LESSON 1 – WHO GLOBAL HEALTH SITUATION

 The inability to prevent infections could seriously

WHO AND UN compromise surgery and procedures such as
 World Health Organization chemotherapy. 
 WHO began when our Constitution came into
force on April 7, 1948 – a date we now celebrate EBOLA AND OTHER HIGH-TREAT PATHOGENS
every year as World Health Day  In 2018, the Democratic Republic of the Congo saw two
 United Nations separate Ebola outbreaks, both of which spread to cities of
 The United Nations is an international more than 1 million people.
organization founded in 1945.
 It is currently made up of 193 Member States. WEAK PRIMARY HEALTH CARE
 The mission and work of the United Nations are  Primary health care is usually the first point of contact
guided by the purposes and principles contained people have with their health care system, and ideally
in its founding Charter. should provide comprehensive, affordable, community-
based care throughout life. 
10 OF MANY ISSUES THAT WILL DEMAND ATTENTION
FROM WHO 7 HEALTH PARTNERS IN 2019 VACCINE HESITANCY
 It includes the following:  It is the reluctance or refusal to vaccinate despite the
1. Air Pollution and Climate Change availability of vaccines – threatens to reverse progress
2. Noncommunicable Diseases made in tackling vaccine-preventable diseases.
3. Global Influenza Pandemic  Vaccination is one of the most cost-effective ways of
4. Fragile and Vulnerable Settings avoiding disease.
5. Antimicrobial Resistance  It currently prevents 2-3 million deaths a year,
6. Ebola and Other High-treat Pathogens and a further 1.5 million could be avoided if
7. Weak Primary Health Care global coverage of vaccinations improved. 
8. Vaccine Hesitancy
9. Dengue
DENGUE
10. HIV
 A mosquito-borne disease that causes flu-like symptoms
and can be lethal and kill up to 20% of those with severe
dengue, has been a growing threat for decades.
 An estimated 40% of the world is at risk of dengue fever,
and there are around 390 million infections a year.
AIR POLLUTION AND CLIMATE CHANGE  WHO’s Dengue control strategy aims to reduce deaths by
 Nine out of ten people breathe polluted air every day. 50% by 2020. 
 In 2019, air pollution is considered by WHO as the
greatest environmental risk to health. HIV
 Microscopic pollutants in the air can penetrate respiratory  The progress made against HIV has been enormous in
and circulatory systems, damaging the lungs, heart and terms of getting people tested, providing them with
brain, killing 7 million people prematurely every year from antiretrovirals (22 million are on treatment), and providing
diseases such as cancer, stroke, heart and lung disease. access to preventive measures such as a pre-exposure
 Around 90% of these deaths are in low- and middle- prophylaxis (PrEP, which is when people at risk of HIV
income countries, with high volumes of emissions from take antiretrovirals to prevent infection). 
industry, transport and agriculture, as well as dirty
cookstoves and fuels in homes.   8 MILLENIUM DEVELOPMENT GOALS
 It includes the following:
NONCOMMUNICABLE DISEASES 1. To eradicate extreme poverty and hunger
 Noncommunicable diseases, such as diabetes, cancer 2. To achieve universal primary education
and heart disease, are collectively responsible for over 3. To promote gender equality and empower
70% of all deaths worldwide, or 41 million people. women
 This includes 15 million people dying prematurely, aged 4. To reduce child mortality
between 30 and 69. 5. To improve maternal health
6. To combat HIV/AIDS, malaria, and other
GLOBAL INFLUENZA PANDEMIC diseases
 The world will face another influenza pandemic – the only 7. To ensure environmental sustainability
thing we don’t know is when it will hit and how severe it 8. To develop a global partnership for development
will be.  The United Nations Millennium Development Goals are
 Global defenses are only as effective as the weakest link eight goals that all 191 UN member states have agreed to
in any country’s health emergency preparedness and try to achieve by the year 2015.
response system.   The United Nations Millennium Declaration, signed in
September 2000 commits world leaders to combat
FRAGILE AND VULNERABLE SETTINGS poverty, hunger, disease, illiteracy, environmental
 More than 1.6 billion people (22% of the global population) degradation, and discrimination against women.
live in places where protracted crises (through a  The MDGs are derived from this Declaration, and all have
combination of challenges such as drought, famine, specific targets and indicators.
conflict, and population displacement) and weak health  The MDGs are inter-dependent; all the MDG influence
services leave them without access to basic care. health, and health influences all the MDGs.
 For example, better health enables children to
ANTIMICROBIAL RESISTANCE learn and adults to earn.
 Refers to the ability of bacteria, parasites, viruses and  Gender equality is essential to the achievement
fungi to resist these medicines. of better health.
 Threatens to send us back to a time when we were unable  Reducing poverty, hunger and environmental
to easily treat infections such as pneumonia, tuberculosis, degradation positively influences, but also
gonorrhea, and salmonellosis. depends on, better health.

