Today is World Health Day. Usually, when writing about global health days, I look for the optimism. No matter the issue or disease, you can almost always find tangible progress from the last year to highlight. Today, though, I’m having trouble finding the upside. Maybe because the subject – world health – is so broad it’s hard to find specific achievements to point out. Or maybe this is just a bad time for global health.

So, for World Health Day, my top three fears:

1.       I’m afraid of antibiotic resistance. This is the topic the WHO has chosen to highlight for World Health Day. In the words of WHO Director-General Margaret Chan, “In the absence of urgent corrective and protective actions, the world is heading towards a post-antibiotic era, in which many common infections will no longer have a cure and, once again, kill unabated.” Picture a world where people once again die from appendicitis or syphilis, and TB is completely untreatable. That could be our world in ten years.

2.       I’m afraid that global health has missed its moment. Over the last decade, support from the Gates Foundation, better marketing, and anew understanding of global interdependence has brought global health to the forefront of international priorities. We discussed a new era of global health diplomacy, established the Global Fund to Fight AIDS, TB, and Malaria, and made heroes out of Paul Farmer and Jim Kim. International donors took the fight for global health seriously, and we saw progress against long-time killers like HIV and polio.

Now, though, we’re at risk of losing all that progress. In the face of global recession, donors are cutting their support to global health. The Global Fund and the people who depend on its programs are suffering from a lack of resources. We’re going to have to stop expanding HIV treatment to new patients in many places, which is a tragedy for individual people living with HIV and a failure to contain the pandemic.

3.       I’m afraid of climate change. Climate change is going to have a massive direct and indirect effect on human life, most of it bad. And nobody seems to be doing anything about it. Even if we accept climate change as inevitable, we need to focus on resilience. The world – and poor communities in particular – needs to prepare for the impact of the new weather and find ways to survive the change with minimal damage. But no one seems to be stepping up to think about the coming change, or finding ways to support poor communities as they endure it.

(photo credit: AJC1)