A year of successes in global health

BANGKOK – In the field of human development, the year that just ended was better than many predicted it would be. A decade after the Great Recession began, economic recovery continued in 2017, and progress was made on issues like poverty, education, and global warming. But perhaps the most significant achievements of the last 12 months were in global health. I count 18 unique successes in 2017, many of which will help sow the seeds of progress for the months and years ahead. The first notable success occurred early in the year, when a Guinness World Record was set for the most donations of medication made during a 24-hour period. On January 30, more than 207 million drug doses were donated to treat neglected tropical diseases including guinea-worm disease, leprosy, and trachoma. This extraordinary feat was made possible by the Bill & Melinda Gates Foundation, and by pharmaceutical firms including Bayer, Novartis, Pfizer, and my company, Sanofi Pasteur. India’s elimination of active trachoma was another milestone, as it marked an important turning point in the global fight against a leading infectious cause of blindness. Last year, trachoma was also eradicated in Oman, Morocco, and Mexico. A third key health trend in 2017 was further progress toward the elimination of human onchocerciasis, which causes blindness, impaired vision, and skin infections. Fourth on my list is a dramatic drop in the number of guinea-worm disease infections. A mere 26 cases were recorded worldwide in 2017, down from 3.5 million cases in 1986. Efforts to eradicate leprosy earned the fifth spot on my list, while vaccine advances in general were sixth. Highlights included a new typhoid vaccine, shown to improve protection for infants and young children, and a new shingles vaccine. Number seven is the dramatic progress made in eliminating measles. Four countries – Bhutan, the Maldives, New Zealand, and the United Kingdom – were all declared measles-free last year. The war on Zika is number eight on my list of health achievements in 2017. Thanks to coordinated global efforts, most people in Latin America and the Caribbean are now immune to the mosquito-borne virus, and experts believe transmission will continue to slow. Number nine is polio eradication. Fewer than 20 new cases were reported globally, a 99% reduction since 1988. Although the year ended with reports of cases in Pakistan, health experts remain optimistic that polio can be fully eradicated in 2018. Rounding out my top ten was the creation of the Coalition for Epidemic Preparedness Innovations (CEPI), which was established to develop vaccines for infectious disease threats. Launched with nearly $600 million in funding from Germany, Japan, Norway, the UK charity Wellcome Trust, and the Bill & Melinda Gates Foundation, CEPI aims to reduce sharply the time it takes to develop and produce vaccines. Huge gains in disease control and prevention were made last year, and the next few items on my list (11 through 16) reflect progress on specific illnesses. For example, rates of premature death fell for non-communicable diseases like cardiovascular disease, cancer, diabetes, and chronic respiratory conditions. Another highlight was the historic approval of a sophisticated cancer treatment, CAR T-cell therapy, which uses a patient’s own immune cells to attack tumors. Improvements were also made in treating HIV. Clinical trials for an HIV vaccine started at the end of 2017, while doctors in South Africa reported curing a young boy of the disease after he received treatments as an infant. These and other initiatives give new hope to the many who are still suffering from this chronic condition. Advances in treating gonorrhea, a common sexually transmitted infection that has become increasingly resistant to antibiotics, are also worthy of mention. Wrapping up my list of disease-specific gains of 2017 is the renewed commitment made by global health ministers to eradicate tuberculosis by 2030. The final two successes are reminders of how much work remains. In August, the fast food giant McDonald’s unveiled a Global Vision for Antimicrobial Stewardship in Food Animals. Although recognition of the food industry’s ethical responsibilities for public health is to be welcomed, the pledge also represents a cautionary note about how closely connected food and health really are. Finally, rounding out my list was the historic Universal Health Coverage Forum held in Tokyo, where global leaders gathered to discuss how to improve health-care access. The World Bank and the WHO note that half of the world’s population still cannot obtain essential health services. I therefore count the December meeting as a “success” not for its achievements, but because it was a reminder to the international community that improving health-care access remains a long-term endeavor. As the global health community resets its annual clock – and I begin cataloguing the big health stories of 2018 – we should take a moment to reflect on the 12 months recently ended. Even in a mediocre year, the global health community saved millions of lives. Imagine what we will achieve in an extraordinary year. Melvin Sanicas, a public health physician and vaccinologist, is a regional medical expert at Sanofi Pasteur. Copyright: Project Syndicate.

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A year of successes in global health