Leaders of the Millennium Development Goals

During my post-graduate education, I attended a session that strived to provide a context for the numbers that we were exposed to every day. In global health, we are constantly in discussions where figures such as millions, billions, and trillions are part of the lexicon. Few of us can truly picture what a million looks like, let alone conceptualize a trillion. We can all understand the number one. In this issue of the GHD Journal, the number one weaves its way into many of the diverse topics discussed by our contributors. It ties together many of the challenges that remain in providing care for the health of our world’s population.

Infectious diseases remain an important threat to health populations. Despite advances in prevention, diagnosis and treatment, countless people still die from infections every year. Periodically certain pathogens rise in prominence in the public view and draw attention to the complex challenges that exist in disease control and eradication in the global village in which we live. The rapid spread of Ebola mobilized the world. While the economic impacts of Ebola can only be measured in unthinkably large numbers, the success of a coordinated effort to control and treat the disease can be measured in one final patient being discharged from a hospital in Sierra Leone. Lest we become complacent the need for vigilant surveillance for re-emergence of Ebola can be measured in one new case arising six days later.

One of the Millennium Development Goals was the reduction in child mortality (MDG4). This laudable goal has led to the investment of billions of dollars and has allowed hundreds of millions of children to survive to healthier adulthoods. However, challenges still exist. Four out of five children receive the necessary vaccines to support healthy development. One child remains unvaccinated. This fact highlights the continued need to continue to improve the supply chain for securing and delivering vaccines to one of our most previous and vulnerable populations.

The emerging impact of non-communicable diseases (cancer, diabetes, cardio-vascular disease) on populations has created new challenges across the globe. These challenges include disease prevention and control, improvement in access to care, and improved treatment outcomes. The urgency of addressing NCDs such as cancer means that no one treatment can be globally applied. Rather there is a need to develop a method for delivery of individualized treatment to the one patient. This represents an enormous challenge when scaled globally. This issue of GHD highlights some of the valuable collaborations between private sector medical technology companies and the public sector to bring state of the art diagnostics and therapeutics to underserved populations.

As we prepare to work towards the Sustainable Development Goals, we must not allow our vision to get clouded by the billions of people at risk and trillions of dollars of financing needed to achieve these goals. We have to remember to maintain focus on the one mother raising one healthy child, one fewer HIV/AIDS patient, and one more cancer survivor.

— Joanne Manrique

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