1 Health: A DECISIVE YEAR FOR GLOBAL HEALTH
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a human right Since the World Health Organization was founded, human health has improved significantly – but progress in many areas has slowed or stalled, and this year represents an important opportunity to chart a new path forward and put people’s health first
T
he World Health By Tedros Adhanom Organization was Ghebreyesus, founded 75 years director-general, ago, as countries World Health were rebuilding Organization after the collective trauma of World War Two. It was against that backdrop that the authors of the WHO’s constitution affirmed both that health is a human right and that the health of all people is fundamental to peace and security. Since then, human health has improved significantly. Global life expectancy has increased from 46 to 73 years, with the greatest gains in the poorest countries. Smallpox has been eradicated, polio and Guinea worm disease are on the brink, and the epidemics of HIV, malaria and tuberculosis have been pushed back. In the past 20 years alone, smoking has fallen by a third, maternal mortality has fallen by a third and child mortality has more than halved. However, even before Covid-19 arrived, progress towards many health targets agreed by all in the Sustainable Development Goals had slowed or stalled, and the pandemic set us even further back. On top of the death and suffering it caused, Covid-19 severely disrupted health systems, roiled economies and caused immense social upheaval, while also fraying the fabric of multilateralism. One of the key lessons of Covid-19, therefore, is that a pandemic is so much more than a health crisis: when health is at risk, everything is at risk. If
we fail to learn that lesson, we expose ourselves and future generations to the potentially devastating impacts of future pandemics on lives, livelihoods, societies and economies. That means investments in protecting health are also investments in social, economic and political stability and security. Countries spend vast sums preparing for the threat of a terrorist attack, but relatively little preparing for the attack of a virus, which can be far more damaging, and far more costly. GOVERNMENTS UNDER PRESSURE
At a time when economies are stagnating, debt is rising and budgets are squeezed, governments are under pressure to tighten the purse strings. But now is exactly the right moment to make strategic investments in health – investments in human capital – that will pay dividends for decades to come in more healthy, productive, secure, equitable and sustainable societies. The best investments in health – and the most cost effective – are in primary health care. Many people think of primary health care as delivering essential health services at the local level, and it certainly includes that. But a primary health care approach goes beyond providing health services to include action to address the drivers of disease, and to empower people to take charge of their own health. It recognises that health does not start in hospitals or clinics, but in homes, schools, streets, workplaces and markets – in the air people breathe,
