HEALTH CHALLENGES OF 21ST CENTURY

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HEALTH CHALLENGES OF 21ST
CENTURY

OUTLINE

1)
Introduction

  1. Health-related challenges humanity faced
    in the past
  2. A look into the future of pandemics and
    other health challenges

2)
How did Infectious Diseases Morph into
Formidable Health Challenges?

  1. Epidemic
  2. Endemic
  3. Pandemic

3)
How the Mighty Have Fallen: Failure to
Tackle COVID-19

  1. WHO
    warnings regarding future diseases falling on deaf ears
  2. Ted TalkMarch 2015 by Bill Gates: We are not
    ready
  3. Health
    system overloaded
  4. Ineffective
    lockdowns in Italy, the USA, etc.
  5. The probable
    outcome of this pandemic and the lessons learned

4)
Health Challenges likely to be faced in the
21st Century

  1. Change is
    the only constant: Mutant strains of drug-resistant pathogens
  2. The pursuit
    of economic prosperity at the expense of the healthcare system
  3. Ultra-optimistic
    military ventures ignoring basic health concerns: resurfacing of old diseases
  4. Lack of
    sensitivity to basic public health issues
  5. Anti-vaxxers
  6. Conspiracy theorists

iii.   Wrong motivated religious leaders

  1. The absent political will to support
    public health issues
  2. Military might versus healthcare system: the
    US model
  3. Novel
    Pathogens:
  4. Water-borne diseases
  5. Air-borne diseases

iii.   Radiation based illnesses

  1. Pollution related ailments
  2. Mental health
    disorders: the elephant in the room

5)
Humanity’s Probable Response to Future
Health Challenges

  1. Role of the
    UN in forging health-oriented SDGs with the global consensus
  2. The WHO –
    the bedrock of humanity’s health-related response
  3. Research
    and Development: employing future tech for the benefit of human health
  4. Improved
    Attitude towards Future Pandemics: A Must for Humanity’s Survival
  5. Social
    changes
  6. Economic
    changes

iii.
Political
changes

  1. Polio –
    the litmus test for future health-related preparedness

6)
We Can and We Will

  1. Life of a
    person born in the 1900s vs the life of Generation Z
  2. Better
    Technology – better chances to counter challenges
  3. No global
    wars: more focus on healthcare
  4. Stitching
    together the economic and the social spheres of life
  5. Universal
    focus on service provisions

7)
Conclusions:

 

 

Health Challenges of the 21st
Century

“I did in Drury-lane see two or three houses marked with a red cross upon the doors, and “Lord have mercy upon us” writ there,” writes Samuel Pepys, a British bureaucrat on the 7th June 1665 in his diary. This happened fully 355 years back in London. And I recalled these words just some days back when on the same June day, my Londoner friend sent me pictures of the crossed houses. It immediately made me recall the Great London Plague, equating it with now COVID-19. This shows how chronicles of public health have witnessed interestingly the same crises time and again throughout history. Prehistoric man – although faced fundamental problems of food, shelter, and security, yet was lucky as far as health challenges were concerned. It was because of his nomadic tribal lifestyle with constant mobility for greener pastures and resourceful places. Therefore the risk of catching an epidemic was minimal, for waste accumulation, person to person contact and food diversity provided the people a long hiatus from contagious diseases. The agricultural revolution,
however, brought these far off challenges to the proximity of human beings, mainly, because it provided opportunities for big settlements, causing sanitation and food scarcity issues. Since then, diseases have made men fearful of them, despite great leaps in medical sciences. For example, the Antonine Plague of 165 AD was the first public health challenge recorded in the history caused, probably, by smallpox or measles. This disease spread to Greece, Turkey, Egypt, and Italy, causing more than 5 million deaths. Since then, every other century has witnessed such an epidemic taking on one or the other country and sometimes an entire continent. Bubonic plague, cholera, flu, typhoid, tuberculosis, measles, and HIV/AIDS are some of the other health challenges humanity has faced in the past. Although some challenges occurred during the pre-modern age, interestingly a major outbreak at the beginning of the 20th century made man oblivious to this ever-latent risks, forcing him to turn his focus on economic
prosperity and military prowess instead of physical/mental wellbeing.

