Global Health in the 21st Century: Identifying the Big Priorities

Blog Post — October 17, 2009

What do sex and chickens have to do with global health?

While at first glance an amusing comparison, Sir Richard Feachem uses the two as an allegory for the threat of infectious disease pandemics in the 21st century.  These new pandemic strains will be transmitted through respiratory droplets or sexually, and be viral or multi-drug resistant bacteria in nature.  And the chickens?  Similar to diseases like H5N1 or the current H1N1 strain, Dr. Feachem predicts that the disease will be zoonotic, or transmitted from animals to humans.

During his speech at CSIS yesterday, Professor Feachem identified the following issues as being of highest priority:

  1. the avoidable life and health expectancy gaps between developed and underdeveloped countries;
  2. the potential danger of the human-to-human transmitability and mortality rates of emerging viral pandemics;
  3. the dual pandemics of hunger and obesity; and the governance of health systems, including the vital role that the private sector can play in improving the healthcare of low- and middle-income countries.  


In “a global zip code lottery of health” he pushed the audience to close equity gaps both between and within countries.  His third theme, “the world’s biggest muddle” asked how we can improve healthcare, the world’s biggest industry comprising 12% of global GDP, and empower planners in low- and middle-income countries to improve health systems. Healthcare is a hot election issue in most countries, and a topic where there is a "striking lack of agreement" and a ground for an "array of strongly held opinions."  Without strong models in developed or developing countries, the current system is in a state of disarray that is too often large, unregulated and anarchic. He strongly advocated for harnessing the power of the private sector, which accounts for large portions of healthcare services in low-income countries, emphasizing the seriousness in "bringing private health care providers into the task of delivering public policy goals."

Sir Feachem concluded his talk by illustrating the 3 cross-cutting dimensions for global health: multisectoriality, integration of specific objectives and broader health care system strengthening, and global joint action to collectively achieve the goals that we want to achieve.

Although Sir Feachem underlines the importance of these 3 objectives, he urged us not to forget and to celebrate the monumental achievements have been made from the focus on specific conditions and diseases, such as AIDS, tuberculosis, and child mortality, adding that this remarkable progress needs to maintain its momentum in order to continue with its line of accomplishments.

Watch the entire speech below, and download the powerpoint presentation (PDF) here:

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