What doctors can do about WHO’s Urgent Health Challenges

With medical discoveries and news being disseminated at breakneck pace, exigent health concerns have advanced to the fore like never before. This month alone, the WHO released a list of 13 urgent, global health challenges for the next decade (triskaidekaphobia, anyone?). 

“This list, developed with input from our experts around the world, reflects a deep concern that leaders are failing to invest enough resources in core health priorities and systems. This puts lives, livelihoods and economies in jeopardy. None of these issues are simple to address, but they are within reach. Public health is ultimately a political choice,” wrote Tedros Adhanom Ghebreyesus, PhD, WHO Director-General.

Some of the challenges on the WHO’s list don’t directly relate to your individual practice of medicine, such as climate change. (A doc can do a lot of things, but reducing carbon emissions by industrial interests may not be one of them.) However, some of these points are actionable by physicians and are, thus, worth unpacking: 

Expanding access to medications

Globally, one-third of people lack access to medicines, vaccines, diagnostic tools, and the like. In the United States, access is also a problem. For instance, the price of brand-name prescription drugs is spiraling out of control, which hits many Americans where it hurts.

In a 2019 Consumer Reports survey of 1,015 US adults, 30% of Americans who take prescription meds reported that their out-of-pocket costs had increased. Of these respondents, 12% reported an increase of $100 or greater during the past year. Sadly, those who faced higher drug prices were nearly twice as likely to pass on filling a script, forgo medical treatments and diagnostics, buy fewer groceries, or even find a second job.

What can you do? Always prescribe generic alternatives whenever possible. After all, even though generics account for 90% of all scripts, brand-name drugs account for 79% of all drug spending. Unsurprisingly, more affordable prescription drugs result in better patient adherence and outcomes.  

Combating infectious disease

Worldwide, infectious disease rates are rising, including those for tuberculosis, hepatitis, malaria, tropical diseases, HIV, and other sexually transmitted infections. Furthermore, vaccine-preventable diseases, such as measles and polio, are seeing a surprise return.

In the United States, sexually transmitted infections are also climbing. Specifically, in 2017, there were 2.3 million cases of chlamydia, gonorrhea, and syphilis, which set a new record. The United States has also seen a  recent spate of measles and mumps outbreaks, which are preventable by vaccination.

As a physician, take a bit of time to counsel your patients on the value of vaccinations and safe sex. Remember, your patients listen to you and value your advice.

Eliminating unhealthy diets and drugs of abuse

A paucity of food, unsafe foods, and unhealthy diets account for one-third of disease burden across the globe. It’s a good idea to advise patients to steer clear of a preponderance of saturated fats, sugars, and other treats, and to maintain a healthy weight.

The WHO also noted that although tobacco use is on the decline, e-cigarette use is a real problem. Recently, we’ve seen a rise in serious complications due to vaping.  

In a previous article, MDLinx expounded on the dangers of vaping. We also mentioned what physicians can do to curb the threat and improve clinical outcomes, including reporting vaping-related illnesses or deaths within the past 90 days to local or state health departments. 

Read our full list of recommendations here. 

Investing in your staff

By 2032, the United States is projected to experience a shortfall of between 46,900 and 121,900 physicians, according to the American Association of Medical Colleges. More medical schools are being opened to rectify this problem. But, without a concomitant increase in residency spots, any potential impact is questionable.

By 2030, the entire world will need an additional 18 million healthcare workers, according to the WHO. As a physician, you can help address deficiencies in the availability of healthcare providers and services by supporting the work of your nurses and mid-level providers, such as physician assistants, nurse practitioners, and midwives.

In fact, the WHO declared 2020 the “Year of the Nurse and Midwife.” 

“Nurses and midwives play a vital role in providing health services. These are the people who devote their lives to caring for mothers and children; giving lifesaving immunizations and health advice; looking after older people and generally meeting everyday essential health needs. They are often the first and only point of care in their communities. The world needs 9 million more nurses and midwives if it is to achieve universal health coverage by 2030,” the WHO explained.

“Join WHO and partners including the International Confederation of Midwives (ICM), International Council of Nurses (ICN), Nursing Now and the United Nations Population Fund (UNFPA) in a year-long effort to celebrate the work of nurses and midwives, highlight the challenging conditions they often face, and advocate for increased investments in the nursing and midwifery workforce,” they encouraged.

Youth advocacy

The youth are our future. Across the world, there are 1.2 billion adolescents aged between 10 and 19 years, and more than 1 million of these kids die every year. Leading causes of death include suicide, violence, drugs, unprotected sex, and child abuse.

If you’re a physician who sees kids, plenty can be done to promote healthy outcomes due to such causes. For instance, according to the Suicide Resource Prevention Center, those who die by suicide are more likely to see a primary care physician than any other physician during the month before death, and this visit may be the best (or only) chance to prevent this tragic outcome.

Here are a few things that can be done in the clinic to prevent suicide:

• Establish effective screening, assessment, intervention, and referral protocols, and inform staff of these measures

• Train staff in suicide care practices, such as safety planning and “lethal means”  counseling to assess whether a person at risk for suicde has access to a firearm or other lethal means, and working with them and their families/support systems to limit access until they aren’t at elevated risks

• Establish connections with behavioral health referral centers

• Maintain continuity of care

• Direct patients at risk for suicide to the National Suicide Prevention Lifeline

Garner the public’s trust

Of course, you want those under your care to listen, take their meds, get their vaccinations, and use condoms. In order for these things to happen, however, trust must be earned. Sometimes, all you need to do in addition to counseling is to truly listen and reflect on your patients’ problems. For instance, if your patient heard something questionable on social media and is inquiring about advice, ask meaningful questions and take time to listen. Don’t assume, presume, or dismiss.

Combating antimicrobial resistance As you know, antibiotic resistance is a problem both stateside and across the world. The WHO highlights this concern as highest priority. In addition to appropriate prescribing, combating antibiotic resistance involves patient education. Some nifty resources from the CDC that you can post around the office to help educate your patients can be found here. Keep in mind that ancillary resources can serve as excellent conversation starters. 

In his note, Dr. Ghebreyesus puts the WHO’s guidance in perspective: “We face shared threats and we have a shared responsibility to act. The cost of doing nothing is one we cannot afford.”