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Reflections on 2023… And thoughts for 2024 and Beyond…

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by Dr. Sebastien Bertin-Maghit, PhD, faculty member at CSII.

Cardiovascular diseases, stroke, high blood pressure, type 2 diabetes, cancer… We are used to considering those as our main health concerns. It is true that such diseases are major causes of deaths and are spreading globally. For example, diabetes was not a big concern in Asia two decades ago; it is now a pressing public health matter. Unlinked from obesity, it is often undiagnosed and is spreading even faster with new lifestyles that include richer food and less exercise.

However, according to the Journal of Public Health Challenges, the ten main concerns for health in 2023 were:

  1. Health systems,
  2. Mental health crises,
  3. Reproductive and sexual health,
  4. Malnutrition and food safety,
  5. Diabetes,
  6. Cancer,
  7. Environmental pollution,
  8. Substance abuse,
  9. Infectious diseases, and
  10. Climate change.

In 2023, we finally left COVID-19 behind us. The diseases associated with SARS-CoV-2 have slowly turned into seasonal infections, more or less similar to the flu in some aspects. But COVID-19 has left deep footprints, and many of the health matters mentioned in that list can be linked directly or indirectly to COVID-19.

The epidemic revealed some defects in our health systems, no matter the level of development and the public money allocated to these services. We saw vulnerabilities in health systems all over the world, in terms of access to health services and treatments. We also saw that very few countries were able to design and manufacture effective vaccines in a short time, and that world cooperation to fight the pandemic was not always as good as expected; nationalistic reflexes are still very much alive.

Image generated by DALL-E 3.

More than the pandemic itself, the measures taken by most governments to tackle it now have repercussions on mental health. This year, mental health became as pressing an issue as cancer. According to WHO, “a great number of people have reported psychological distress and symptoms of depression, anxiety, or post-traumatic stress. And there have been worrying signs of more widespread suicidal thoughts and behaviors, including among healthcare workers.” The young population, in particular, has suffered from isolation and disconnectedness… in this era of social networks, showing us that online socializing cannot replace socializing in real life. The recent surge in substance abuse may not be entirely unrelated to the weakening of our social connections, especially in the youngest populations who are growing up in a world dominated by new technologies and the Metaverse, and who sometimes have difficulties differentiating real reality from virtual reality.

In November 2023, WHO recognized climate change as “one of the greatest health threats for humanity.” Heatwaves have posed public health issues, especially for the elderly, in temperate areas for a few years now. Climate change is also connected to the emergence or re-emergence of infectious diseases and the changing distribution of pathogenic agents’ vectors. The impact on water resources is also affecting health through access to clean water and food, and hence healthy nutrition.

Yes, cancer and diabetes are still major health issues… It could almost be reassuring for biomedical scientists to feel that there are still some “comfort zones” in their health R&D journey. The advances in biotechnology, the development of innovative biologics and other small molecules have led us to the threshold of a world without AIDS and with curable cancer. But it will not be enough to guarantee good health in the future.

In 2024, we must rethink and reorganize health into a more integrated and holistic manner: it was not always easy to bring medical practitioners, mental health workers, biomedical scientists, and technologists all together to work jointly on health matters. We now must work on another level, considering matters that were only indirectly considered by people in the health sector, such as climate change, access to clean food, city planning to promote social connection, and fast infection dissemination prevention…

COVID-19 taught us that we could overcome a global health threat; it also showed us that there was still much to do to be better prepared for the next pandemics. In future years, the focus cannot be only on disease control but also on all disease’s implications at many different levels and on prevention. The best medicine is not getting ill…

As it is time we extend our greetings for 2024, it is traditional to wish others good health for the year to come. Let’s keep in mind what we have to do to make this wish possible for many years to come and for the next generation.

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