Global Health: when health and sustainable development go hand in hand

March 29, 2019

Global Health: when health and sustainable development go hand in hand

The concept of health is in continuous evolution. Today it extends far beyond the single individual, towards an idea of global health which is inseparable from sustainable development.


People’s health is not just a matter of medicine. Nor is it enough to add other aspects to a lack of disease – such as a person’s physical, mental and social wellbeing, as suggested in the definition of health laid down in 1948 by the World Health Organisation (WHO) – in order to be able to say that one has comprehensively defined health. In an article  published in 2011 in the British Medical Journal, Machteld Huber and colleagues tried to take a new step forward by proposing a definition in which health is identified as the ability to adapt and look after oneself. A definition which, as the authors explain, is close to a concept already present among scientists dedicated to the study of the environment: the health of the earth defined as the ability of a complex system to remain stable within relatively limited borders.

Today, in a world where sustainable development is an issue of ever increasing importance, we cannot do without a new concept: global health. To put it simply, this is a matter of widening our gaze on the one hand in geographical terms – including the global population as a whole in our analyses and health strategies – and on the other in interdisciplinary terms – with the awareness that the health of the individual is influenced by factors that are economic, social, environmental and political, and that in turn these factors are influenced by the individual's state of health.

First step in global health: knowing what is needed

"If countries don’t know what makes people sicken and die, it becomes much more difficult to know what to do about it," explains Marie Paul Kieny of the WHO. Obviously, once the concept of global health has been introduced and one is aware that health is closely interconnected with numerous factors that are apparently distant and unrelated to one another, we must confront the critical points and the obstacles that block the achievement of health for everyone on the planet. This goal is described very clearly in the United Nations Sustainable Development Goals, of which the third is dedicated to well-being and global health. How can we correctly identify the needs of whole populations, and then design and implement ad hoc strategies to meet these needs? Data from the WHO Global Health Observatory (GHO) can undoubtedly be a good starting point. 

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The GHO portal provides statistical health data derived from over 1,000 indicators in 194 member states, all organized in order to monitor progress in achieving sustainable development goals. From this observatory we can see, for example, that over 45% of WHO member states have less than one doctor for every 1,000 people, or that in 2015, only 68% of the population had access to sanitation technologies. Thanks to the thematic pages on the site, we can obtain information on the priorities of global health, from maternal-infant mortality, to communicable and non-communicable diseases, plus technological innovations, environmental pollution and the health economy. Finally, the WHO also monitors the link between global health and the achievement of the 17 United Nations sustainable development goals through periodic World Health Statistics reports. Its 2018 publication highlights considerable progress made by some nations, but also emphasizes that the road ahead is still long and packed with obstacles.

Ten challenges to global health in the near future

To face the countless challenges that threaten global health every day, in 2019 the WHO has launched the 13° General Work Program, a five-year strategic plan which from 2019 to 2023 aims to achieve three goals for a billion people: compared to today’s situation, to guarantee a further billion people universal health coverage, protection from health emergencies to a further billion people, and the possibility of enjoying greater health and well-being to a further billion. According to WHO experts, in order to achieve these results we must to start immediately to tackle 10 global health challenges, closely connected with the theme of sustainable development. The first two will be climate change and air pollution, the latter considered the greatest environmental risk for global health: it is estimated that 7 million people die prematurely each year specifically because of the polluting particles they breathe, produced largely by industry, transport and agriculture. The release of these polluting particles into the atmosphere is specifically one of the main causes of the climate change that is affecting human health through various causes: according to experts, between 2030 and 2050 climate change will cause 250,000 deaths per year, through malnutrition, malaria, diarrhea and heat-related stress. The focus will then shift to non-communicable diseases such as cancer or diabetes, responsible for over 70% of deaths worldwide, linked to tobacco use, physical inactivity and abuse of alcohol, unhealthy diets and pollution as some of their main causes. Also included in the priority list are pandemics of influenza and outbreaks of diseases such as Ebola, caused by potentially lethal pathogens. Then there is the age-old issues of resistance to antibiotics and Dengue fever, which puts the health of 40% of the world's population at risk. The experts also ascribe great importance to dealing with the decline in vaccination coverage and situations where primary care is still too weak. Finally, another priority must be HIV infection, a condition with which 37 million people now live, and also care for the 22% of the global population that still lives in situations of ongoing crisis due to, for example, wars, droughts and famines.

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