Received: 16 February 2023 Accepted: 12 April 2023

DOI: 10.1002/puh2.86

RESEARCH ARTICLE

Top 10 public health challenges to track in 2023: Shifting focus

beyond a global pandemic

Don Eliseo Lucero-Prisno III1,2,3 Deborah Oluwaseun Shomuyiwa4,5

M. B. N. Kouwenhoven6 Thinley Dorji7 Goodness Ogeyi Odey8
Adriana Viola Miranda9 Isaac Olushola Ogunkola8 Yusuff Adebayo Adebisi10
Junjie Huang11 Lin Xu12 Joseph Christian Obnial13 Aminath Huda14
Sarawut Thepanondh3 Manuel Millar Dayrit15 Salvador B. Evardone16
M. D. Lamawansa17 Samrawit Solomon Ethiopia18 Lydia Aziato19
Philip Baba Adongo20 Mohamed Hindolo Samai21 Fernando B. Garcia Jr22
Joselito F. Villaruz23 Indika Mahesh Karunathilake24 Hao Li25
Patrick Alain Azanza26 Ian Findlay27 Martin C. S. Wong11
1
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
2
Faculty of Management and Development Studies, University of the Philippines Open University, Los Baños, Laguna, Philippines
3
Faculty of Public Health, Mahidol University, Bangkok, Thailand
4
Faculty of Pharmacy, University of Lagos, Lagos, Nigeria
5
Global Health Focus Africa, Lagos, Nigeria
6
Department of Physics, Xi’an Jiaotong-Liverpool University, Suzhou, China
7
Department of Internal Medicine, Central Regional Referral Hospital, Gelephu, Bhutan
8
Department of Public Health, University of Calabar, Calabar, Nigeria
9
Global Health Focus Asia, Bandung, Indonesia
10
Nuffield Department of Population Health, University of Oxford, Oxford, UK
11
JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, SAR China
12
Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
13
East Avenue Medical Center, Quezon, Philippines
14
School of Medicine, The Maldives National University, Malé, Maldives
15
Ateneo School of Medicine and Public Health, Manila, Philippines
16
Eastern Visayas Regional Medical Center, Tacloban City, Philippines
17
Department of Surgery, Teaching Hospital Peradeniya, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka
18
School of Public Health, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
19
Department of Adult Health, School of Nursing, College of Health Sciences, University of Health and Allied Sciences, Volta Region, Ghana
20
Department of Social and Behavioural Science, School of Public Health, University of Ghana, Accra, Ghana
21
College of Medicine and Allied Health Sciences, Freetown, Sierra Leone
22
College of Public Health, University of the Philippines, Manila, Philippines
23
West Visayas State University, Iloilo City, Philippines

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original
work is properly cited.
© 2023 The Authors. Public Health Challenges published by John Wiley & Sons Ltd.

Public Health Chall. 2023;2:e86. wileyonlinelibrary.com/journal/puh2 1 of 9

https://doi.org/10.1002/puh2.86
 27692450, 2023, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/puh2.86 by Cochrane Poland, Wiley Online Library on [03/12/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
2 of 9 LUCERO-PRISNO ET AL.

24
Department of Medical Education, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
25
Global Health Institute, Wuhan University, Wuhan, China
26
Office of the University President, Catanduanes State University, Virac, Catanduanes, Philippines
27
University of Puthisastra, Phnom Penh, Cambodia

