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 Table of Contents  
Year : 2015  |  Volume : 59  |  Issue : 3  |  Page : 239-241  

Public health beyond the millennium development goals

1 Research Assistant, Manipal Centre for Virus Research (MCVR), Manipal University, Manipal, Karnataka, India
2 Assistant Professor, Manipal Centre for Virus Research (MCVR), Manipal University, Manipal, Karnataka, India

Date of Web Publication7-Sep-2015

Correspondence Address:
Hindol Maity
Research Assistant, Manipal Centre for Virus Research (MCVR), Manipal University, Manipal, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-557X.164673

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How to cite this article:
Maity H, Dowarha D, Mudgal PP. Public health beyond the millennium development goals. Indian J Public Health 2015;59:239-41

How to cite this URL:
Maity H, Dowarha D, Mudgal PP. Public health beyond the millennium development goals. Indian J Public Health [serial online] 2015 [cited 2022 Dec 2];59:239-41. Available from:

"Pioneering spirit should continue, not to conquer the planet or space . . . but rather to improve the quality of life." - Bertrand Piccard.

According to the United Nations' World Health Organization (WHO)'s definition of public health, it is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals." [1] Ironically, despite several diseases being preventable and treatable, significant portions of the developing continents still remain afflicted, with little/no signs of improvement. Negligence toward maternal and child health, fuelled by poverty and malnutrition, are among the painful truths imposing serious concerns on the face of growing economies. The world is confronting issues related to public health on a routine basis. Emerging and reemerging infectious diseases, such as Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and Ebola Virus Disease (EVD), ambiguities in health insurance programs, upsurge in childhood obesity and type II diabetes, and health challenges post natural disasters/calamities/war have emerged as key concerns influencing public health.

The topic "Public Health Beyond the Millennium Development Goals" compels us to look at a big picture with a microscopic lens to probe into the minute details of the staggering issues that every country on this planet is facing today, which is tackling its people's health. The twentieth century culminated with the dawn of the United Nations' Millennium Declaration, presenting an agenda to achieve the eight Millennium Development Goals (MDGs) by 2015. These targets were primarily focused on poverty eradication, improvement of maternal and child health, and overall advancement of nations. The colossal health challenges confronted by the world's underdeveloped economies, together with the ambitious drive behind these goals, witnessed the birth health initiatives such as the Integrated Management of Childhood Illness, Global Alliance for Improved Nutrition, Global Alliance for Vaccines and Immunization, and the Global Fund to Fight AIDS, TB. Indeed these initiatives apparently improved public health; however, on the global canvas, the change has not been quite remarkable. As observed from the WHO reports on HIV deaths, there has been a marginal reduction from 1.7 million (3.2%) deaths in 2000 to 1.5 million (2.7%) deaths in 2012. [2] Approximately, 1.5 million lives succumbed to diarrhea in 2012 itself, though the disease has moved from the fifth to the tenth position in causing death. [2] The MDGs nowhere talk about counteracting the worldwide leading causes of death such as ischemic heart disease, stroke, lower respiratory infections, and chronic obstructive lung disease. Under these circumstances, achieving the MDGs' health targets by 2015 seems at stake.

The roads to effective health systems in every governance and worldwide economies confront hurdles related to human resources, funds, therapeutic drugs and supply systems, and creation and dissemination of information. These hurdles lead to failure in the practical implementation of successfully planned health schemes. The instrumental lead player in directing a country's health policies is its government. Government strategies considerably influence public and private health sectors; therefore, reformations are sought at this rudimentary level in the very first place to witness an overall transformation in the country's health profile. Strategic management in the health sector policies is required to ensure preparedness for tackling nationwide health-related issues or unexpected health crises. To fulfil this gigantic task we require political commitment to issues governing health, overcoming financial crises, judicious bifurcation of resources, synchronization between health and financial sectors, coordination between funding agencies, non-governmental organizations and government organizations in providing health services, imposition of strict legislative regulations on public and private stakeholders, and deployment of monitoring systems for gathering information from public and private sector and using it effectively in improving health services. In the current scenario, it can be very well argued that alongside increasing expenditures on health, strengthening the policies and institutions within and beyond the health sector is also important. A serious transformation is sought in the health services delivery systems as well. The focus should be on building an infrastructure that will be capable of providing equal medical facilities to all the classes of the society. However, stigma associated with infectious diseases and socioeconomic/gender influences on behavior, access, and use of care have been found to markedly impede the health progress throughout the socioeconomic strata. Deploying a well-balanced systemic approach, contributing to overall system strengthening needs to be considered. This will facilitate capacity building for efficient execution of health goals in a timely manner.