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  Achieve, by 2015, universal access to reproductive health.

FAST FACTS
 Globally, maternal mortality declined by 47 per cent over
the last two decades.
 Maternal mortality has declined by about two-thirds in
Eastern Asia, Northern Africa and Southern Asia.
ERADICATE EXTREME POVERTY AND HUNGER  Only half of pregnant women in developing regions
 Halve, between 1990 and 2015, the proportion of people receive the recommended minimum of four antenatal care
whose income is less than $1 a day visits.
 Achieve full and productive employment and decent work  Complications during pregnancy or childbirth are one of
for all, including women and young people the leading causes of death for adolescent girls.
 Halve, between 1990 and 2015, the proportion of people  Some 140 million women worldwide who are married or in
who suffer from hunger union say they would like to delay or avoid pregnancy, but
do not have access to voluntary family planning.
FAST FACTS  Most maternal deaths in developing countries are
 The proportion of people living in extreme poverty declined preventable through adequate nutrition, proper health
by half at the global level. care, including access to family planning, the presence of
 In developing regions, the proportion of people living on a skilled birth attendant during delivery and emergency
less than $1.25 a day fell from 47 per cent in 1990 to 22 obstetric care.
per cent in 2010, five years ahead of schedule.
 While the proportion of undernourished people globally COMBAT HIV/AIDS, MALARIA, & OTHER DISEASES
decreased from 23.2 per cent in 1990-1992 to 14.9 per  Halt and begin to reverse, by 2015, the spread of
cent in 2010-2012, this still leaves 870 million people— HIV/AIDS
one in eight worldwide—going hungry.  Achieve universal access to treatment for HIV/AIDS for all
those who need it
ACHIEVE UNIVERSAL PRIMARY EDUCATION  Halt and begin to reverse, by 2015, the incidence of
 Ensure that, by 2015, children everywhere, boys and girls malaria and other major diseases
alike, will be able to complete a full course of primary
schooling. FAST FACTS
 Worldwide, the number of people newly infected with HIV
FAST FACTS
continues to fall, dropping 33 per cent from 2001 to 2011.
 Literacy rates among adults and youths are on the rise  In 2012, 290,000 fewer children under age 15 were
and gender gaps are narrowing. infected with HIV than in 2001.
 New national data show the number of out-of-school  A record 9.7 million people were receiving antiretroviral
children dropped from 102 million to 57 million from 2000 therapy for HIV in 2012. In the decade since 2000, 1.1
to 2011. million deaths from malaria were averted.
 Primary education enrolment in developing countries  Treatment for tuberculosis has saved some 20 million lives
reached 90 percent in 2010. between 1995 and 2011.