Despite entering the marvelous era of tech advances in nanotechnology and space travel, human beings are still grappling with resources to face the magnitude of the current pandemics – COVID-19 pandemic. This leads to a thought that the future may hold more such challenges, while our preparedness for countering them is subpar at most. A wild streak of imagination about future challenges demonstrates that they may be in the shapes of drug-resistant pathogens, failed immunizations, overstraining of the healthcare system, radiation-related ailments, pollutants, and new pathogens that cross the species barrier in the future. On the other hand, our hopes are tied to
advancements in research and development (R&D), the role of the United Nations (UN) in forging a consensus over health-oriented SDGs, and positively sustainable social, economic, and political changes in the global society. It
has become a supposed belief that with enormous strides in technology, sustainable world peace, and socioeconomic balance (free healthcare for all), we can deal with future challenges in a more productive way. Let us look into
the details of the health challenges humanity may confront in the future, including the ways to cope with them in a better way.

To properly understand and confront the health-related threats in the future, we need to understand how a disease breaks out. A health-related problem, much like COVID-19, starts at the basic level of transmission from one organism to another. The causative organism, a virus, in this case, moves from one organism to another. If this causative organism moves across the species, it is said to have crossed the species barrier. After having infected the first human being, the disease progresses from that human, also known as the patient zero. This is how the disease spreads directly from person to person or through some other media. Having been widely spread in a community at a certain time, the disease turns into an epidemic. The next probable course of the disease is to sustain the host in that specific area, making it endemic to that area or population. Polio, for instance, has bee  endemic in Pakistan and Afghanistan for long. Depending on the virulence of the virus, epidemiology of the disease, and population trends, the disease can, then, spread globally, encompassing all demographics, making it a pandemic. COVID-19, for instance, after crossing the species barrier in Wuhan, China,  became an epidemic in the city, also called the first epicenter of the disease, and it spread outside of the country to multiple epicenters in other areas of the world such as Italy, South Korea, and Japan. This accounts for the journey of a virus from  animals to becoming a novel and globally widespread health challenge for humanity – becoming a modern threat.

Regarding this threat, multiple red flags raised by the health-related organizations have gone unnoticed. Back in January 2020, the Director General of the WHO, Dr. Ghebreyesus, declared a medical emergency but that statement faced a subpar response across the globe. This is not the first time that health concerns raised by an organization have yielded less than optimal response. Bill Gates, the tech giant and the major funding contributor of the WHO, while addressing a Ted Talk in 2015, explicitly stated that we are unprepared for the next pandemic. When saying this, he went into the details of an ordinary pathogen that could prove deadly for the world’s economy, society, and life in general. This statement was also taken at a face value nothing more than speculation at that moment as no politically motivated plan was put in place to prepare humanity for an impending disaster.

Once unleashed, however, this clue of Bill Gates about that pathogen has turned into a real threat in that the health systems of the world are now facing the responsibility of providing healthcare to a skyrocketing population with a plethora of health-related issues. According to the latest data provided by the UN, 4.12 newborns are welcomed in the world every second. With this population explosion, even a health system light years ahead in technology may find it hard to cater to the needs of our global population. All communicable and vaccine preventable diseases, cancers, infectious diseases, and other illnesses, including mental and health issues, put a nerve-breaking strain on the healthcare systems. Effectively monitoring, responding to, and treating this load of patients put the entire system under immense pressure. Resultantly, infrastructure, capacity building, personnel training (Human Resource), funding, and R&D; all aspects crumble one after another. This sequential crumbling makes the perfect recipe for disaster when an epidemic occurs, regardless of the magnitude. The present case is no exception. The healthcare systems around the world witnessed a virtual collapse within weeks, if not days, of the pandemic hitting a country, let alone work properly.

