Gender and Development

Health For All And By All

Through a conscious effort by the World Health Organization and the international community overall, many strides have been made in global health. With World Health Day approaching, Ana Zhelyazkova reflects on the achievements and the path forward in the realm of global health.

BY: ANA ZHELYAZKOVA

The annual World Health Day, April 7th, has a certain nicety this year as the World Health Organization (WHO) will be observing 70 years since its establishment. With the WHO being the official United Nations agency to direct and coordinate international health, the tasks and responsibilities of the Organization have been expanding in quantity and relevance year by year. However, one specific trend can be observed in the work of the WHO since 1948 – the priorities have been gradually shifting from mitigating the spread of naturally occurring health hazards to controlling the damage done by human (in)action.

From Awareness to Persuasion

Since the very beginning of international health cooperation, vaccination coverage has been a top priority. While success stories such as the eradication of Smallpox have been an effective tool in promoting vaccines in the 20th century, the life-saving benefits of immunization have been under a series of attacks in past years by anti-vaccination movements in industrialized countries. Despite the relatively high availability and low costs of vaccines in a majority of European countries, the continent continues to observe an unexpectedly high incidence of preventable infectious diseases. The recurring measles epidemic puts a distressing highlight on the problem. As children below the age of 1 are too young to receive the first vaccine and most of those below the age of 5 have not yet received the second recommended dose, they rely on the vaccination coverage of the whole population (so called “herd immunity”) to prevent the disease from spreading. In cases of compromised herd immunity, infants and children are faced with the highest risk of getting infected, experiencing severe complications and even death. Accordingly, the lower immunization coverage in Europe has led to a threefold increase of reported Measles cases in 2017 compared to 2016 and 2015 (amounting to 14.732 cases and 57 deaths for last year only) with infants below the age of 1 being the most affected, followed only by children under 15 years who have not received one or both of the recommended vaccinations – a clear indication of the magnitude of the problem.

Having recognized the damaging potential of the anti-vaccination rhetoric, the WHO promptly developed the necessary counter measures: the Global Vaccine Action Plan (GVAP) adopted in 2012 marked the beginning of a communication campaign for the promotion of immunization. With the argument of risk versus benefit still being the main determinant for vaccine hesitancy, the Organization retaliates against anti-vaccination movements with a mix of direct and indirect messaging focused on the benefits of vaccination and the accuracy of scientific data. From implementing more delicately messaging tactics, such as highlighting the benefits, successes and relevance of vaccines in its resources on the topic, to setting the theme of the upcoming World Immunization Week to “#VaccinesWork”, the Organization is determined to truly prevent preventable infectious diseases from spreading.

The New Communicable Diseases

While the impact of infectious diseases is gradually decreasing, another group of diseases have been continuing to strengthen their effect on individuals and on health systems worldwide. The steady increase in the incidence of noncommunicable diseases (NCDs) has claimed the leading spot for chronic conditions among the top ten causes of mortality in the world and has set a new priority for the international community. In the case of overweight and obesity alone, the rapid upsurge of the number of affected children and adults has led to a tripling of the percentage of people with excessive weight since 1975, now causing more deaths globally than underweight. With NCDs currently accounting for 70% of deaths worldwide (88% in high-income countries), the annual global economic impact driven by human behavior amounts to over $5 trillion.

Although chronic conditions can be visibly tracked back to individual behavioral patterns, thus, making them communicable via behavior, the root cause of and solution to the NCD epidemic bears resemblance to the actions taken to streamline the prevention of infectious diseases – providing access first, then preventing high-risk behavior. “Individual responsibility can only have its full effect where people have access to a healthy lifestyle”, states the WHO as the Organization has actively begun working with countries to implement population-wide health promoting policies – from trade and regulatory measures limiting access to high-risk products (e.g. tobacco, sweetened drinks), to challenging the marketing approaches of the private sector. Some Member States have already committed to the voluntary #beatNCDs campaign of the WHO, which will be reviewed during this year’s United Nations General Assembly.

The World Around Us

The developments in the incidence and, subsequently, preventive efforts on communicable and noncommunicable diseases are evolving in concurrence. Furthermore, while the environment had been previously observed as the setting in the context of which diseases break out and spread, it has gradually become one of the main health risk factors itself. With 92% of the world’s population living in places exceeding the WHO guideline limits, air pollution is now linked to three times as many premature deaths as AIDS, Tuberculosis and Malaria combined and a loss of labor income amounting to $225 billion per year.

In addition to the health hazards deriving from environmental contamination and climate change, indirect implications of extreme weather are amplifying the long-term consequences for population health, domestic economies and even security worldwide. Between 2008 and 2016 alone, approximately 21.8 million people annually were reported to be internally displaced due to sudden onset of extreme weather, with people in low- and middle-income countries being up to five times more likely to be affected. The staggering number of climate refugees from regions already pre-exposed to destabilization exacerbates the implementation of monitoring, preventive and controlling health measures, as well as hinders the improvement of quality of life by averting progress on the social determinants of health.

Despite the increasing number and depth of global cooperation on environmental preservation and WHO’s extensive work on the topic since 2008, the Organization raised the alarm at the beginning of 2018 as a further partnership with the United Nations Environment Programme was announced, making climate change and health one of the main issues the Organization is collaborating with other stakeholders on.

Although #HealthForAll, the theme of this year’s World Health Day, has been the umbrella term for WHO’s work since 1948, the unavoidable shift in the focus areas and the approaches the Organization had to adopt in the past decades leads to the conclusion that at this decisive point, the WHO goals can only be achieved if all involved actors collaborate. In that sense, the Organization has been reliant on the fact that Health For All equals Health By All.


Ana Zhelyazkova is a student in the Master of Public Health program of Ludwig-Maximilians University. She also serves as Social Engagement Coordinator for the Association for UN Interns, New York, student employee at the Max-Planck Institute for Social Law and Social Policy and volunteer for the German branch of Médecins du Monde.

Please note that opinions expressed in this article are solely those of our contributors, not of Political Insights, which takes no institutional positions.

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