PROMOTE GENDER EQUALITY & EMPOWER WOMEN ENSURE ENVIRONMENTAL SUSTAINABILITY

 Eliminate gender disparity in primary and secondary  Integrate the principles of sustainable development into
education, preferably by 2005, and in all levels of country policies and programmes and reverse the loss of
education, no later than 2015. environmental resources.
 Reduce biodiversity loss, achieving, by 2010, a significant
FAST FACTS reduction in the rate of loss.
 Steady progress has been made towards equal access of  Halve, by 2015, the proportion of the population without
girls and boys to education, though disparities remain sustainable access to safe drinking water and basic
between regions and education levels. sanitation.
 Globally, the share of women employed outside of  Achieve, by 2020, a significant improvement in the lives of
agriculture rose to 40 per cent, but rose to only 20 per cent at least 100 million slum dwellers.
in Southern Asia, Western Asia and Northern Africa.
 The global share of women in parliament continues to rise FAST FACTS
slowly and reached 20 per cent in 2012—far short of  More than 2.1 billion people have gained access to
gender parity, though an increase of one percentage point improved drinking water sources since 1990, exceeding
was seen during 2012. the MDG target.
 While almost 2 billion more people now have access to
REDUCE CHILD MORTALITY proper sanitation than in 1990, 2.5 billion still do not have
 Reduce by two-thirds, between 1990 and 2015, the access to toilets or latrines.
mortality rate of children under five  An estimated 863 million people reside in slums
in developing countries.
FAST FACTS  Global carbon dioxide emissions have increased by more
 Since 1990, the under- five mortality rate has dropped by than 46 per cent since 1990.
47 per cent.  Nearly one-third of marine fish stocks have been
 While around 17,000 fewer children are dying each day, overexploited and the world’s fisheries can no longer
6.6 million children under five died in 2012 — mostly from produce maximum sustainable yields.
preventable diseases.  More species are at risk of extinction despite an increase
 More than 10 million lives have been saved through in protected areas.
measles vaccines since 2000.  Forests, particularly in South America and Africa,
 In sub-Saharan Africa, one in ten children dies before age are disappearing at an alarming rate.
five, more than 15 times the average for developed
regions. DEVELOP A GLOBAL PARTNERSHIP FOR DEVELOPMENT
 Develop further an open, rules-based, predictable, non-
IMPROVE MATERNAL HEALTH discriminatory trading and financial system
 Reduce by three-quarters, between 1990 and 2015, the  Address the special needs of least developed countries,
maternal mortality ratio landlocked countries and small island developing states

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 Deal comprehensively with developing countries’ debt  Rapid growth in countries such as China and India has
 In cooperation with pharmaceutical companies, provide lifted millions out of poverty, but progress has been
access to affordable, essential drugs in developing uneven.
countries  Women are more likely to be poor than men
 In cooperation with the private sector, make available because they have less paid work, education,
benefits of new technologies and own less property.

FAST FACTS FACTS AND FIGURES

 Official development assistance stood at $126 billion in  736 million people still live in extreme poverty.
2012.  10% of the world’s population live in extreme poverty,
 A total of 83 per cent of least developed country exports down from 36 percent in 1990.
enter developed countries duty-free.  Half of all people living in poverty are under 18.
 In 2012, trade of developing countries and transition  One person in every 10 is extremely poor.
economies outpaced the world average.  80% of people living on less than $1.90 are in South Asia
 ✧ In the developing world, 31 per cent of the population and sub-Saharan Africa
use the Internet, compared with 77 per cent of the  1 in 3 women of reproductive age is anemic.
developed world
KEY MDG ACHIEVEMENTS ZERO HUNGER
 More than 1 billion people have been lifted out of extreme  End hunger, achieve food security, and improved nutrition
poverty (since 1990) and promote sustainable agriculture.
 Child mortality dropped by more than half (since 1990)  The number of undernourished people has dropped by
 The number of out of school children has dropped by more almost half in the past two decades because of rapid
than half (since 1990) economic growth and increased agricultural productivity.
 HIV/AIDS infections fell by almost 40 percent (since 2000)  Unfortunately, extreme hunger and malnutrition remain a
huge barrier to development in many countries. There are
17 SUSTAINABLE DEVELOPMENT GOALS 821 million people estimated to be chronically
undernourished as of 2017, often as a direct consequence
 The 2030 Agenda for Sustainable Development, adopted
of environmental degradation, drought & biodiversity loss.
by all United Nations Member States in 2015, provides a
shared blueprint for peace and prosperity for people and  Over 90 million children under five are dangerously
the planet, now and into the future. underweight. Undernourishment and severe food
insecurity appear to be increasing in almost all regions of
 At its heart are the 17 Sustainable Development Goals
Africa, as well as in South America.
(SDGs), which are an urgent call for action by all countries
- developed and developing - in a global partnership.  The number of undernourished people reached 821 million
in 2017.
 It includes the following:
1. No Poverty
FACTS AND FIGURES
2. Zero Hunger
3. Good Health and Well-being  In 2017 Asia accounted for nearly two thirds, 63 percent,
4. Quality Education of the world’s hungry.
5. Gender Equality  Nearly 151 million children under five, 22 percent, were
6. Clean Water and Sanitation still stunted in 2017.
7. Affordable and Clean Energy  More than 1 in 8 adults is obese.
8. Decent Work and Economic Growth  1 in 3 women of reproductive age is anemic.
9. Industry, Innovation and Infrastructure
10. Reduced Inequality GOOD HEALTH AND WELL-BEING
11. Sustainable Cities and Communities  Life expectancy has increased dramatically
12. Responsible Consumption and Production  Infant and maternal mortality rates have declined
13. Climate Action  HIV and malaria deaths have halved.
14. Life Below Water  Every 2 seconds someone aged 30 to 70 years dies
15. Life on Land prematurely from noncommunicable diseases
16. Peace and Justice Strong Institutions  Cardiovascular disease, chronic respiratory
17. Partnerships to achieve the Goal disease, diabetes or cancer.