In fact, healthcare systems could only function properly, if they were managed properly. The halfhearted response to the serious threat of COVID-19 by many governments across the globe is another reason why we have failed to effectively tackle the pandemic. Even the most developed countries such as  Italy, Spain, and the United States have demonstrated a shoddy response to the said pandemic. Not only was the response much delayed, but it was also ineffective in its manifestations; whether it was lockdown or the public willingness to take the situation seriously. It resulted in cascading effects in the disease spreading across the countries. Some put forward the argument that developing herd immunity was an effective way while having precautionary measures to check the unhinged spread of disease remains pivotal. The proverbial dictum that a stitch in time saves nine seems the most correct response at the right time from the governments that could have prevented the upward movement of graphs, showing new cases. Contrarily, effective lockdowns from the start and public awareness regarding the sensitivity of the situation could have helped “flatten the curve,” knowing the pandemics follow the usual path of dying down and reemerging.

The current pandemic, like all its predecessors, has, too, been following the same trajectory. For example, the flu pandemic of 1918 also started in March that year and took over a year to settle down. The impacts and outcomes of COVID-19 might be similar to that. The IMF has projected that the global economy shows a current downward
trend of about -3% and an estimated -6% of growth loss is expected following the widespread of the pandemic. These figures rival, and possibly surpass, the economic slowdown of the Great Depression of 1929-1933, which showed -5% growth. This is besides the social and emotional losses brought on by the pandemic. The constant fear of impending doom and an unseen enemy to fight against, the world is in far worse shape in morale. Social distancing practiced currently is necessary to counter the pandemic, but the terror it strikes in the heart of a common man closely resembles a post-apocalyptic Hollywood movie. Apart from that, the soaring joblessness and glaring loss of progress in multiple fields may take a long time to recover after the initial blow of the disease is over.

Having learned about the current pandemic and reasons for its spread across the world, it gets easy to explore the possible health challenges human beings may confront in the future.

First, the obvious health-related challenges arise from the unlimited and careless use of antibiotics for every other disease. This sweeping use of medication may be helpful for the disease in the short term, but it causes the pathogen to react to the drug a little differently with every subsequent exposure. Tuberculosis, for instance, spreads
from mycobacterium tuberculosis. Quite recently, Multi Drug Resistant Tuberculosis or MDR TB is now common because of drug resistance these microbes have produced. If a pathogen evolves to become resistant to a medication being used, it might render that conventional medication entirely ineffective. This potential challenge can become formidable in the future where antibiotics are overused. Mutant strains of the same pathogens from the past could evolve and wreak havoc on human physiology, presenting a more potent threat to humanity in the near future. It could be a simple virus previously treated with anti-allergic medication or home remedies. Changes in the structure of the virus may cause it to be impervious to the attacks of medicine.  These could be any if human acts, too, are taken into account.

A glaring fact is humanity’s misdoings which could result in bringing challenges to public health in the future. Ever since the Industrial Revolution, mankind has been tirelessly striving for better economic conditions. This relentless pursuit of economic prosperity came but at the cost of the decreased focus on healthcare system management. What should have been the prime concern of an economically strong community became a distant afterthought as our global civilization went down the rabbit hole of capitalism. Looking into the future, this global obsession with capitalism – including the short to medium term gains it offers – may prove more detrimental than beneficial to our social fabric. The main concern is the compromise we are willing to make in terms of service provision like universal healthcare. Although many developed nations have achieved universal healthcare such as the USA,
which is a prime example of having a billion dollar industry that favors capitalist ideal but not support public health. If this trend continues at this relentless speed, healthcare may become costly to a point where it is a bargain and not an undeniable right. The time when people have to weigh their options for necessary healthcare benefits against other material things is not far – a courtesy of the race for more money, while warmongering has been another
stupidity.

This stupidity of the past would haunt future generations. It is because diseases run rampant in societies that face conflict – a fact which has resurfaced recently in various continents. When peace in a community is compromised, the first casualty is the healthcare system. Public health finds its groove in a peaceful society where disease transmission can be kept to a minimum level through strict and thorough surveillance, resource mobilization, and general will of the people – a fact cultivated by strong governments. In the times of war, public health – already bleeding from overpopulation and lack of concern – falls victim to it, and diseases at the brink of extinction find their way back into circulation. A pertinent example of this is Yemen where a continuous conflict has made even the trivial matters of malnutrition a problem to be reckoned with. As long as the conflict persists in Yemen, public health cannot hope for an iota of growth, leaving a gap filled only by diseases of the past to emerge in the future. The community will remain vulnerable to diseases so long as there is a war. Military misadventures of any kind, hence, pose a serious threat to the healthcare system of the future provided the people are oblivious to it on account of engagement in countering the military threats.

