NR 553 Week 1 Global Health Challenges

Week 1: Global Health Challenges

Over the past three decades, HIV/AIDS has remained one of the most pressing global health challenges. This epidemic has profoundly affected millions worldwide and has absorbed a substantial portion of development assistance for health. In 2011, approximately 34.2 million people were living with HIV, with 2.5 million new infections and 1.7 million AIDS-related deaths reported globally (WHO/UNAIDS/UNICEF, 2011).

The epidemic has disproportionately impacted Sub-Saharan Africa, where infection rates in some countries exceed 30% of the adult population (USAID Bureau of Global Health, 2010). The Caribbean region ranks second in global HIV/AIDS prevalence, particularly affecting individuals aged 25 to 44 years (USAID Bureau of Global Health, 2010).

Factors Contributing to HIV Prevalence

Several key factors contribute to the persistence and spread of HIV/AIDS across regions:

(Adapted from USAID Bureau of Global Health, 2010)

Access to Treatment

A significant inequity exists in the access to treatment for HIV/AIDS. Individuals in high-income nations benefit from highly active antiretroviral therapy (HAART)—commonly referred to as the “triple cocktail”—introduced in 1996 (Busby & Kapstein, 2016). Conversely, millions in low- and middle-income countries still lack access to antiretroviral medicines (ARVs). This disparity contributes to approximately 5,700 AIDS-related deaths daily worldwide (USAID Bureau of Global Health, 2010).

The Need for Comprehensive Prevention

HIV/AIDS poses threats beyond individual health, extending its impact to families, communities, and national economies. Although prevention programs exist, many fail to address the specific needs of local populations. Research indicates that treating sexually transmitted infections can significantly reduce HIV risk, making STI management a vital part of HIV control strategies.

Comprehensive prevention requires integrated approaches that include provider-initiated testing, counseling, and linkage to treatment. Sustained political commitment, adequate resource allocation, and innovative prevention strategies are essential to achieve universal access and reduce the global burden of HIV/AIDS.

Response to Peer 1

You effectively highlighted the connection between economic conditions and access to healthcare, which is indeed critical. Expanding on this, it is also essential to recognize the influence of environmental pollution on health inequalities.

Environmental pollution refers to the presence of harmful substances in the environment that damage both ecosystems and human health (Briggs, 2003). This includes water contamination, poor sanitation, air pollution (indoor and outdoor), radiation, and chemical exposure.

Pollution and Global Health

According to Landrigan et al. (2017), 92% of deaths from pollution-related diseases occur in low- and middle-income countries, disproportionately affecting children and other vulnerable groups. Even minimal exposure to chemicals during early life can cause lifelong disabilities and reduced earning potential.

Environmental risks are also intertwined with climate change, which worsens air quality and heightens the vulnerability of disadvantaged populations. To address these concerns, the United Nations Sustainable Development Goal (SDG) 3.9 aims to reduce deaths from hazardous environmental exposures by 2030 (United Nations, 2015).

Transitioning toward sustainable economies and enforcing pollution control policies are critical steps for improving global health equity and reducing pollution-induced health risks.

Response to Peer 2

You correctly emphasized that health inequities hinder opportunities for vulnerable populations. Tackling these disparities requires a multisectoral approach that includes governments, NGOs, academic institutions, and civil society.

Research shows that structural determinants—such as social, economic, and political exclusion—systematically limit opportunities for certain groups, thereby worsening health outcomes. Hence, effective interventions must not only provide healthcare but also address the root causes of inequity.

The World Health Organization’s Health 2020 Framework (WHO/Europe, 2013) offers a strategic model that focuses on two key objectives:

1. Improving health for all and reducing inequalities, and

2. Strengthening participatory governance for health.

Example: European Healthy Cities Network (EHCN)

The European Healthy Cities Network (EHCN), established in 1987, now includes over 100 member cities and 1,500 cities in national networks across Europe (WHO/Europe, n.d.). This initiative promotes:

• Cross-sector collaboration,

• Policy integration at the local level, and

• Public health advocacy for equity and sustainability.

The EHCN has effectively transformed how local governments and communities approach health, emphasizing inclusivity, sustainability, and evidence-based decision-making. Such models demonstrate that intersectoral partnerships and community engagement are essential to reduce health inequities and improve outcomes globally.

References

Briggs, D. (2003). Environmental pollution and the global burden of disease. British Medical Bulletin, 68(1), 1–24. https://doi.org/10.1093/bmb/ldg019

Busby, J. W., & Kapstein, E. B. (2016). Framing global health as human rights: Learning from the case of HIV/AIDS. Global Health Governance, 10(3), 24–40.

Landrigan, P. J., Fuller, R., Acosta, N., Adeyi, O., Arnold, R., Basu, N., Bibi-Baldé, A., … Zhong, M. (2017). Pollution responsible for 16 percent of early deaths globally. ScienceDaily. https://www.sciencedaily.com/releases/2017/10/171020182513.htm

United Nations. (2015). Sustainable development goal 3: Ensure healthy lives and promote well-being for all at all ages. https://sustainabledevelopment.un.org/sdg3

USAID Bureau of Global Health. (2010). HIV/AIDS surveillance. https://www.globalhealthlearning.org/course/hiv-aids-surveillance

NR 553 Week 1 Global Health Challenges

WHO/Europe. (2013). Health 2020: A European policy framework and strategy for the 21st century. http://www.euro.who.int/__data/assets/pdf_file/0011/199532/Health2020-Long.pdf

WHO/Europe. (n.d.). Promoting health and reducing health inequities by addressing the social determinants of health. http://www.euro.who.int/__data/assets/pdf_file/0016/141226/Brochure_promoting_health.pdf

WHO/UNAIDS/UNICEF. (2011). Progress report 2011: Global HIV/AIDS response. http://www.who.int/hiv/pub/progress_report2011/summary_en.pdf?ua=1