UNGA: Progress in Global Health Shows the Path to a Safer, More Secure World

19 September 2024

As the world gathers for the United Nations General Assembly in New York this week, the focus on the interconnected crises the world faces underscores a critical truth: Today’s challenges are inextricably linked to global health. Many of the General Assembly’s key events – including the high-level meeting on antimicrobial resistance and the Summit of the Future, which aims to reaffirm commitments to the Sustainable Development Goals (SDGs) – highlight the urgent need to not only respond to immediate health crises but also address their underlying causes.

From climate change displacing communities and increasing exposure to diseases, to antimicrobial resistance undermining decades of medical progress, the challenges we face are complex and interconnected. However, our experience fighting the world’s deadliest infectious diseases is instructive. Over the last two decades, investments in the fight against HIV, TB, and malaria, and in enhancing health and community systems in low- and middle-income countries, have saved millions of lives and helped create a more equitable world. That experience shows us that the path to a safer, more stable world runs through global health.

Worldwide efforts to fight the three diseases have made a remarkable impact in the last two decades. In 2001 – the year before the Global Fund was founded – AIDS, TB and malaria killed a staggering 4.6 million people globally. A new Global Fund report shows that those deaths have dropped by about half to 2.4 million. Global inequality in life expectancy across countries declined by one-third between 2002 and 2019. Reduced mortality from HIV, TB, and malaria accounted for one-half of this decline.

The new report shows that over the last two decades, efforts to combat the three diseases have saved 65 million lives in countries where the Global Fund invests. In those countries, the combined death rate from AIDS, TB and malaria has fallen by 61% over the same period.

Noelia Sosa, Anastacio Dermott and their children Maria Jose and Isaias at their home in San Pedro, Paraguay. Anastacio, Maria Jose and Isaias were tested and treated for TB. The Dermott Sosa family is a success story in TB treatment, the father is still in treatment but his two children are recovered after one year of medication. Photo: The Global Fund/Johis Alarcón/Panos

Those are not mere numbers. Each of the 65 million lives saved is a family member, a friend, a neighbor, a teacher, a worker. Every life saved has a multiplier effect across families, communities and entire nations. Every infection averted not only improves people’s health but also reduces the burden on health care systems, fostering economic stability and supporting social cohesion.

While saving millions of lives is a powerful achievement, there is clear evidence that fighting HIV, TB and malaria and building health and community systems delivers gains far beyond reducing deaths. Sharp reductions in morbidity from the three diseases result in less time off work or school and overall improvement in the health and well-being of communities. For example, in 2023, HIV investments in countries where the Global Fund invests freed up 174 million hospitalization days that would have otherwise been used for HIV-related activities and averted 154 million outpatient visits, generating US$9.5 billion in cost savings.

Despite these hard-won gains and a remarkable recovery from the setbacks caused by the COVID-19 pandemic, the fight against HIV, TB and malaria is far from over. A combination of crises is stifling progress toward the SDG 3 target of ending the three diseases by 2030 and risks deepening global health inequities.

Climate change is destabilizing the foundations of human health, driving extreme poverty and leading to the emergence and spread of infectious diseases. It is the biggest global health challenge of our time and a rapidly escalating threat to efforts to defeat the three diseases.

Sirajul Islam wades through a flooded area with his 6-year-old daughter, Sumaiya, near the spot where their family home once stood in the village of Sreeula in Bangladesh. Every year, hundreds of thousands of people in Bangladesh leave their homes because of climate-related disaster and settle in cities, where inadequate hygiene and crowded conditions can fuel the spread of tuberculosis and other diseases. Photo: © UNICEF/UNI424978/Sokhin

Intense conflict, widening humanitarian crises and political turmoil in many countries are disrupting HIV, TB, and malaria programs and diminishing health system performance, with devastating consequences for the poorest and most vulnerable communities.

The rise of interconnected anti-rights and anti-gender movements, alongside shrinking civic spaces, is preventing those most at risk of HIV, TB and malaria from getting the services they need.

Antimicrobial resistance is increasing humanity’s risk of being confronted with pathogens impervious to lifesaving medical tools, undermining the effectiveness of antibiotics and HIV, TB and malaria treatments and jeopardizing billions of lives.

These challenges are truly enormous. But the extraordinary achievements of the fight against HIV, TB and malaria – millions of lives and livelihoods preserved, and billions of dollars in health costs saved – prove that fighting these diseases makes the world more equitable and better equipped to withstand and respond to current and emerging threats.

Ramping up our response to HIV, TB, malaria and other major infectious diseases is an urgent imperative in today’s challenging context of interconnected crises.

Building equitable access to innovation is a key part of this response. Executing market-shaping strategies to ensure equitable and affordable access at scale is critical for ensuring biomedical innovations reach those who need them as quickly as possible.

To accelerate progress, we must also significantly scale up investment, strengthen political will and tackle human rights and gender-related barriers to health. Failing to do so risks perpetuating the threat of infectious diseases, costing lives and overburdening fragile health systems.

The discussions at the United Nations General Assembly provide a platform to galvanize international cooperation and commitment. When United Nations member states seize the opportunity to accelerate progress to end AIDS, TB and malaria, they will be able to simultaneously strengthen health resilience worldwide and ensure that health systems are prepared to face evolving global health challenges. By taking bold action now, we can end these diseases and build a healthier, safer and more equitable world for all.

This op-ed was originally published on Forbes.