If I were to say that I had all the resources, the knowledge and the data to give you information on ‘how healthy the world is’, what would you really like to know? Would you like to know if we could have controlled Ebola earlier? Would you like to know how being more healthy has impacted income levels and hence standard of living in developing countries? Or does it just matter to you that we are making progress on the MDG’s?
It’s a monumental question and there is no dearth of information to answer all of these questions, but its important we know the scope and boundaries of what we really matters.
At the risk of oversimplifying how we may define this better, I would like to start by focusing on some very relevant data on child health from the State of the World’s Children 2014 Report – an area we have relatively the most up to date information in. What stands out to me, as part of this report is data that allows me to compare what progress really means in child health:
– ‘About 90 million children who would have died if mortality rates had stuck at their 1990 level have, instead, lived past the age of 5.’
– ‘Deaths from measles among children under 5 years of age fell from 482,000 in 2000 to 86,000 in 2012, thanks in large part to immunization coverage, which increased from 16 per cent in 1980 to 84 per cent in 2012.’
– ‘Nearly 1.9 billion people have gained access to improved sanitation since 1990.’
Similarly, The World Health Statistics 2014 report reveals very interesting comparisons:
– ‘Life Expectancy: Low-income countries have made the most significant progress, with an increase of 9 years of average life expectancy between 1990 and 2012 – from 51.2 to 60.2 years for men and 54.0 to 63.1 years for women.’
– ‘In the past decade almost every country in the world experienced a major shift away from premature deaths due to infectious diseases and towards non communicable diseases and injuries. Countries are at very different stages of this epidemiological transition. On average, in the WHO African Region, 70% of all years of life lost are due to infectious diseases and maternal, neonatal and nutritional causes. In high-income countries, these causes now account for only 8% of all years of life lost.’
These comparisons allow us to draw conclusions on how much the needle has moved and help us get a broad sense on how healthy the world is as compared to how healthy it was. If we take a closer look, the data behind this gives us more specific information on what is working well and what is not. The reason there is so much focus on the accuracy and relevancy of data is primarily what comes after that – what programs can be implemented at scale to improve child and maternal health, what best practices can we learn from polio elimination drives that can be replicated to solve similar problems and what health services must be provided in developing countries to suit life expectancy.
It’s crucial we look at historic data and track progress over decades on various efforts made to improve health, but it is also important for us to be able to predict how healthy we will be in the future. Millions of dollars are spent on predictive models where companies can somewhat accurately predict an art of choice and tastes of individuals based on a network and their interaction with the network. Big Data, predictive analysis – things we read often about enough for us to worry about our privacy settings and what we share online. Health is a science and is less abstract. It should be possible for us to tell how healthy the world will be in the next 20 – 50 years based on all the historic data we have, or at least to begin with focus on a more specific geography where we have the most relevant and recent information and where people are at the highest risk of poor health in the future – such as West Africa.
WHO released a report back in 2005 on using climate change to predict epidemics and Nicholas Christakis is his TED Talk in 2010 talks about this concept. For us to be able to respond to the question adequately on how healthy the world is, its important to know the past, the present and the future. If Google could predict how many people will be online by 2020, there has to be a way to say more about how healthy the world will be in the future.