Posted by: rstewart1 | 01/04/2011

Not Another Top 10 List

What should be the hot issues in global health in 2011?

Health systems?

Vaccine development?

Maternal and child health?




Chronic diseases?

Other issues?

Share your thoughts in the comments.


  1. Research should be one of the hottest issues in global health for 2011. Last year saw amazing successes in global health science and research that must be carried forward in 2011. For example, dramatic progress was announced in HIV prevention research, including daily pills to prevent infection, the first indications that a vaginal microbicide offers protection against HIV, and recently discovered antibodies that could lead to an HIV vaccine and new treatments. Research also helped develop a new diagnostic for TB that can provide results in less than two hours. A new meningitis vaccine made specifically for Africa was launched in December and costs less than 50 cents per dose.

    These remarkable achievements in global health research would not have been possible without the dedication of many global health partners, and the support of the US Government. All of the breakthroughs listed above received support from US agencies such as USAID, NIH, and FDA. Once research is completed and distribution in the field begins, these new health tools are certain to save millions of lives worldwide. It’s therefore critical that the US and its global health partners continue to support research in 2011 to sustain the successes we saw in 2010.

  2. NCDs in children must be addressed by the global health community.

    1. NCDs affect children – by definition, NCDs impact upon the health of children (directly and indirectly) just as much as they do the health of adults. Cancer, diabetes (and other endocrine conditions), chronic respiratory diseases (such as asthma), congenital heart disease and many of the endemic NCDs all affect children. In fact, most of these conditions start in childhood or are triggered by a mismatch between the child’s body and surrounding environment and living conditions. Children suffer from a wide range of NCDs: Each year an estimated 7.9 million children are born with a serious birth defect or symptomatic genetic abnormality (there are more than 7,000 known conditions), and it is estimated by 2015 there will be 1.2 billion children ages 5-14 living with some kind of significant chronic disease. Chronic health conditions are a major cause of preventable disability and death amongst children in low- and middle-income countries (LMICs).

    2. Children have a right to health and life. Children’s right to health requires special attention. Children are especially vulnerable and powerless, with no voice to advocate for their own needs, and yet they face unique challenges and have special needs. The period of rapid growth and development that occurs in childhood has a profound impact on the future health and quality of life enjoyed in adulthood, thus representing a “golden window” of opportunity in terms of promoting the rights to health for all. Whilst various international and national laws recognise the importance of the rights of the child to adequate health care and medical assistance, discourse often focuses on adults. The rights of the child however provide an element of accountability to State parties and organisations that must work towards addressing health issues specifically related to children.

    3. Lifecycle approach to NCD prevention and risk factors is vital – there is now strong evidence for the importance of good maternal health, healthy birth weights and breast-feeding to reduce the future risk of children developing “lifestyle” NCDs as adults. Furthermore, children’s bodies are especially vulnerable to the same risk factors responsible for many NCDs in adulthood (obesity, low physical activity, poor diet and tobacco exposure), and reducing exposure to these risk factors earlier in life will have a substantial impact on the future health of populations. A focus on children promotes generational and population-based change, and empowers an early-onset, lifecycle approach to prevention. Children can often claim a stronger ethical imperative in having these NCDs treated, as a case can rarely if ever be made that voluntary lifestyle choices contributed to their burden of illness (as is the case, for example, with adults who acquire NCDs through alcohol or tobacco consumption). Many NCDs in children are actually caused by adults (for example through passive smoking, alcohol consumption or inhalation or ingestion of toxic chemicals during pregnancy), again justifying a particularly strong case for developing strong NCD policies for children as a vulnerable group.

    4. Paediatric health system strengthening is essential – even more so than for adults, many NCDs that affect children are poorly managed within the health systems of LMICs. The needs of children with chronic health conditions are complex: they extend beyond the traditional “acute” health context, involving families, schools and the broader community. Increased capacity is required at local and national levels to develop comprehensive chronic care platforms that address the entire lifecycle of humans rather than simplistic silo-approaches to change that fail to address the needs of children.

    Recommendations: A Lifecycle Framework on NCD Outcomes for Children
    The 2011 UN NCD Summit offers a unique opportunity to promote holistic, systematic and sustainable approaches to health-system strengthening by focusing on the entire human lifecycle, and we have a special obligation to integrate children into all policy discussions and decisions.

    Effective integration of children within NCD policy development across the human lifecycle will result in large-scale primary, secondary and tertiary prevention of NCDs. Multisectoral efforts (beginning with UN recommendations and other governance statements) must therefore focus on:

    I. Pre-conception factors – supporting gender equity and a rights-based approach to women’s: health and wellbeing; nutrition; education and financial security as a means to reducing NCD risk factors and promoting health for all

    II. Maternal and newborn health – quality pregnancy and peri-natal care, healthy birth-weights, breastfeeding, newborn screening and immunisation

    III. Child health – rights-based, “whole of society” efforts to address the social determinants of health, improve access to primary health care, optimise health and development in early childhood and reduce NCD risk factors

    IV. Caring for children currently affected by NCDs and other chronic health conditions – respecting and fulfilling the rights of chronically ill children and promoting community development based action aimed at:
    1) Affordable access to essential medicine and equipment
    2) Education (of all stakeholders), research and advocacy
    3) Optimisation of medical management (with a holistic approach to health and a focus on primary, secondary and tertiary prevention) and inclusion of chronic health conditions within IMCI , the WHO Pocket book and other relevant documents and policies to increase the capacity of paediatric health systems in LMICs
    4) Encouragement of grassroots, community-development approaches to supporting families and children living with NCDs and
    5) Reducing financial burdens on families that lead to poverty, and promoting financial independence for those living with NCDs

    V. Recognising the impact of NCDs on parents of young children – so that children are not forced to become carers themselves or bear the financial burden for the family.

  3. Cancer, I think, will be the hot issue in global health 2011. I am very convinced.

  4. Two brief points:

    1. Sorry, but the title reveals the amount of effort you put into writing this lame post.

    2. I think it’s time for another term for “advocacy” that is actually when someone just bangs the same old drum in support of their specific issue at every possibly opportunity, rather than engaging in the current dialogue. It’s like advocacy with Tourette syndrome: Whatever the topic of discussion, someone blurts out (cuts and pastes) another six-para monologue about their priority that does nothing to engage with, or add to, the subject at hand. Vanity campaigns? It’s so pointless and insensitive.

  5. Yes, I agree with that cancer will be the hot issue in 2011. It was related to global warming and changing people behavior in their lifestyle.

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