WHO Director Chan highlights global health changes, challenges

Dr. Margaret Chan

On World TB Day, March 16, Dr. Margaret Chan, director-general of the World Health Organization, addressed public health professionals at the Centers for Disease Control and Prevention in Atlanta at the eighth annual Jeffrey P. Koplan Global Leadership in Public Health Lecture. In introducing Chan, Koplan noted their long-term friendship, which grew from their work together in China.

While in Atlanta, Chan also visited Emory to meet with President James Wagner and Emory Global Health Institute Director Koplan. She heard presentations about global health field projects by students in public health, medicine, and theology.

Chan recalled the “lost decade for development,” the 1980s, a dismal time for public health. The 1979 energy crisis followed by a recession made for tighter public health resources and few health care improvements worldwide, she explained. Some developing countries have still not recovered.

In contrast, public health has faired better in the new millennium, when the world has benefited from financial commitments backed by substantial resources, often from innovative sources, says Chan.

Dr. Margaret Chan and Dr. Jeffrey Koplan at the Emory Global Health Institute

A few of those resources: Global health initiatives that deliver life-saving interventions on a massive scale. Presidents and prime ministers launching and funding international programs for diseases rarely seen within their own borders. Public-private partnerships for development of drugs and vaccines. Strategic R&D initiatives producing more effective, easy-to-use products at prices developing countries can afford.

Still, Chan says the world continually faces multiple crises, such as floods, droughts and famine. While this is nothing new, today’s crises have unprecedented dimensions that reveal what it means to live in a closely interdependent and interconnected world.

For example, novel H1N1 could have turned into a crisis, but it did not. The virus initially spread in countries with good surveillance systems. The honesty and speed of early reporting set the standard for the international response, explained Chan.

In contrast, polio has resurged in Nigeria with the virus spilling over the borders into at least 12 neighboring countries that had been certified as polio-free. And in Europe and North America, many parents remain convinced that the measles-mumps-rubella vaccine is linked to autism and bowel disease. That’s why some countries are seeing unnecessary outbreaks of measles despite the unprecedented drive to control it.

Much has been achieved. Much remains to be done. New problems have surfaced, but public health is accustomed to setbacks and surprises. Our value system, says Chan, is irreproachable and our optimism and determination are irrepressible.

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