Top 10 Global Health Threats in 2019

The top threats include "vaccine hesitancy," which is based on fraudulent research and has done extraordinary damage to public health.

The World Health Organization recently released its list of the Top Ten global health threats in 2019. Making that list is "vaccine hesitancy." This includes parents who don’t get their children vaccinated from 100%-preventable, highly contagious diseases for personal liberty or religious reasons. Others include people who are simply too confused, too busy or badly misinformed and thus won’t get the annual flu shot. Why is WHO so concerned? It’s simple—the anti-vaccination movement has done incredible harm to the field of public health. WHO research estimates that vaccines prevent between 2-3 million deaths worldwide each year and that another 1.5 million children could be saved from preventable deaths such as the measles and diphtheria. Louis Pasteur and Florence Nightingale are turning over in their graves. As a small child, I participated in one of the greatest public health success stories in American history. I got the polio vaccine. Polio had been around since the start of recorded history. In 1952, there was a nationwide polio epidemic, with 58,000 new cases. With the advent of the first polio vaccine in 1955, developed by American medical researcher Jonas Salk, the number of new cases dramatically decreased to fewer than 6,000 by 1957. Another medical researcher, Albert Sabin, developed an oral vaccine (a sugar cube with the vaccine) in the early 1960s. I got the oral vaccine in 1962 with all the other kids in my neighborhood. Polio has since been virtually eliminated in the U.S. WHO reported only 22 cases world-wide in 2017, mostly in remote places controlled by the Taliban. Today, the polio vaccination program would be met by widespread resistance. The anti-vaccination movement would insist that the polio vaccine gives you polio. There are anti-polio vaccine researchers today who believe that the vaccine does not work and that the declining numbers are due to underreporting, manipulation of data and simply better sanitation. Really…? See also: Bridging Health and Productivity at Work   The anti-vaccination madness began in earnest when British medical journal the Lancet published an article using purported research linking the MMR vaccine (measles, mumps and rubella) to autism in children. The supposed link between the MMR vaccine and autism was later declared by the publisher of the Lancet to be “the greatest public health hoax in the past 100 years.” ( See, "To Be or Not To Be (Vaccinated)" The major problem is that recent surveys have shown that 30% of American adults still believe the link to be true. The measles, which is a highly contagious and dangerous disease, was once an epidemic in America. I got my lifetime immunity the hard way—I had the measles. Due to the development of the MMR vaccine, the measles was officially eliminated in America by the Centers for Disease Control and Prevention (CDC). However, the world-wide scare due to the hoax linking MMR to autism, and the false belief that the measles is not dangerous, has reared its ugly head and led to the WHO reporting a 30% increase in measles cases worldwide. There have now been a handful of measles hot spots reported in the U.S. in the past couple of years. Just recently, it has been reported that a person infected with the measles at a Portland Trailblazers NBA game has left at least 36 people infected in neighboring Washington state. A measles outbreak occurred in New Jersey in December that spread to two counties and that has been 100% linked to anti-vaccination sentiments and beliefs. This "vaccine hesitancy" threat is directly linked to another Top 10 global health threat: the fear of a global influenza pandemic. Unlike with polio or the measles, many different strains of the flu circulate around the world each year that have the potential to mutate into strains never seen before. The anti-vaccination sentiment contributed significantly to last year’s flu epidemic in the U.S. that killed 80,000 Americans, including 185 children. CDC research shows that 85% of children who die from the flu each year were not vaccinated. A recent survey performed in November by NORC, a research organization at the University of Chicago, found that 40% of adults in America do not plan on getting the flu shot this flu season (2018-2019). The CDC also estimates that up to 100,000 children will not be vaccinated against the flu this season. The scientific facts include that adults are five times more likely to die from complications from the flu, such as pneumonia, if they don’t get the flu shot. In addition, the flu shot prevents deaths in 65% of otherwise healthy children. CDC studies in the 2016-2017 flu season found that the flu shot prevented 5.3 million illnesses, 2.4 million medical visits and 85,000 hospitalizations. The biggest myth continues to be that the flu shot can give you the flu. I’ve heard people swear to it. Yet it is a scientific impossibility. It takes up to two weeks for the flu shot to take effect. So, people who get the flu after getting the shot either got the shot too late or they caught an entirely different strain of flu. Some people do experience a mild reaction to the flu shot. This actually means it is working. Everyone over six months should get the flu shot. Public health researchers state that even people who are allergic to the flu shot should get vaccinated, but only in a medical office or hospital where they can be monitored for a reaction. Flu season typically peaks in February, so there is still time to get the flu shot to help prevent serious illness—especially among the elderly, and infants less than six months who are exposed to a contagious person. See also: Focus Areas for Insurers in 2019   The WHO 2019 report shows that public health officials are deeply concerned with the potential for new outbreaks of vaccine-preventable diseases like the measles, diphtheria and influenza. What else is there to be concerned about? You name it: Air pollution and climate change are considered the greatest environmental risks to health. The primary cause of both is the burning of fossil fuels. Non-communicable diseases such as diabetes (See, "Diabetes: Defining Moment of a Crisis"), cancer and heart disease will account for 70% of the deaths this year worldwide, or roughly 41 million people. Rounding out the WHO Top 10 Global Health Concerns for 2019 are: anti-bacterial resistance due to the overuse of antibiotics; HIV; dengue fever; Ebola; fragile and vulnerable geographic locations where a quarter of the world population lives; and the overall lack of primary healthcare around the world. Stay tuned. I would like to thank my medical research assistant Chandler Berke (B.S., public health, and 2019 medical school candidate).

Daniel Miller

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Daniel Miller

Dan Miller is president of Daniel R. Miller, MPH Consulting. He specializes in healthcare-cost containment, absence-management best practices (STD, LTD, FMLA and workers' comp), integrated disability management and workers’ compensation managed care.


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