FACTS AND FIGURES

 7 million people die every year from exposure to fine
particles in polluted air.
 More than one of every three women have experienced
either physical or sexual violence at some point in their life
resulting in both short- and long-term consequences for
their physical, mental, and sexual and reproductive health.

QUALITY EDUCATION
 The total enrollment rate in developing regions reached 91
percent in 2015, and the worldwide number of children out
of school has dropped by almost half.
NO POVERTY  There has also been a dramatic increase in literacy rates,
 Eradicating poverty in all its forms remains one of the and many more girls are in school than ever before.
greatest challenges facing humanity.
 While the number of people living in extreme FACTS AND FIGURES
poverty dropped by more than half between 1990  Enrollment in primary education in developing countries
and 2015, too many are still struggling for the has reached 91 percent.
most basic human needs.  Still, 57 million primary-aged children remain out of school,
 As of 2015, about 736 million people still lived on less than more than half of them in sub-Saharan Africa.
US$1.90 a day; many lack food, clean drinking water and  In developing countries, one in four girls is not in school.
sanitation.  About half of all out-of-school children of primary school
age live in conflict-affected areas.

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 103 million youth worldwide lack basic literacy skills, and lasting impact of the 2008 economic crisis and global
more than 60 percent of them are women recession. In developing countries, the middle class now
makes up more than 34 percent of total employment – a
GENDER EQUALITY number that has almost tripled between 1991 and 2015
 Ending all discrimination against women and girls is not
only a basic human right, it’s crucial for sustainable future FACTS AND FIGURES
 It’s proven that empowering women and girls  An estimated 172 million people worldwide were without
helps economic growth and development. work in 2018 - an unemployment rate of 5 percent.
 It is vital to give women equal rights land and property,  As a result of an expanding labor force, the number of
sexual and reproductive health, and to technology and the unemployed is projected to increase by 1 million every
internet. year and reach 174 million by 2020.
 Today there are more women in public office than  Some 700 million workers lived in extreme or moderate
ever before, but encouraging more women poverty in 2018, with less than US$3.20 per day.
leaders will help achieve greater gender equality  Women’s participation in the labour force stood at 48 per
FACTS AND FIGURES cent in 2018, compared with 75 percent for men. Around 3
in 5 of the 3.5 billion people in the labour force in 2018
 Women earn only 77 cents for every dollar that men get
for the same work. INDUSTRY, INNOVATION, AND INFRASTRUCTURE
 35 percent of women have experienced physical and/or
 Investment in infrastructure and innovation are crucial
sexual violence.
drivers of economic growth and development.
 Women represent just 13% of agricultural landholders.
 With over half the world population now living in cities,
 Almost 750 million women and girls alive today were mass transport and renewable energy are becoming ever
married before their 18th birthday. more important, as are the growth of new industries and
 Two thirds of developing countries have achieved gender information and communication technologies
parity in primary education.
 Only 24 percent of national parliamentarians were women FACTS AND FIGURES
as of November 2018, a small increase from 11.3 percent
 Worldwide, 2.3 billion people lack access to basic
in 1995
sanitation.
CLEAN WATER AND SANITATION
 In some low-income African countries, infrastructure
 Water scarcity affects more than 40 percent of people, an
constraints cut businesses’ productivity by around 40
alarming figure that is projected to rise as temperatures
percent.
do.
 2.6 billion people in developing countries do not have
 2.1 billion people have improved water sanitation since
access to constant electricity.
1990, dwindling drinking water supplies are affecting every
 More than 4 billion people still do not have access to the
continent.
Internet; 90 percent of them are in the developing world.
 By 2050, it is projected that at least one in four people will
 The renewable energy sectors currently employ more than
suffer recurring water shortages
2.3 million people; the number could reach 20 million by
2030.
FACTS AND FIGURES
 In developing countries, barely 30 percent of agricultural
 71 percent of the global population, 5.2 billion people, had products undergo industrial processing, compared to 98