Public health infrastructures are in a nascent phase in many developing countries, lacking adequate trained health personnel, and financial sources, thus, failing to deliver even a primary level of medical facilities. Consequently, a vicious circle of disease associated morbidities and mortalities, resulting from and contributing to extreme poverty and malnutrition, is created. Considering the disparity that exists in accessing health care facilities and implementing public health initiatives, the developed countries need to come to the aid of the developing nations to strengthen their economies and health structures. Adopting an interdisciplinary approach toward global public health needs to be considered seriously for the betterment of future generations. Inputs of professionals hailing from health services, epidemiology, biostatistics, medical insurance companies, and disaster management may be put together to design a practically feasible, result-oriented health plan.

Dealing with the day to day routine diagnosis of several infections gives us an advantage to examine the current scenario of diseases from a wide angle. It can be clearly quoted here that "Humans are standing at the brink of emerging and reemerging infections." In order to predict, avert, or mitigate these events, a field and laboratory research initiative, rather than a routine surveillance and reference diagnostic approach, is required for catering to global public health needs. The "One-Health approach," imbibing collaborative efforts of multiple disciplines, working locally, nationally and globally, to attain optimal health for people, animal, and environment, [3] incorporating the biosecurity issues, is the need of the hour. This may be the most cost-effective and efficient approach to address the threats posed by emerging viral infections to global health.

In regards to zoonotic diseases such as EVD, SARS, H1N1, H5N1, and Rabies., a perpetual lack of awareness exists among common people, which indicates that, in order to prevent an outbreak, more than taking appropriate public health measures, spreading correct information about the disease and its consequences is equally important. On that note, it will not be entirely wrong to quote here that public-private partnership can be instrumental in spreading awareness, about diseases looming at the human-animal interface, among the people. Sociological aspects related to certain disease epidemics should be addressed sensitively. In addition, there is a need to fight rumors and hoax calls regarding disease outbreaks. Health also encompasses "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity," as quoted by the WHO. However, increasing addiction to smoking/alcohol/drugs together with the growing number of depression cases among the new generation strongly hampers the mission of "complete health."

The focus of public health intervention should be on improving health and quality of life by adopting four core strategies, which are promoting of hygienic practices, refraining from deteriorative addictions, disease management, and ecosystem surveillance. This will transpire the much awaited dream of "health for all" into reality, which will sustain for many millennia to come. Complementing good health, every country should aim at achieving the well-being of its citizens.

Well-being is a more pragmatic approach to health and life, which encompasses mental, physical, cultural, and spiritual health and is of the utmost importance in achieving positive life outcomes. This is also a principle of the Ayurveda, a system of Hindu traditional medicine of Vedic tradition. On this note, the United Nations adopted Indian Prime Minister Mr. Narendra Modi's proposition and declared June 21 as the "International Yoga Day," as a recognition of ancient India's "holistic approach" to health and well-being. With the foresight of the great historians who brought public health to life, every nation should not only aim but achieve good health for its inhabitants.
"For he who has health has hope; and he who has hope, has everything." Ϳ Owen Arthur.

   References Top

Winslow CE. The untilled fields of public health. Science 1920;51:23-33.  Back to cited text no. 1
World Health Organization. The top 10 Causes of Death. Media Centre; 2014. Fact sheet no 310.  Back to cited text no. 2
Calistri P, Iannetti S, Danzetta ML, Narcisi V, Cito F, Sabatino DD, et al. The components of 'One World - One Health' approach. Transbound Emerg Dis 2013;60 (Suppl 2):4-13.  Back to cited text no. 3


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