The Public Health Opportunity
Public health offers the greatest return on investment to improve both health and environmental outcomes. It is the common platform that will enable us to tackle the existential challenge of our time: how we can live sustainably on our planet as we add another 2 billion people to the world’s population by 2050. This is an urgent challenge given that we already utilize more resources on a yearly basis than our planet’s ecosystems can provide. This global population increase will primarily occur in urban settings in developing countries that already have a fractured or fragile infrastructure. This is a precarious mix that lends itself to instability, poor health and worsening environmental outcomes.
Furthermore, 70% of the world’s deaths are due to non-communicable diseases (NCDs – cardiovascular diseases, cancer, lung diseases, diabetes, mental health and injury). They are the dominant cause of disability, with mental health topping the list as the world’s leading cause of morbidity. Also, environmental degradation is a powerful, but neglected contributor to these illnesses. Their impact is not felt equally as they affect the poor the most.
The Lancet just released two Commission Reports: “Pollution and Health” and “Climate Change and Health.” They stated that more than 9 million people die prematurely each year due to pollution, killing more than HIV, malaria and tuberculosis combined. They also illustrated the powerful, negative effect climate change is having on populations around the world. Both clearly demonstrated the much greater effect these threats have on the poor. It is hoped that the reports will compel policymakers and communities to scale up what we already know will reduce pollution and the production of greenhouse gases. Despite this awareness, investments in global health and development do not reflect this crisis. Acute care dominates health sector expenditures and the environment drops to the bottom of most governments’ spending priorities.
While the acute care system is vital to treating illnesses, it is prevention and detection that offer the best return on investment. Public health is the platform to do this. It is also, as we saw during the Ebola crisis in West Africa, a mechanism to prevent, detect and respond to outbreaks of deadly infectious diseases. Other global health threats, environmental degradation and NCDs are also mitigated through this pathway.
To realize the power of public health, it is critically important that all of us speak with one voice, educate the public, and advocate strongly for increased investments in public health. Academia, NGOs, the private sector and governments can create meaningful collaborations to widely scale up known, proven, low-cost public health interventions at a local and regional level.
At the Consortium of Universities for Global Health (www.cugh.org) we work closely with the Centers for Disease Control and Prevention, National Institutes of Health, Association of Schools and Programs for Public Health, other global health organizations, our 167 institutional members and network of 30,000 individuals around the world to share good practices, build capacity, and advocate for public health investments to implement effective public health and environmental initiatives. Our next annual conference, March 15-18, 2018 in New York City (www.cugh2018.org), will bring together experts from around the world to share how we can build healthy cities, reduce NCDs, tackle climate change and more.
Modest efforts by many can change people’s behavior and government priorities. Public health programs can have a powerful, cost-effective impact on the health of any community. It is up to us to encourage the uptake and investment in effective public health practices that will enable us to live in a healthy, sustainable planet. Time is not on our side.
Keith Martin MD, PC, is executive director of the Consortium of Universities for Global Health.
This blog post is part of a series focusing on different aspects of public health in recognition of Public Health Thank You Day, held each year on the Monday before Thanksgiving. Visit www.publichealththankyouday.org for more information, and join us on social media using the hashtag #PHTYD