Correspondence
Deborah Oluwaseun Shomuyiwa, Faculty of Abstract
Pharmacy, University of Lagos, Lagos, Nigeria. The year 2022 saw COVID-19 as the primary public health concern, with vaccine
Email: [email protected]
rollout and mandates at the forefront. Other viral infectious diseases, such as Mon-
keypox and Ebola, emerged as public health concerns. Climate change and political
conflicts significantly impacted global health, increasing the demand for human-
itarian assistance and protection. In 2023, it remains crucial to identify global and
public health priority areas to coordinate and implement effective solutions. Through
discussions with public health practitioners and researchers, we have identified key
priority areas for 2023, namely, health systems, the mental health crisis, substance
abuse, infectious diseases, malnutrition and food insecurity, sexual and reproductive
health challenges, environmental pollution, the climate crisis, cancer, and diabetes.
These priority areas highlight shared concerns that should be addressed to facili-
tate proactive and innovative health interventions and practices. To achieve universal
healthcare targets for 2030, prioritization, financial investment, international cooper-
ation, and collaboration in addressing these global health challenges are crucial. This
requires coordination among public health decision-makers, the private health sec-
tor, and opinion leaders to implement country-specific healthcare financing and food
security measures. Research, scientific knowledge, and technical capacities must be
leveraged to produce sustainable interventions that effectively reduce health dispar-
ities and improve health system responsiveness to prevent these challenges from
progressing to public health emergencies.

KEYWORDS
global health, health challenges, health priorities, public health

INTRODUCTION projected, the consequences of the climate crisis were notable

in 2022, with countries in Europe experiencing their hottest
As the New Year begins, response measures to public summers [3], deadly floods in Pakistan and Nigeria, and
health challenges are crucial for global human development. widespread droughts across Africa [4], Sexual and reproduc-
COVID-19 was the main focus in 2022, with the rollout tive health rights were fiercely debated with the landmark
of vaccines and vaccination mandates at the forefront. The ruling of the US Supreme Court to overturn Roe v. Wade. The
potential for herd immunity in the light of emerging virus 2022 list of global public health challenges also projected the
variants and the evaluation of the transmission-stopping capa- already obvious high requirement for humanitarian assistance
bilities of available vaccines was a major concern. Other viral and protection due to political conflicts and natural disasters.
infectious diseases such as Ebola and Monkeypox also repre- The world will continue to experience an influx of global
sented significant global public health concerns [1]. Political health challenges in 2023. To proactively plan for and address
conflicts, such as the Russia–Ukraine conflict, had global these complex issues, it is crucial to identify global and public
impacts, leading to soaring food and energy prices, migrant health priority areas. This allows the global community to
and refugee crises, inordinate health systems effects, and a coordinate, implement, and scale up local and international
potential nuclear disaster [2]. collaborative actions. Identifying these important challenges
The 2022 list of global public health challenges [3] is integral to monitoring and developing policies to address
included COVID-19, human resources for health, health these health risks, focusing on lessening the burden in low-
financing, conflict and humanitarian crises, mental health, and middle-income countries (LMICs).
poverty, climate change, child health, reproductive health, In developing this study, we engaged public health practi-
and the global infodemic. Responses to COVID-19 and tioners, experts, and researchers across sectors in discussions
emerging infectious diseases drove the concept of col- to identify and prioritize global public health priorities for
laborative intelligence, optimizing disease surveillance and 2023. Corroborating the responses with existing literature,
developing capacity for locally manufacturing vaccines. As we provide analysis and evidence to support public health
 27692450, 2023, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/puh2.86 by Cochrane Poland, Wiley Online Library on [03/12/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
TOP 10 PUBLIC HEALTH CHALLENGES 3 of 9

priority areas for 2023. These highlight shared concerns fac- lic health emergencies and early identification of people
ing human health and development that should be addressed requiring clinical care [6].
to facilitate proactive, collaborative, and innovative health
interventions and practices.
Mental health

