The New Public Health (Fourth Edition): Chapter 16- Global Health

The New Public Health (Fourth Edition), 2023, Pages 1097-1158
Theodore H. Tulchinsky, Elena A. Varavikova, Matan J. Cohen

Health has been a global issue for millennia since diseases began to travel with migrating populations, armies, shipping, colonizers, commerce, and more recently by air, mass commercial air, and tourist travel. The COVID-19 pandemic is among the most tragic epidemiologic events since the swine flu in 1917–18 and HIV/AIDS beginning in 1981, both of which killed tens of millions globally. Since the 1870s, life expectancy in industrialized countries has increased steadily, and life expectancy in developing countries has risen dramatically since the 1920s. The spread of public health and medical sciences greatly reduced the massive number of killing and crippling diseases, such as smallpox, malaria, measles, polio, and tuberculosis. Public health has evolved, addressing and shaping an epidemiologic transition in which noncommunicable diseases have become the preeminent cause of illness and death. Since the 1960s, public health and clinical medicine have developed, in tandem, a new transition emphasizing health promotion. This transition has seen dramatic success in improving life expectancy through prevention modalities, including early diagnosis and treatment. The 21st century has seen global health advance through networks of public–private and academic health organizations that have promoted crucial initiatives to expand public health to low- and middle-income countries to improve sanitation, reduce poverty, reduce maternal and child mortality, and control infectious diseases via the Millennium Development Goals to 2015, with commendable participation and success. Those goals were followed by the expanded Sustainable Development Goals to 2030. The first decades of the 21st century have witnessed a series of coronavirus and influenza pandemics. The deadly COVID-19 pandemic has cast a pall over global health, with hundreds of millions of cases, millions of deaths, and a stream of viral variants that have swamped control measures. But the future of global health is ripe with positive developments, such as developing new vaccines for Ebola, malaria, and the COVID-19 virus. The evolving New Public Health faces old and new diseases, the challenges of poverty, and the inequities discussed in previous chapters. Global health will need expanded public–private cooperative health networks and initiatives to build on successes and learn from setbacks, including looming climate change, persistent social and health inequity, new global health challenges, and follow-up on many recent achievements.