Question

27. Describe 3 challenges to medicine that currently confronts global health in regard to pathogens and our ability to respond to them?

Answer 1

• Antibiotic resistance is one of the biggest threats to global health, food security, and development today. • Antibiotic resistance can affect anyone, of any age, in any country. • Antibiotic resistance occurs naturally, but misuse of antibiotics in humans and animals is accelerating the process. • A growing number of infections - such as pneumonia, tuberculosis, gonorrhoea, and salmonellosis - are becoming harder to treat as the antibiotics used to treat them become less effective. • Antibiotic resistance leads to longer hospital stays, higher medical costs and increased mortality.

1. Antimicrobial resistance:- The development of antibiotics, antivirals and antimalarials are some of modern medicine's greatest successes. Now, time with these drugs is running out. Antimicrobial resistance - the ability of bacteria, parasites, viruses and fungi to resist these medicines – threatens to send us back to a time when we were unable to easily treat infections such as pneumonia, tuberculosis, gonorrhoea, and salmonellosis. The inability to prevent infections could seriously compromise surgery and procedures such as chemotherapy. Resistance to

chemotherapy. Resistance to tuberculosis drugs is a formidable obstacle to fighting a disease that causes around 10 million people to fall ill, and 1.6 million to die, every year. In 2017, around 600 000 cases of tuberculosis were resistant to rifampicin - the most effective first- line drug- and 82% of these people had multidrug-resistant tuberculosis. Drug resistance is driven by the overuse of antimicrobials in people, but also in animals, especially those used for food production, as well as in the environment.

2. Vaccine hesitancy:- the reluctance or refusal to vaccinate despite the availability of vaccines – threatens to reverse progress made in tackling vaccine-preventable diseases. Vaccination is one of the most cost- effective ways of avoiding disease-it currently prevents 2-3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved. Measles, for example, has seen a 30% increase in cases globally. The reasons for this rise are complex, and not all of these cases are due to vaccine hesitancy. However, some countries that were close to eliminating the disease have seen a resurgence.

Measles, for example, has seen a 30% increase in cases globally. The reasons for this rise are complex, and not all of these cases are due to vaccine hesitancy. However, some countries that were close to eliminating the disease have seen a resurgence. The reasons why people choose not to vaccinate are complex; a vaccines advisory_group to WHO identified complacency, inconvenience in accessing vaccines, and lack of confidence are key reasons underlying hesitancy. Health workers, especially those in communities, remain the most trusted advisor and influencer of vaccination decisions, and they must be supported to provide trusted, credible information on vaccines.

3. Noncommunicable diseases:- Noncommunicable diseases, such as diabetes, cancer and heart disease, are collectively responsible for over 70% of all deaths worldwide, or 41 million people. This includes 15 million people dying prematurely, aged between 30 and 69. Over 85% of these premature deaths are in low- and middle-income countries. The rise of these diseases has been driven by five major risk factors: tobacco use, physical inactivity, the harmful use of alcohol, unhealthy diets and air pollution. These risk factors also exacerbate mental health issues, that may originate from an early age: half of all mental illness begins by the age of 14, but most cases go undetected and untreated – suicide is the third leading cause of death among 15-19 year-olds.

4. Air pollution and climate change:- Nine out of ten people breathe polluted air every day. In 2019, air pollution is considered by WHO as the greatest environmental risk to health. Microscopic pollutants in the air can penetrate respiratory and circulatory systems, damaging the lungs, heart and brain, killing 7 million people prematurely every year from diseases such as cancer, stroke, heart and lung disease. Around 90% of these deaths are in low- and middle-income countries, with high volumes of emissions from industry, transport and agriculture, as well as dirty cookstoves and fuels in homes. The primary cause of air pollution (burning fossil fuels) is also a major contributor to climate change, which impacts people's health in different ways. Between 2030 and 2050, climate change is expected to cause 250 000 additional deaths per year, from malnutrition, malaria, diarrhoea and heat stress.