Margaret Chan, Director General of the World Health Organization, addressed the World Health Assembly in Geneva in May and provided a frank and wide-ranging discussion of the health status of the world today.

Polio Setbacks

She began her talk by noting the dramatic setback in polio eradication. “Two years ago, polio was on its knees,” she said. However, armed conflicts, civil unrest, migrant populations, weak border controls, low routine immunization coverage, bans of immunization by militant groups, and the targeted killing of polio workers have all contributed to increasing international spread of the virus.

The Good News

On the positive side of the world health situation, she noted that pursuit of the Millenium Development Goals has saved many millions of lives, and has placed 12 million people on retroviral therapy for AIDS.  “We learned that high ambitions pay off,” she said and noted that India’s eradication of polio tells us there is no such thing as impossible.

Health and Progress Index

She described rising inequality and economic exclusion, saying that it threatens social cohesion and stability, and added “Wealth does not trickle down,” and using GDP as the best index of overall progress is outmoded. As she noted later in her talk, “Better health is a good way to track the world’s true progress in poverty elimination, inclusive growth, and equity.”

More Problems

She focused some of her remarks on the latest report from the Intergovernmental Panel on Climate Change and said “our planet is losing its capacity to sustain human life in good health.”

Another notable concern is WHO’s estimate that exposure to air pollution killed approximately 7 million persons worldwide in 2012, making it the world’s largest single environmental health risk.

In an attention grabbing statement, she stated that “parts of the world are quite literally eating themselves to death” without any evidence that obesity and diet-related non-communicable diseases are decreasing anywhere. In contrast, other parts of the world are starving with equally few signs of progress.

Chan noted that the 2014 World Cancer Report states the number of new cancer cases has reached an all time high and is projected to increase.  “No country anywhere, no matter how rich, can treat its way out of the cancer crisis,”  she warned. She called for a much greater commitment to prevention to tackle not only cancer, but also heart disease, diabetes, and chronic lung diseases.

Black Holes in Epidemiology

Of special note for epidemiologists, she said that “overall, only about one third of all deaths worldwide are recorded in civil registries along with cause of death information. “Think about what this means,” she added, “we are investing in black holes.” She called closing this data gap a top priority.  ■

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