safely-managed drinking water in 2015, but 844 million percent high-income countries
people still lacked even basic drinking water.
 39 percent of the global population, 2.9 billion people, had REDUCED INEQUALITIES
safe sanitation in 2015, but 2.3 billion people still lacked  Income inequality is on the rise—the richest 10 percent
basic sanitation. 892 million people practiced open have up to 40 percent of global income whereas the
defecation. poorest 10 percent earn only between 2 to 7 percent.
 80 percent of wastewater goes into waterways without  If we take into account population growth inequality in
adequate treatment. developing countries, inequality has increased by 11
 Water stress affects more than 2 billion people, with this percent
figure projected to increase.
 80 percent of countries have laid the foundations for SUSTAINABLE CITIES AND COMMUNITIES
integrated water resources management  More than half of us live in cities.
 By 2050, two-thirds of all humanity—6.5 billion people—
AFFORDABLE AND CLEAN ENERGY will be urban.
 Between 2000 and 2016, the number of people with  Sustainable development cannot be achieved without
electricity increased from 78 to 87 percent, and the significantly transforming the way we build and manage
numbers without electricity dipped to just below one billion. our urban spaces
 Yet as the population continues to grow, so will the
demand for cheap energy, and an economy reliant on FACTS AND FIGURES
fossil fuels is creating drastic changes to our climate.
 In 2018, 4.2 billion people, 55 percent of the world’s
FACTS AND FIGURES population, lived in cities.
 By 2050, the urban population is expected to
 One in 7 people still lacks electricity, and most of them live reach 6.5 billion.
in rural areas of the developing world.  Cities occupy just 3 percent of the Earth’s land but
 Energy is the main contributor to climate change, it account for 60 to 80 percent of energy consumption and at
produces around 60 percent of greenhouse gases. least 70 percent of carbon emissions.
 More efficient energy standards could reduce building and  828 million people are estimated to live in slums, and the
industry electricity consumption by 14 percent. number is rising.
 More than 40 percent of the world’s population — 3 billion  In 1990, there were 10 cities with 10 million people or
— rely on polluting and unhealthy fuels for cooking. more; by 2014, the number of mega-cities rose to 28, and
 As of 2015, more than 20 percent of power was generated was expected to reach 33 by 2018. In the future, 9 out of
through renewable energy 10 mega-cities will be in the developing world.
 In the coming decades, 90 percent of urban expansion will
DECENT WORK AND ECONOMIC GROWTH be in the developing world.
 Over the past 25 years the number of workers living in
extreme poverty has declined dramatically, despite the RESPONSIBLE CONSUMPTION AND PRODUCTION

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 Achieving economic growth and sustainable development  Some regions enjoy peace, security and
requires that we urgently reduce our ecological footprint by prosperity, while others fall into seemingly
changing the way we produce and consume goods and endless cycles of conflict and violence.
resources.  This is not inevitable and must be addressed
 Agriculture is the biggest user of water worldwide, and
irrigation now claims close to 70 percent of all freshwater FACTS AND FIGURES
for human use.  By the end of 2017, 68.5 million people had been forcibly
displaced as a result of persecution, conflict, violence or
FACTS AND FIGURES human rights violations.
 1.3 billion tons of food is wasted every year, while almost  There are at least 10 million stateless people who have
2 billion people go hungry or undernourished. been denied nationality and its related rights.
 The food sector accounts for around 22 percent of total  Corruption, bribery, theft and tax evasion cost developing
greenhouse gas emissions, largely from the conversion of countries US$1.26 trillion per year.
forests into farmland.  49 countries lack laws protecting women from domestic
 Globally, 2 billion people are overweight or obese. violence.
 Only 3 percent of the world’s water is fresh (drinkable),  In 46 countries, women now hold more than 30 percent of
and humans are using it faster than nature can replenish seats in at least one chamber of national parliament.
it.  1 billion people are legally ‘invisible’ because they cannot
 If people everywhere switched to energy efficient prove who they are. This includes an estimated 625 million
lightbulbs, the world would save US$120 billion annually. children under 14 whose births were never registered

