Are Things Better Now? ...and if it is, will it last?

Of course they are. We live longer, we live better, we’re better educated and most of us are better off than before. By and large we don’t own slaves, we don’t burn women as witches any more, nor do we hang children for stealing handkerchiefs. Yes, bad things happen, possibly more of them than happened back in Genghis Khan’s day but… back in 1340 there were only 440,000,000 of us. Today there are over 7,700,000,000. So, yes it’s better now.

If it doesn’t exactly feel like that, you may have a good reason. Many of us born and raised in a developed country may actually be doing less well than we were, but that’s not the way millions of people in India and China feel about the way things are. Or, if you’ve been spooked by Israeli pop philosopher Yuval Noah Harari’s view of a post-human world where 99.7 percent of us are a ‘useless class’ existing solely by the grace and favour of a god-like part human cyber-enhanced elite, you may be forgiven for feeling a little uneasy.

Then of course, there’s climate change and we all know that’s on it’s way, except for the irretrievably demented or the self-servingly rich and vile.

Apart from that things must be getting better because the United Nations and the World Health Organisation tell us so.

In the Year 2000 the UN launched the Millennial Development Goals (MDGs) to be achieved by 2015. Of the eight MDGs in the areas of health, water, food, education and treatment of women, one was achieved in full and the remaining seven were achieved in part, between 50 to 66.6 percent. A respectable result, all things considered.

In 2016 the UN launched a follow-up campaign to achieve 17 Sustainable Development Goals (SDGs) continuing and adding to the earlier MDGs.

Last month the World Health Organisation (WHO) joined in the virtuous cycle with their plan to eliminate the ten most serious threats to global health by 2024.

The WHO says the world faces multiple health challenges ranging from outbreaks of vaccine-preventable measles and diphtheria, drug-resistant pathogens, growing rates of obesity and physical inactivity, to the health impacts of environmental pollution and climate change.

To address these threats the WHO launched its new 5-year strategic plan with a triple billion target: to ensure 1 billion more people benefit from universal health coverage, 1 billion more are protected in case of health emergencies and another billion enjoy greatly improved levels of overall health.

Here’s what the WHO is committed to address by 2025:

Air pollution and climate change
Nine out of ten people breathe polluted air every day and air pollution is the greatest environmental risk to health of all. Microscopic pollutants in the air penetrate respiratory and circulatory systems, damaging the lungs, heart and brain, killing 7 million people prematurely every year from diseases such as cancer, stroke, heart and lung disease. Around 90 percent of these deaths are in low- and middle-income countries, with high volumes of emissions from industry, transport and agriculture.

Non-communicable diseases
Non-communicable diseases, like diabetes, cancer and heart disease, are responsible for over 70 percent of all deaths worldwide, or 41 million people, including 15 million who die prematurely, aged between 30 and 69. Over 85 percent of these premature deaths are in low- and middle-income countries driven by five major risk factors: tobacco use, physical inactivity, the harmful use of alcohol, unhealthy diets and air pollution.

Global influenza pandemic
The world will face another influenza pandemic – the only thing we don’t know is when and how bad. The WHO constantly monitors the circulation of influenza viruses to detect potential pandemic strains: 153 institutions in 114 countries are involved in global surveillance and response. If a new flu strain develops pandemic potential, the WHO will have the necessary diagnostics, vaccines and antivirals (treatments) ready.

Fragile and vulnerable settings
More than 1.6 billion people (22% of world population) live in places where drought, famine, conflict, population displacement and weak health services leave them without access to basic care. The WHO will strengthen health systems to detect and respond to outbreaks, as well as deliver higher quality health services, including immunization.

Antimicrobial resistance
The development of antibiotics, antivirals and antimalarials are among modern medicine’s greatest successes but these drugs are less effective. Antimicrobial resistance threatens to send us back to a time infections such as pneumonia, tuberculosis, gonorrhoea, and salmonellosis were lethal. The WHO is working to implement a global action plan to reduce antimicrobial resistance.

Ebola and other high-threat pathogens
In 2018, the Democratic Republic of the Congo saw two separate Ebola outbreaks, both of which spread to cities of more than 1 million people, one of them in an active conflict zone.

The WHO will identify diseases and pathogens with the potential to cause a public health emergency but where effective treatments and vaccines are lacking. The watchlist includes Ebola, several other haemorrhagic fevers, Zika, Nipah, Middle East respiratory syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS) and WHO will prepare for any unknown pathogens.

Weak primary health care
Primary health care is the first point of contact people have with their health care system, and ideally should provide comprehensive, affordable, community-based care throughout life. The WHO will work to strengthen primary health care globally.

Vaccine hesitancy
Vaccine reluctance or refusal to vaccinate despite availability, threatens to reverse progress made in tackling preventable diseases, says the WHO. Vaccination is one of the most cost-effective ways of avoiding disease – it currently prevents 2-3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved, it claims

Dengue
Dengue, a mosquito-borne disease, which can be lethal, killing up to 20 percent in severe cases. Dengue, has been a growing threat for decades and is spreading to less tropical and more temperate countries. An estimated 40 percent of the world is at risk of dengue fever, and there are around 390 million infections a year. The WHO aims to reduce deaths by 50% by 2020.

HIV
Progress against HIV has been enormous in getting people tested, providing anti-retrovirals (22 million being treated), and providing access to preventive measures via PrEP. However, the epidemic continues to rage with nearly a million people every year dying of HIV/AIDS. Since the beginning of the epidemic, more than 70 million people have acquired the infection, and about 35 million people have died. Today, around 37 million worldwide live with HIV. The WHO will work with countries to support the introduction of self-testing so that more people living with HIV know their status and can receive treatment or take preventive measures.

Action & Redemption…?
For anyone fifty and under I can only counsel you to take aboard and emulate the intensity and scorn that young Dutch historian Rutger Bregman directed at the world’s influential business and ruling elite at Davos last month and get actively involved in addressing inequality and climate change in a meaningful way. The rest of us to pitch in as best we can.

On a symbolic note, I think it is high time that the Unabomber was released. He has both served society and paid his debt to it. And, while we are at it, if the Americans won’t amnesty Snowden and let him return home with honour, then at least (Trump poodles all…for shame!) all well-intentioned countries should offer him asylum.