If I had to pick a phrase to describe the Global Health arena in 2010, I would choose “2 steps forward, 1 step back”. With tightened purse strings, public health programs had hands tied in many ways; but on the research front, some of the breakthroughs were mind-blowing. All in all, it was a year of tentative steps forward rather than bold leaps.
- Funding Fears: While the actual funding figures did not contract significantly, the sentiment was one of fear. Most significantly, the expectation of flatlined funding for HIV/AIDS with the PEPFAR reauthorization struck fear in the hearts of HIV programmers, particularly those in the area of treatment. Fears of funding shortages raised the calls for “doing more with less” and “innovation”, but the big drum beat was for health systems strengthening (read: less money for direct services).
- Research Breakthroughs: On the research front, several break-throughs created hope in the areas of HIV, malaria and TB. In HIV, drugs used for treatment were found to be preventive too and a study in South Africa showed the effectiveness of a microbicide in prevention for women. A promising malaria vaccine entered Stage 3 trials, triggering calls for health systems to be strengthened to accommodate its use. And advances in tuberculosis detection are just the tip of the iceberg in medical advances for the huge population of TB sufferers.
While not entirely unexpected, the most surprising development in 2011 (to my mind) was the rise of chronic illness in developing countries. As emerging economies enter phases of longer lifespans and more decadent diets, as well as suffer from increased pollution and contaminants, these populations are experiencing the same increase of diabetes, heart disease and cancer as those in developed countries. It is a cruel irony that public health and economic development success is coupled with greater complexity and yet new problems to solve.
And what’s yet to come? In 2011, here’s what I’ve got on my radar:
- Women. With funding scarce, health advocates are looking for a silver bullet, and the experts have weighed in. Want to get the most for your health dollars? Focus it all on the women.
- mHealth (mobile health). The mHealth Summit held in Washington, DC this year was a sign of things to come. Participants vied to show their tech savviness and many returned to their posts with renewed excitement. This is the one area where I truly believe that innovation will evolve into standard practice.
And my big curiosity for 2011? I’ll be watching for political “magic hats” as governments and politicians try to claim achievements with flatlined funding. Perhaps we’ll finally find out what President Obama and Secretary Clinton have up their sleeve with the Global Health Initiative. And we’ll need to watch vigilantly that governments make good on their commitments to multilaterals like the Global Fund.