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The World Health Organization (WHO), while addressing the latest Ebola outbreak in Africa, continues to work on the change of structure and form of work. This year begins its new strategic plan until 2022 and, as a first step, the organization has defined ten challenges It will pay particular attention this year to: pollution and climate change, influenza, antimicrobial resistance, primary care, dengue fever, noncommunicable diseases, fragile environments, Ebola, vaccines and HIV.
With the arrival in 2017 of Tedros Ghebreyesus as director, the WHO has embarked on a change of course that continues to take off. After badyzing their internal organization, Ghebreyesus and his team concluded that the organization needed to be more efficient, more profitable and more efficient. The organizational reform, elusive in recent years and now conducted, is based on the evaluation of its decisions in terms of profitability, economy, utility and equity.
For example, WHO developed the first financial plan in its history and admitted that it needed an additional $ 12 billion (14% increase in its budget) and reliably met the objectives of the next five years. These 10 priorities should benefit from the new WHO.
Ten threats to global health in 2019
Pollution
The WHO estimates that between 2030 and 2050, climate change will result in an additional 250,000 deaths a year from diseases and processes such as malnutrition, malaria, diarrhea and heat stress. Air pollution is linked to damage to the lungs, heart and neurologies, and it is estimated that it kills 7 million people prematurely. 90% of these deaths occur in low-income countries. Last year, the first Global Conference on Environmental Health and Pollution was organized. This year, the United Nations Climate Summit is scheduled.
Pandemic flu?
The flu is always a concern. Every year WHO recommends strains for inclusion in the vaccine to protect against seasonal influenza and, in essence, there is still the worry about a new pandemic. If that happens, which is taken for granted even if we do not know when, there is a plan of action with all health, social and political actors involved "to ensure effective and equitable access to diagnostic products, vaccines and antivirals, especially in developing countries". 153 institutions in 114 countries participate in the annual surveillance of the virus and its influence.
Antibiotic Resistance
The development of antibiotics, antivirals and antimalarials is a medical success, but threatened. The growing resistance to microbial diseases augurs greater difficulties to treat diseases such as pneumonia, tuberculosis, gonorrhea and salmonellosis, warns WHO. In addition, if the prevention of these infections failed, other processes such as surgeries and treatments such as chemotherapy would be compromised. WHO is working on a global plan of action integrating human and animal health to tackle a problem that is already killing 1.6 million people each year.
Primary care
The first level of care is still pilloryy. As always, the main problem of their weakness concerns the least developed countries, although other developed countries, such as Spain, consider that primary education is undervalued. Last year, the Astana Declaration was signed, the new Alma-Ata 40 years after the original, whose development is expected to begin to be noticed in 2019. WHO considers that many low- and middle-income countries lack facilities and resources at the first level, which directly affect the rest of the health system and health indicators.
The dengue
This disease, which can be fatal in 20% of severe cases, has been a growing threat for decades. Its influence in countries particularly affected by the rainy season (India, Bangladesh, …) is increasing because these weather cycles are prolonged and cause the spread of the disease to neighboring countries, traditionally little affected. The WHO estimates that 40% of the world's population is at risk of dengue fever and estimates the incidence at 390 million cases per year. The goal is to reduce deaths by 50% by 2020.
Non-communicable diseases
Noncommunicable diseases – diabetes, cancer and heart disease – account for more than 70% of all deaths worldwide. This translates into the premature deaths of 15 million people aged 30 to 69, more than 85 percent of them in low- and middle-income countries. The increase in noncommunicable diseases is due to five risk factors: smoking and alcohol consumption, sedentary lifestyle, unhealthy diet and pollution. WHO will work with governments to implement policies that reduce physical inactivity by 15% by 2030.
Fragile environments
22% of the world's population lives in areas where protracted crises – which combine drought, famine, conflict and displacement – and weak health systems leave basic health care behind. These fragile environments exist in almost all regions of the world and it is in these areas that half of the essential aspects of the Sustainable Development Goals, including maternal and child health, are not being achieved. The WHO wishes to continue to work to strengthen these health systems so that they are better prepared to detect and treat epidemics, as well as to provide quality health services.
Ebola and other pathogens
The Democratic Republic of Congo has suffered two Ebola outbreaks in 2018, including one still active, which occurred in densely populated areas. At the conference on public health emergency prevention, WHO was invited to designate 2019 Year of action for the prevention of health emergencies, especially in densely populated areas. The WHO has identified pathogens – Ebola, other haemorrhagic fevers, respiratory syndrome due to the Middle East coronavirus, SARS and X-disease … – that can cause emergencies and have neither treatment nor treatment. effective vaccines to prioritize their development and research.
Anti-vacuum movements
Anti-vaccine movements threaten progress in public health. Vaccination avoids between 2 and 3 million deaths a year and could prevent 1.5 million more if global coverage improves. The reasons why some sectors decided not to be vaccinated are complex, a group of WHO advisers identified self-sufficiency, lack of access to vaccines and lack of self-confidence . In 2019, WHO will intensify its efforts to eradicate cervical cancer and could be the year in which wild polio transmissions will be eliminated in Afghanistan and Pakistan.
Self test for HIV
22 million people are treated with antiretrovirals. However, despite considerable progress in the fight against HIV, the epidemic has not stopped and almost one million people die each year from HIV or AIDS. Since the beginning of the epidemic, 70 million people have been infected, 35 million have died and 37 million are currently living with the virus.
The WHO will focus in 2019 on supporting the introduction of self-diagnosis of HIV or preventive measures if the result is negative. In addition, in collaboration with the International Labor Organization, they will support companies offering self-badessment in the workplace.
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