International Health Challenges of the 21st Century
Laxminarayan R, Mills AJ, Breman JG, et al. Advancement of global health: key messages from the Disease Control Priorities Project. Lancet. 2006;367:1193-1208. The Disease Control Priorities Project is a joint effort of the Fogarty International Center, US National Institutes of Health, the World Health Organization, World Bank, and Gates Foundation which was launched in 2001 to identify policy changes and interventions to deal with health problems in developing countries. Table 1 shows a selected summary of their conclusions for interventions in a multitude of different health problems expressed as disability-adjusted life-years averted.
The authors conclude with a list of what they consider to be 4 important challenges that the world faces in the 21st century.
High incidences of noncommunicable conditions in developing countries (such as heart disease, cancer, traffic accidents, and smoking);
The HIV pandemic;
The possibility of an influenza pandemic similar to that of 1918; and
The persistence of population subgroups with high levels of preventable disease (such as malaria, tuberculosis, diarrhea, and pneumonia).
They urge wider use of interventions that have already proven cost-effective and more attention to some of the noncommunicable diseases noted above. They also urge more research to identify those prevention and treatment programs that are likely to be most effective.