The last 20 years or so have seen many shifts of emphasis in global health. Among them, two stand out: a concern that the poor do not get left behind in the rush to achieve global goals and a concern that health services are affordable.
However, these were not big issues in global health in the last century. In 1996, one of us (Timothy Grant Evans) launched the Global Health Equity Initiative while at the Rockefeller Foundation, in response to what we and others described as the “disturbing disparities” between rich and poor.
Helena Costa, a smallholder from Sao Tome & Principe, has been investing in her family’s small agribusiness for a decade, wanting it to be more productive, more profitable, and produce quality fruits and vegetable products to supply local and export markets. The quality improvements she’s invested in include food safety practices, shifting to organic production, and planting biofortified crops. However, these food quality improvements are not yet recognized by the market. So, for Helena, improving the nutritional value of her food products is an extra cost that puts her at a disadvantage in relation to her competitors.
Many of us have vivid memories of the joy and excitement of young adulthood, but this can also be a time of stress, apprehension and fear of the unknown. For many young people, this unease can lead to acute anxiety, severe depression or substance use disorders, if not recognized and managed.
Young people living in environments where they face death and suffering daily, such as in West Africa during the Ebola epidemic of 2014-2015, in post-tsunami or earthquake-affected areas, or in countries experiencing extended conflict and violence, are particularly vulnerable to mental distress and illness.
This year’s World Mental Health Day, on Oct. 10, recognizes this critical time in life with the theme “Young People and Mental Health in a Changing World.” Many changes occur during adolescence and the early years of adulthood, but they are not always acknowledged or treated.
Under the East Africa Public Health Laboratory Networking Project, diagnostic capacity has been strengthened through the construction of state of the art laboratories. © Miriam Schneidman / World Bank Group 2018
My interest in public health began in childhood and was marked by my experiences growing up in a low-income country with limited public health infrastructure. I felt firsthand the impact of an inadequate public health system when a beloved cousin succumbed to AIDS. My mother suffered a prolonged, resistant infection with complications after invasive surgery, and my family constantly battled malaria due to drug resistance or counterfeit drugs.
I was deeply touched by statements and testimonies from people from all walks of life, but what impressed me the most was the discussion about the “veil of oblivion” surrounding the dire conditions of mentally ill people in jails and prisons.
Accumulated scientific evidence shows that proper nutrition and stimulation in utero and during early childhood benefit physical and mental well-being later in life and contribute to the development of children’s cognitive and socioemotional skills. Yet, a critical but often overlooked fact in policy design and program development across the world is the association between maternal depression and childhood stunting -- the impaired growth and development measured by low height-for-age.
The best first food for a baby, providing essential nutrition in the critical early years of life. A child’s first immunization and her best opportunity for bonding, early stimulation and healthy brain development. Breastfeeding is all these things, but it also more than that -- it is a country’s first step towards building the human capital that will drive their economies in the future.
Investing in Universal Health Coverage (UHC) so that every person has access to quality, affordable health services is a critical step towards building a country’s human capital. And as part of UHC, every woman and child should be able to access quality health services at a price they can afford, and are able to use them when needed. This includes access to comprehensive reproductive, maternal, newborn child and adolescent health services, including family planning.
The vignette below was originally published in a new joint report from the World Bank, WHO and OECD, Delivering quality health services: A global imperative for universal health coverage.
Eight years ago, when she was diagnosed with rheumatoid arthritis, an autoimmune disease that causes inflammation, swelling and acute pain in the joints, Cecilia Rodriguez was Director of a primary health care facility. “I had very bad rheumatoid arthritis and spent a lot of time in bed,” says Rodriguez, who was in her thirties when she first experienced the painful symptoms. “I realized that what I had been promoting as a health administrator was very different from what I needed as a patient.”