The World Health Organization (WHO) has listed, human immunodeficiency virus (HIV) – in terms of getting people tested and providing access to preventive measures- as one of its top 10 health threats facing the world in 2019.
Each year the WHO, publishes a list of the ten biggest threats to world health to set its agenda for the next 12 months. This is the first year that HIV has made the list.
However, the epidemic continues to rage with nearly a million people every year dying of HIV/AIDS. Since the beginning of the epidemic, more than 70 million people have acquired the infection, and about 35 million people have died. Today, around 37 million worldwide live with HIV.
Human immunodeficiency virus has taken hold in a many Africa countries and around the world in recent times and particularly in the Nigeria as well. Data from the WHO shows that Nigeria has the second largest burden in the world after South Africa with an estimate of 3.2 million people, with only 1 million on Antiretroviral Therapy (ART).
According to the Joint United Nations Programme on HIV/AIDS (UNAIDS); data shows that in 2016, Nigeria had the highest share (26.9%) of new mother-to-child HIV infections out of 23 priority countries. It estimated that 37,000 children younger than 15 were newly infected with the virus.
“Currently only 38 percent of people living with HIV/AIDS in Nigeria know their status, this shows that there is still a 52 percent gap. In 2017, available data indicate that a total of just over 9 million persons were counselled and tested with 239, 542 testing positive; 136, 987 female and 102, 555 male,” said Araoye Segilola, coordinator of the National AIDS/Sexually Transmitted Infections Control Programme of the Federal Ministry of Health.
According to the WHO, Reaching people like sex workers, people in prison, men who have sex with men, or transgender people is hugely challenging. Often these groups are excluded from health services. A group increasingly affected by HIV are young girls and women (aged 15–24), who are particularly at high risk and account for 1 in 4 HIV infections in sub-Saharan Africa despite being only 10 percent of the population.
This year, WHO will work with countries to support the introduction of self-testing so that more people living with HIV know their status and can receive treatment (or preventive measures in the case of a negative test result).
However, in Nigeria also there are significant problems ranging from the weak primary health care and prevalence of deadly non-communicable diseases to the damaging effects of environmental pollution which also made the list.
Below are 10 lists for threats to global health that will be tackling in 2019 as World Health Organization’s new 5-year strategic plan – the 13th General Programme of Work to address these challenges from a variety of angles.
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 cook stoves 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.
WHO reports that 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.
Among many things, this year WHO will work with governments to help them meet the global target of reducing physical inactivity by 15% by 2030 – through such actions as implementing the ACTIVE policy toolkit to help get more people being active every day.
Global influenza pandemic
The world will face another influenza pandemic – the only thing we don’t know is when it will hit and how severe it will be. Global defences are only as effective as the weakest link in any country’s health emergency preparedness and response system.
WHO is constantly monitoring the circulation of influenza viruses to detect potential pandemic strains: 153 institutions in 114 countries are involved inglobal surveillance and response. In the event that a new flu strain develops pandemic potential, WHO has set up a unique partnership with all the major players to ensure effective and equitable access to diagnostics, vaccines and antivirals (treatments), especially in developing countries.
Fragile and vulnerable settings
Over 1.6 billion people (22% of the global population) have been estimated to live in countries with weak health services. This leaves these people without access to basic care.
Fragile settings exist in almost all regions of the world, and these are where half of the key targets in the sustainable development goals, including on child and maternal health, remains unmet. This year, WHO will increase its efforts to strengthen the health systems in these places.
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.
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. WHO is working with these sectors to implement a global action plan to tackle antimicrobial resistance by increasing awareness and knowledge, reducing infection, and encouraging prudent use of antimicrobials.
Ebola and other high-threat pathogens
In 2018, the Democratic Republic of the Congo saw two separate Ebola outbreaks, both of which spread to cities of more than 1 million people. One of the affected provinces is also in an active conflict zone.
This shows that the context in which an epidemic of a high-threat pathogen like Ebola erupts is critical – what happened in rural outbreaks in the past doesn’t always apply to densely populated urban areas or conflict-affected areas.
Weak primary health care
Primary health care is usually the first point of contact people have with their health care system, and ideally should provide comprehensive, affordable, community-based care throughout life.
Health systems with strong primary health care are needed to achieve universal health coverage. Yet many countries do not have adequate primary health care facilities. This neglect may be a lack of resources in low- or middle-income countries, but possibly also a focus in the past few decades on single disease programmes. In 2019, WHO will work with partners to revitalize and strengthen primary health care in countries.
The remaining three threats to global health are:
Human immunodeficiency virus (HIV)