It means that the general mindset of the public in the future will play a vital role in the health scenario of the future. If the public is sensitive toward public health issues will decide its health. The anti-vaxxers, conspiracy theorists, wrongly motivated religious leaders and demagogues do the rest of the job. For example, anti-vaxxers, who believe that vaccinating a child is against the sanctity of the human body, develop a faith against vaccines, despite knowing that this notion is utterly baseless and downright moronic from the scientific point of view and has proved so over centuries. Conspiracy theorists, on the other hand, spread rumors that vaccination is a ploy of the government to keep tabs on the people, or that it is somehow related to population control. These notions, too, are equally idiotic – if not outright false. In fact, these misguided minds, when coupled with firebrand speeches of zealot clerics, deal decisive blows to public mentality about health. With the rise of populism in the near past as well as the present, it is not baseless to assume that masses in the future may fall victim to ideas averse to the common sense and result in the lack of public interest in healthcare. According to a recent estimate by the WHO, the Polio Eradication Initiative (PEI) has fallen back at least a decade due to the current pandemic. So fragile is our system of public health that it certainly cannot bear the weight of such conspiracies and non-serious political demagoguery – a fact that might cost the society its mental balance.

Despite seemingly a trivial issue, mental health may become another healthcare challenge in the coming century. Depressive illness, mood disorders, psychotic ailments, and other psychological disorders; they all account for an array of social and personal problems of every individual. Moving into the 21st century, it stands to reason that mental health problems are going to prove significant than before. The IT revolution, the social media boom, and the way we process information have to have some burden on the individual as well as the collective psyche of a segment of the society. Although the technology used by NASA to land on the moon can now fit easily into the palm of our hand, yet humanity has not had a time to cope with psychological issues engendered by the skyrocketing growth of technology and penetration of digital devices. According to the recent estimates by the WHO, the ratio of the suicide attempts due to pressing social issues after every 40 seconds is one. This deteriorating situation of mental
health is not likely to improve, given the attention our society is paying to mental health issues. In the future, mental health issues may become more complex as we evolve socially at a pace never experienced in the history of
mankind. Hence, mental health issues will probably be more of a challenge to the general health of the public in the 21st century.

Having appraised the health challenges humanity in the 21st century may confront, it would be reasonable to shed some light on what may be the probable responses to future pandemics or similar health challenges in terms of global institutional response, improved research, conventional pursuance as well as generational
response as given below.

To start with the role of the UN and the WHO in dealing with future challenges, it seems that there is a need for a broad international consensus regarding the importance of healthcare. The goals set for this century in the form of Sustainable Development Goals (SDGs) must be reoriented around better preparedness for health-related calamities. In this connection, as the economy is vital, the fragile balance of healthcare and the economy needs to be a constant theme in tailoring the SDGs for the 21st century and beyond that. No poverty, zero hunger, quality education, clean water, renewable energy, and safe environment; all need to revolve around healthcare. An overarching theme of all SDGs must be public health, and there must be a holistic consensus over the UN resolutions on this subject. If the role of international law is enhanced for effective legislation against potential threats to humanity’s health, the UN becomes more relevant and could pass a resolution where military escalation passing a certain cap would trigger a WHO response in the area as well as sanctions on the belligerent actors involved. Hence, platforms like World Health Summit must be strengthened and given teeth so that they could reprimand those endangering public health. As such, the UN will have to play a proactive role regarding health problems facing humanity in the future but for this to happen, there must be a strong R&D.