Health systems One of the lasting impacts of the COVID-19 pandemic is the
decline in mental health. Historically, mental health and dis-
Healthcare systems are crucial in implementing health orders were not a global health priority, focusing more on
actions that promote population health and Sustainable communicable and noncommunicable diseases [13]. In many
Development Goals (SDGs). However, achieving universal countries, the management of mental health disorders has
health coverage (UHC) is impossible without the proper been isolated from conventional healthcare, with little fund-
actions to strengthen health system challenges, especially in ing relative to the disease burden [14]. Mental health concerns
developing countries. The COVID-19 pandemic has exposed have risen post-pandemic, with an incidence level higher than
the weaknesses in many health systems across high-, middle- cancer [15]. There were disruptions in the delivery of mental
, and low-income countries. It has led to the overburden of healthcare and suicide prevention services during the pan-
healthcare systems and human resources for health, limit- demic. The 2022 WHO World Mental Health report indicated
ing the capacity of the systems to deliver essential services that the COVID-19 pandemic triggered a 25% increase in the
to communities [5]. Inadequate access to healthcare systems global prevalence of anxiety and depression [13]. The com-
is a threat to global health: At least 50% of the world’s binations of factors such as the rising cost of living, ongoing
population does not have access to the essential healthcare global conflicts, and the impact of climate change are driv-
services they need [5]. In addition, due to uninsured medical ing the epidemic of anxiety and depression worldwide. The
costs, nearly 100 million individuals have been forced into Russia–Ukraine conflict is estimated to have put nearly 10
extreme poverty annually due to the burden of out-of-pocket million people at risk of mental health disorders like acute
expenditures [6]. stress, anxiety, depression, and post-traumatic stress disorder
Health systems challenges vary across the globe, with [16].
developing countries experiencing more problems in health The global community must act toward the inclusion
financing, health workforce development, infrastructures, and funding of mental health support programs that extend
supplies, healthcare information systems, and other vital beyond the pandemic. Despite countries only allocating less
aspects [7]. Developed countries also experience significant than 2% of national health budgets to mental health, fund-
gaps in health systems concerning prescription drugs, the ing has been received from both domestic and international
high costs of long-term care, mental health services, den- contributions [17]. These must then be used to promote new
tal services, and eye care [8]. Chronic global shortages of models of interventions that integrate mental health support
health workers are also prevalent due to an uneven supply of throughout the healthcare continuum. This transformation
healthcare workers across countries further compounded by a will strategically position mental healthcare and provide more
significant migration of workers from developing to devel- effective support. The models that can be used include col-
oped countries [9]. Health workforce shortages contribute laborative care models, digital health interventions, and peer
to health inequities, which affect vulnerable populations, support programs.
including women and children, rural communities, and
marginalized groups [10]. This shortage affects the ability
of healthcare systems to deliver essential services, includ- Substance abuse
ing maternal and child health, infectious disease control, and
noncommunicable disease management [11]. Today, alcohol and tobacco are legal and easily accessible
At a time when countries have yet to recover from the to adults in most countries. However, substance use, exclud-
impacts of COVID-19, a surge of emerging infectious dis- ing alcohol and tobacco, is responsible for approximately
eases poses significant public health challenges that need to 500,000 deaths annually, with tobacco and alcohol estimated
be adequately addressed [12]. Strengthening Primary Health to result in over 8 million deaths annually [14, 18, 19]. Recre-
Care (PHC) systems becomes vital to address health issues ational drug use was also estimated to be responsible for over
effectively and holistically, especially in regions where phys- 42 million years of healthy life loss (disability-adjusted life
ical access through road and transport is a major problem years, DALYs) in 2017, making up approximately 1.3% of
[6]. PHC is essential for improving a health system’s abil- the global burden of disease (GBD) [18]. It is estimated that
ity to withstand crises by empowering the local community about 11 million people globally inject drugs regularly. This
in safeguarding public health, assisting in the surveillance includes 1.4 million infected with HIV and 5.6 million with
of outbreaks and epidemics, and rapid responses to spikes hepatitis C [18, 19].
in service demand. PHC is the “front door” of the health- Substance abuse and its associated harms have contributed
care system; an efficient PHC system lays the groundwork significantly to the shift from infectious diseases to noninfec-
for improving crucial public health functions to address pub- tious diseases in the GBD [14]. The GBD study estimated
 27692450, 2023, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/puh2.86 by Cochrane Poland, Wiley Online Library on [03/12/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
4 of 9 LUCERO-PRISNO ET AL.

