Happy World Health Day to all! This year’s World Health Day is focussed on the important issue of food safety and foodborne illness. However I thought it was also a good moment to take stock of some big issues in global health on UKCDS’ radar and look forward to the year ahead.

Ebola’s devastating impacts in West Africa have dominated the headlines this year, both in the press and the research funding world. The Wellcome Trust, Department for International Development, Medical Research Council, Economic and Social Research Council, Gates Foundation, Pasteur, Fondation Mérieux and other funders teamed-up in various combinations to fund vaccine and treatment trials at unprecedented speed, as well as anthropological and other social science research.

UV screening of Ebola health worker (Image: DFID)

With the focus now on getting to zero cases, a number of key organisations are stepping back to consider Ebola in its broader context, in terms of the outbreak’s implications for development and preparedness for future epidemics. For example:

• Médecins Sans Frontières’ report, Pushed to the Limit and Beyond, critically considers the slow response by the international community and also illustrates the scale of the knock-on health effects of Ebola, with the crisis leading to increases in untreated malaria, delivery complications and road traffic accidents.
• Save the Children’s A Wake-Up Call ranks the quality of countries’ health systems, finding that around 30 are worse off than those of Guinea, Sierra Leone and Liberia. The amount of money needed to achieve universal healthcare in the three countries, and thus plug the most glaring gaps in their health systems, would have cost one-third of the total aid provided in response, and saved countless lives.

Antimicrobial resistance (AMR) also moved to the top of the agenda in 2014, with senior figures warning of a return to the “dark ages of medicine”.

MRSA bacteria escaping a white blood cell (Image: NIAID)

• Science Minister Greg Clark announced a “war cabinet” on AMR last June, and this spurred the creation of a new multidisciplinary cross research council initiative on AMR.
• The Wellcome Trust and Department of Health began funding the independent review panel on AMR in order to catalyse a global response to AMR and stimulate a new drug pipeline. Papers produced by the panel have already highlighted the high number of deaths likely to be attributable to AMR by 2050 in low- and middle-income countries (LMICs).
• We also saw the discovery of a potentially game-changing new antibiotic, teixobactin, and the announcement of the Fleming Fund, a £195m initiative financed by the Wellcome Trust and Gates Foundation to build laboratory capacity and surveillance networks in LMICs.
• The Whitehouse has just released its National Action Plan for Combating Antibiotic-Resistant Bacteriawhich has both a US and global health security angle.

And some other health developments in the past year…

• The Council on Foreign Relations reported on the “emerging global health crisis” of non-communicable diseases in LMICs, responsible for eight million deaths before the age of 60.
• MRC and Gates research assessing diet quality worldwide showed that increases in consumption of processed meat and sweetened drinks have outpaced healthier eating habits, such as higher consumption of fruit and vegetables.
• The WHO reported that 7 million deaths each year are attributable to air pollution (making MRC/NERC’s new programme on air pollution in Chinese and Indian megacities particularly timely).
• Wellcome Trust funded research in Brazil linked breastfeeding to higher IQ and income at age 30.
• The Global Health Network was set up to host collaborative online platforms for researchers to share knowledge, data and resources.
• UNICEF and WHO published their action plan to end preventable deaths among newborns, an area that was neglected in the Millennium Development Goals.
• Research has highlighted the role of climate change in fuelling the spread of various infectious diseases. Scientists demonstrated that malaria is now spreading to higher altitudes in Africa and South America while climate change and urbanisation is exacerbating the global threat of dengue fever.
• Funders pledged the necessary $7.5bn for GAVI, the Vaccine Alliance, to vaccinate 300 million children and save 5-6 million lives worldwide through immunisation.
• The World Bank Group launched the third edition of its Disease Control Priorities series, reinforcing the importance and cost-effectiveness of basic surgery in reducing preventable deaths in LMICs.
• We saw the first ever University Global Health Research league table for the UK, with Oxford University topping the list.

As for the future of global health, it’s 2015 and the impending Sustainable Development Goals  present a milestone opportunity to catalyse progress in health and development. The current draft goal on health and wellbeing (number 3) puts forward an incredibly ambitious and diverse agenda. Targets include:

The eight Millenium Development Goals

• Achieve universal health coverage
• Reduce maternal mortality to less than 70 per 100,000 live births by 2030
• End the “big three” diseases of HIV/AIDS, malaria and tuberculosis as well as NTDs by 2030
• Strengthen treatment of alcohol and substance abuse.

This is only a selection of the many targets, and at the same time a few issues (such as antimicrobial resistance) are conspicuous in their absence. What makes it into the final framework, and how this affects future investments in global health research funding, will be decided at the UN Summit in September.

What key global health issues from the past year have I missed? What do you think are the highlights coming up this year? Let us know your thoughts in the comments section below.