Melinda Gates Foundation

• Contributions to global health initiatives

Gavi, the Vaccine Alliance

• Global health partnership to address immunization gaps.

World Diabetes Foundation

• Aims to improve diabetes prevention and care.

Anti-microbial resistance

• Overuse and misuse of antimicrobial drugs
• Increased resistance across various pathogens

Climate Change

• Significant health threat

Environmental Pollution

• Attributable to the ingestion of microplastics, and toxic heavy metals and air and household pollution, which may lead to health impacts and increase the risk of malignancy.

Health systems

• The need for access to health services, care, and affordable treatment.

Infectious diseases

• Pandemics and the importance of preparedness
• Socioeconomic determinants and limited access to resources.
• Transmission risks and unique challenges.

Substance abuse

• Impacts of substance use (excluding alcohol and tobacco).
• Shift from infectious diseases to non-infectious ones.

Mental Health

• Important global issue.
• Impact of crises
• Prevalence increasing

Malnutrition and food

• Global issues linked to the severity of health complications

Sexual and reproductive health

• Critical considerations to protect the rights and health of all demographics
• Factors linked to improved outcomes