The fact is that an improved R&D in health has always been the driving force in the evolution of all the fields of education known to man. Although it is commendable how far R&D has improved our lives and how rapidly it is working for the same in the future, health-related R&D still not only lacks the same attention but also vigor and funding. It invites praise from developing vaccines to finding cures, from disease prevention to epidemic control, yet it has lost the pace with the time. Although researchers in all walks of life are passionate people in pursuit of knowledge, the motivation is somewhat non-existent in pecuniary gains. According to an article in the Guardian, it comes to light that pop stars and professional athletes reap bounties when compared to doctors and researchers, demonstrating a disturbing reality that our society is less concerned about health and more about entertainment. By that estimate, developing vaccines should be – and is – harder than playing football but it never pays close to that. Therefore, the R&D budget needs to be ramped up to attract public attention to finding solutions to our healthcare challenges. Only through empowering this sector, the global community could be better prepared to face such future challenges, though, one way could be pursuing conventional medical strategies.

Such a strategy adopted in the past in the case of poliomyelitis has proved effective, and this test case for humanity’s preparedness for future health challenges could prepare the world for a future challenge. For example, as polio, caused by a virus transmitted through feces of the infected individual, attacks neurons of the skeletal muscles of the body, it has plagued human society since long and despite systematic efforts by the WHO, the world has so far failed to eliminate it. The year 1988, when the global polio eradication initiative was launched, witnessed 138000 paralysis cases. Despite a drastic cut of 99% in these numbers, the total eradication of polio has still eluded us, though, there are successes against it. After having succeeded in eradicating polio through sustained and calibrated campaigns in areas like Pakistan, Afghanistan, and Nigeria to some extent, the WHO could move against other such emerging threats. It is through chaining this bugbear of century-old disease that would give us a clue to tackle future challenges through examples set with collaboration and motivation of the public.

In fact, the public of the time is a driving force behind this success. Comparing the life of a person born in 1900
with Generation Z (people born in the 21st century), our chances of effectively tackling future challenges appear bright. For example, a person born in 1900 had scores of problems to deal with; both health-related and
otherwise. At that time, diseases like cholera, measles, diphtheria, tetanus, pertussis, tuberculosis, and malaria were common and deadly, too. That person had to grapple with socioeconomic problems as well as facing diseases. Turning
18 years of age, he would have been conscripted in WWI, where a very deadly Spanish flu pandemic could have been his fate. Coming back from the Great War, he would have sought to start a family that would have been more difficult,
keeping in mind the high maternal mortality as well as poor sanitary conditions waiting for the newborns. With immense luck, he would have gotten to see his 30s only to be ambushed by the Great Depression. By his mid-forties, that man of the 20th century would have endured two world wars, countless incurable diseases, and a severe global recession besides other lesser unknown issues. Contrary to that, the worst problem experienced by Generation Z was a mild recession of 2008 and the current pandemic. This comparison looks quite flimsy in the face of the possibilities available to Generation Z that put it in an even better position to handle coming challenges if motivated and put into
action through sustained and calibrated campaigns.

Putting it briefly, multiple health-related challenges in the 21st century are lurking behind the curtains. For instance, antibiotic resistance, mutant pathogens, global political shift, wilful neglect of healthcare in pursuit of
economic stability, lack of sensitivity toward health issues, and new airborne or waterborne pathogens are some of those challenges humankind could face. Besides these, radiation and pollution-related issues as well as mental health
issues of the 21st century also pose a considerable threat to public health. Interestingly, the timing and occurrence of any of these threats in itself is an enigma. Yet these challenges, though formidable, are not impossible to resolve. The reason is that there are sane voices to guide the public. For example, the leading political analyst, Francis Fukuyama, believes that more trust in government than the type of government would be the key determinant in our effective response to this challenge of COVID-19. Hence, any future challenge could be framed in this context of this argument. Then, the UN would have to play a more proactive role in forging a lasting consensus among nations for strong healthcare and smooth supply chain systems. This global consciousness would change the way we think about and react to a situation of health challenges. It would also lead to better R&D to improve our response to the next crisis as well as our preparedness to avert a disaster heading our way. Besides, social, political, and economic systems, too, would be enabled to robustly respond to such a crisis. If these conscious efforts are launched in concert with the global bodies and the public, humankind will be surely confident to meet the challenges head-on through robust technological and economic resources at hand.

 

 

 

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