that in 2017, alcohol and drug use accounted for 5.1% and financial support to the public health infrastructure and work-
0.9% of the GBD, respectively [20]. According to the 2021 ing toward alleviating poverty are all crucial components
World Drug Report by the United Nations Office on Drugs of an effective response to emerging and reemerging infec-
and Crime (UNODC), around 275 million people globally tious disease threats. Marked inequalities within and between
used drugs at least once in 2020, an increase of 22% over countries slow down progress in the responses to infec-
the last decade [21]. tious diseases, necessitating interagency and international
To address this serious public health challenge, a more collaborations for research, optimization of surveillance and
proactive and innovative approach is needed, as the tra- response systems, and the shared goal of improving access to
ditional ways of criminalization and punishment have not quality and affordable health services.
been effective. Stakeholders need to scale up funding and
evidence-based harm reduction interventions while increas-
ing access to treatment and support for those struggling with Malnutrition and food safety
substance abuse. Community education programs, recov-
ery support services, and exercise and nutritional-based Malnutrition affects 2.36 billion adults [26], corresponding
interventions expand interventions for addressing substance to approximately 29% of the global population. Malnutri-
abuse. Additionally, a more holistic approach is needed, tion is a major issue among children: It is estimated that as
targeting the underlying social and economic factors that of 2020, stunting (too short for age) incidents reached 149
contribute to substance abuse, such as stigma, poverty, unem- million children under 5 (21%), whereas wasting (too thin
ployment, violence, and conflict. By aligning drug and for height) incidents reached 45 million (6%) [26]. Forty-
substance abuse interventions with the general scope of men- five percent of mortality under the age of 5 is linked to
tal health disorders, we can develop a system of holistic undernutrition, mostly occurring in LMICs [26]. Conversely,
health protection. overnutrition has also become a threat to public health. Glob-
ally, approximately 39% of adults aged 18 years and over
were overweight, and 13% were obese [26]. Malnutrition
Infectious diseases is linked to several socioeconomic factors, such as limited
access to healthy food and a lack of awareness of what
Emerging and reemerging infectious diseases present signif- constitutes a healthy diet. Moreover, a healthy diet is becom-
icant obstacles to improving health in poor communities and ing increasingly unaffordable, with food prices increasing by
have a significant global impact. Pandemics can occur unex- 11% between 2020 and 2021 globally [27]. The COVID-19
pectedly and spread rapidly, with the COVID-19 pandemic pandemic has further increased the incidence of wasting to 60
serving as a reminder of the importance of preparedness million in 2022 due to reduced access to food [28]. The risk
and rapid response to emerging microbial threats [22]. of undernutrition is further heightened due to ongoing con-
Socioeconomic determinants and inequity can influence the flicts, such as the Russia–Ukraine conflict, which has led to
occurrence and spread of infectious diseases, affecting access a 20% increase in food prices globally [27, 28]. Moreover,
to healthcare, sanitation, and nutrition. Poverty and lim- climate-driven disasters have, to some extent, disrupted the
ited access to clean water and sanitation can contribute to food supply chain. All these factors have contributed to a
the spread of infectious diseases such as cholera and diar- more prominent risk of malnutrition in 2023.
rheal diseases [22]. Furthermore, ongoing issues such as Food safety is also a significant public health challenge
HIV/AIDS and malaria have put significant pressure on with almost 1 in 10 people becoming ill after consuming
healthcare systems. contaminated food every year. This disproportionately affects
Although significant progress has been made with regard LMICs and results in a global annual burden of 33 million
to HIV/AIDS treatment, much remains to be done to ensure DALYs and 420,000 premature deaths. The globalization
that all those living with HIV receive the care and treat- of the production and supply of food has caused a wider
ment they need [23]. High-burden countries such as Africa and faster transmission of foodborne pathogens, including
face unique challenges in responding to HIV, including the those that are resistant to antimicrobials [29]. Govern-
risk of transmission through injection drug use, lack of ments around the world have taken a number of measures
accessibility to antiretroviral therapy, and continued social to improve food security and safety. In 2022, the United
stigma associated with drug use [24]. Similarly, malaria Nations (UN) established the Global Crisis Response Group
disproportionately affects the poorest and rural popula- on Food, Energy, and Finance to address crises related to
tions in Sub-Saharan Africa, with disruptions in healthcare the Russia–Ukraine conflict [30]. Funding has been allocated
supply and demand further exacerbating the burden of the to assist countries that are most at risk of famine [31]. In
disease [25]. October 2022, the WHO published the Global Strategy for
The expanding scope of infectious diseases calls for Food Safety 2022–2030, the third published strategy since
improving the quality of primary health services in healthcare 2002 [29]. The strategy emphasizes a One Health approach,
delivery. Resilient and functional primary healthcare sets the involving collaboration and communication among stake-
foundation for boosting health promotion and services focus- holders in food production, processing, and distribution to
ing on preventing infectious diseases. Providing adequate identify and mitigate safety risks, as well as implement
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TOP 10 PUBLIC HEALTH CHALLENGES 5 of 9

