Vaccine hesitancy — the reluctance or downright refusal of people to allow themselves or their children to be vaccinated despite the availability of vaccines — is one of the top 10 greatest threats to global health of 2019, according to a report released this week by the World Health Organization (WHO).
The agency says that vaccines already prevent 2 to 3 million deaths each year, and another 1.5 million lives could be saved if more people were vaccinated.
Unfortunately, vaccine hesitancy “threatens to reverse progress made in tackling vaccine-preventable diseases,” the WHO officials write. “Some countries that were close to eliminating [diseases] have seen a resurgence.”
The global incidence of measles, for example, jumped 30 percent in 2017. Not all of that increase was due to vaccine hesitancy, the report points out, but the disease has re-emerged in troubling numbers in countries where it was once close to being eliminated.
In the United States, for example, where measles was declared eliminated in 2000 after an effective vaccination campaign, there were 349 confirmed cases of the disease in 2018, according to the Centers for Disease Control and Prevention (CDC).
Most of those cases occurred among children who had not been vaccinated.
WHO officials put together its report on major health threats as part of the agency’s new five-year strategic plan. Here are summaries of the other nine threats on the agency’s list:
Air pollution and climate change
Nine out of 10 people around the world breathe polluted air every day, and that pollution leads to about 7 million early deaths each year from diseases such as cancer, stroke, and heart and lung disease, the WHO report notes.
“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,” the report adds. “Between 2030 and 2050, climate change is expected to cause 250 000 additional deaths per year, from malnutrition, malaria, diarrhea and heat stress.”
These diseases, which include diabetes, cancer and heart disease, are responsible for 70 percent of all deaths worldwide, or 41 million people each year. That includes 15 million premature deaths among people aged 30 to 69.
Noncommunicable diseases are driven by five key risk factors: tobacco use, physical inactivity, alcohol misuse, unhealthy diets and air pollution.
As the report notes, “These risk factors also exacerbate mental health issues, that may originate from an early age: half of all mental illness begins by the age of 14, but most cases go undetected and untreated — suicide is the second leading cause of death among 15-19 year-olds.”
“The development of antibiotics, antivirals and antimalarials are some of modern medicine’s greatest successes. Now, time with these drugs is running out,” the report stresses.
A major contributor to this problem is the overuse of antibiotics — in animals as well as in humans. The overuse has led to antimicrobial resistance, making these once-powerful medicines less and less effective against pneumonia, tuberculosis, gonorrhea, salmonellosis and other potentially deadly infections.
The report offers this detail: About 600,000 people who were treated for tuberculosis in 2017 were found to be resistant to rifampicin, the most effective first-line drug for treating the disease. And more than 80 percent of those patients turned out to be resistant to other antibiotics as well.
Fragile and vulnerable settings
Almost a quarter of the world’s population — 1.6 billion people — live in places where there are protracted crises caused by war, drought, famine or population displacement. As a result, they have access to very weak health services — or no health services at all, the report points out.
Weak primary health care
Many countries lack adequate primary health care facilities, which, ideally, should provide “comprehensive, affordable, community-based health care through life,” write the WHO officials.
“Health systems with strong primary health care are needed to achieve universal health coverage,” they stress.
“Enormous” progress has been made in helping people get tested and treated for HIV, says the report, but “the epidemic continues to rage with nearly a million people every year dying of HIV/AIDS.”
Many groups of high-risk people, such as sex workers, people in prison, men having sex with men and transgender people, often struggle to access health services in their communities. That needs to change.
WHO is also working with countries to introduce self-testing so that people can more easily learn their HIV status and receive appropriate treatment.
WHO officials say this mosquito-borne disease, which infects about 390 million people a year, is a growing health threat largely because the rainy seasons of several countries, such as India and Bangladesh, have lengthened significantly in recent years. The disease is also spreading into more temperate countries, such as Nepal, where it wasn’t seen much in the past.
The officials estimate that 40 percent of the world’s people are now at risk of dengue fever.
Ebola and other high-threat pathogens
Two Ebola outbreaks occurred in the Democratic Republic of the Congo in 2018, both of which spread from rural areas to cities of more than 1 million people. One outbreak developed in an area of active conflict.
As the WHO report warns, these examples show that rural outbreaks of Ebola can move from isolated areas to densely populated ones, where they may spread to tourists or others who can then carry the disease elsewhere.
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,” the report stresses.
WHO is working with institutions and organizations around the world to detect potential pandemic strains of the flu and “to ensure effective and equitable access to diagnostics, vaccines and antivirals (treatments), especially in developing countries.”
Of course, those vaccines will work only if people use them.
For more information: You can find the WHO report on the agency’s website.