CLIMATE ACTION PARTNERSHIPS FOR THE GOALS

 There is no country that is not experiencing the drastic  The SDGs can only be realized with strong global
effects of climate change. Greenhouse gas emissions are partnerships and cooperation.
more than 50 percent higher than in 1990.  Official Development Assistance remained steady but
 Global warming is causing long-lasting changes below target, at US$147 billion in 2017.
to our climate system, which threatens  While humanitarian crises brought on by conflict or natural
irreversible consequences if we do not act disasters continue to demand more financial resources
 The average temperature of the Earth’s surface has and aid.
increased by about 0.85oC in the last 100 years.  Many countries also require Official Development
 Thirteen of the 14 warmest years ever on Earth were Assistance to encourage growth and trade
recorded in the 21st Century, with 2016 as the warmest
year on record. “5 PS” THAT SHAPE THE SDGS
 Because of this increase in temperatures, we have lost an  One way to measure progress is to focus on the “5 Ps”
average of 13.3% of Arctic Sea ice between 1981 & that shape the SDGs
2010.3  People, Planet, Prosperity, Peace, &
 Arctic ice coverage is vital to the survival of vulnerable Partnerships
ecosystems, species, and communities in the North, but it  Progress on one P must balance and support progress on
is also important to humanity at large. another.
 Refocusing on the “5 Ps” feels particularly relevant this
LIFE BELOW WATER year given their clear and intentional alignment with the
 The world’s oceans – their temperature, chemistry, goals under review at HLPF.
currents and life – drive global systems that make the PEOPLE
Earth habitable for humankind.  We are determined to end poverty and hunger, in all their
 How we manage this vital resource is essential for forms and dimensions, and to ensure that all human
humanity as a whole, and to counterbalance the effects of beings can fulfill their potential in dignity and equality and
climate change in a healthy environment.

LIFE ON LAND PLANET

 Human life depends on the earth as much as the ocean  We are determined to protect the planet from degradation,
for our sustenance and livelihoods. including through sustainable consumption and
 Plant life provides 80 percent of the human diet, and we production, sustainable management of natural resources
rely on agriculture as an important economic resource. and by taking urgent action on climate change, so that the
 Forests cover 30 percent of the Earth’s surface, provide planet can support the needs of present and future
vital habitats for millions of species, and important sources generations.
for clean air and water, as well as being crucial for
combating climate change PROSPERITY
 The value of ecosystems to human livelihoods and well-  We are determined to ensure that all human beings can
being is $US125 trillion per year. enjoy prosperous and fulfilling lives and that economic,
social, and technological progress occurs in harmony with
FACTS AND FIGURES nature.
 Around 1.6 billion people depend on forests for their
livelihoods PEACE
 Forests are home to more than 80 percent of all terrestrial  We are determined to foster peaceful, just and inclusive
species of animals, plants and insects. societies, which are free from fear and violence.
 2.6 billion people depend directly on agriculture for a  There can be no sustainable development without peace
living. and no peace without sustainable development.
 Nature-based climate solutions can contribute about a
third of CO2 reductions by 2030. PARTNERSHIP
 We are determined to implement this agenda through a
PEACE, JUSTICE, AND STRONG INSTITUTIONS global partnership, based on a spirit of global solidarity,
 We cannot hope for sustainable development without focused in particular on the needs of the poorest and most
peace, stability, human rights and effective governance, vulnerable and with the participation of all countries, all
based on the rule of law. stakeholders and all people.
 Yet our world is increasingly divided.

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