The speaker for this year’s Southwood Memorial lecture - Professor Christopher Dye of the World Health Organization – could hardly have been more suited to the occasion. Not only did Prof. Dye complete his DPhil from this Department of Zoology led by Dick Southwood some three decades previously, but it was Southwood himself who directed Dye the student to work on Aedes aegypti mosquitoes, the infamous vector of yellow fever, dengue fever and now - tragically – zika virus.
To my mind (confession: I am a mosquito nerd), this DPhil work was a pioneering study of density dependent regulation in mosquitoes, a process that is so important to mosquito borne disease transmission, yet it remains poorly – shockingly – understudied. I, for one, was thus pleased that the lecture began with mosquitoes!
The remainder was a compelling personal tour of some of the challenges the WHO has addressed over the last 25 years. Through numerous case studies, Chris explored themes including science communication to health policy makers; public health investment; affordability of drugs; global trends in public health; and sustainability in public health.
Chris initially joined the WHO to work on TB. It was fascinating to learn that the simple matter of the WHO producing a list of countries worst-affected by TB caused controversy in countries both included and not included (!), yet raised the profile of the disease in parts of the world where it was needed. Unfortunately, TB remains a huge challenge and the development of universal health coverage in developing countries – a major goal of WHO advocacy – will be crucial to reducing TB mortality.
A recurrent theme was how to bring attention to critical health issues. The movement to develop a common framework for addressing Neglected Tropical Diseases, led by the WHO and initiated in 2007, has been extremely helpful in raising the profile of these diseases. Headline statistics have been surprisingly effective in alerting the world to the dangers of both urban air pollution and anti-microbial resistance. However, Chris expressed doubts to the accuracy of the latter statistic (not produced by the WHO), raising thorny questions of accountability in health projections.
Chris stressed the importance of a holistic view to understanding and tackling global health. For example, child mortality has been steadily reducing in the previous 65 years, and the reductions in low-income countries have accelerated in the past two decades. The Millennium Development Goals (MDGs of 2000-15) were given credit for this improvement, though not only because of associated improvements to health systems per se. The contributions from numerous other factors, including female education and economic development, were also significant. Looking ahead from the MDGs to the Sustainable Development Goals, a key focus of WHO attention is to ensure health programmes are both equitable and sustainable.
I believe the audience thoroughly enjoyed this wide-ranging talk, and we thank Chris for giving it.
Dr Ace North is a post-doc working on the population dynamics and control of Anopheles mosquitoes.