improved surveillance, monitoring, and risk assessment Investment in SRHR is critical to surmounting this chal-
systems to prevent, detect, and respond to foodborne ill- lenge in 2023. Communities and governments, especially
nesses. Although the impacts of these efforts remain to those in LMICs, should improve domestic funding for SRHR
be seen in 2023, this holistic approach can help address to increase the present US$6.3 billion annual resources in
food safety challenges more effectively by recognizing the 2020 to the required US$10.8 billion by 2030. A transition
interconnectedness of human, animal, and environmental from the current donor-dependent funding landscape to self-
health. financing systems is necessary to sustain the progress made
in SRHR and global health.

Sexual and reproductive health

Environmental pollution
The unmet needs of sexual and reproductive health can lead to
the illness and death of millions [32]. Some of the major Sex- Globally, there is an increase in the risk exposure for
ual and Reproductive Health and Rights (SRHR) challenges attributable mortality and years of life lost to disability related
include inadequate comprehensive sexuality education (CSE) to environmental pollution, particularly for ambient particu-
[33], gender-based violence [34], teenage pregnancy [3], late matter pollution [42]. The WHO estimates that 7 million
early marriage [35], sexually transmitted infections (STIs) deaths are attributable to the joint effects of environmen-
[36], maternal health [37], unsafe abortion [38], unmet needs tal and household air pollution. It is estimated that nearly
of family planning [39], infertility and reproductive cancers the entire global population breathes air that exceeds the
[40], and poor access to SRHR services [3]. Integrating CSE WHO-recommended guidelines on air particulate matters,
into the national curricula and educational systems is a sig- with LMICs suffering from the highest exposures [44].
nificant challenge for many countries, especially for LMICs The pollution of the environment is a major threat to
[33]. This deficiency is a major driver of adolescent preg- humans, wildlife, and their habitats on land, in waterways,
nancies, estimated to occur annually in 21 million girls aged and in the oceans. The ingestion of microplastics and plasti-
15–19 in developing countries, as approximately 12 million cizers in humans may be associated with infertility, obesity,
of them give birth annually [3, 33]. In addition, more than 12 endocrine dysfunctions, and malignancy [44]. The health
million girls each year get married before reaching the age impacts of using toxic heavy metals such as mercury and lead
of 18 [35]. Although global trends in child marriage have in fuel and paint products continue to be a significant problem
decreased, no region is on track to meet the SDG 5.3 tar- in countries that have yet to adopt appropriate alternatives.
get of eliminating this practice by 2030 [35]. Approximately This is just one aspect of the larger issue of anthropogenic
800 women die daily from pregnancy and childbirth-related pollution, or pollution stemming from human activity [44].
causes, around 45% of all abortions are unsafe, and more Human activities continue to pollute soil, water, and air, often
than 270 million women still have an unmet need for family without adequate monitoring and regulation, particularly in
planning [37, 38]. developing countries. The pollution of the ecosphere harms
Challenges such as gender-based violence and STIs have the health of humans and other living organisms and may
also increased in recent years. Gender-based violence is a sig- also trigger political and security threats. It is crucial that we
nificant challenge that affects one in three women in their take immediate action to address these issues and implement
lifetime [34]. Gender-based violence increased during the sustainable solutions to mitigate the effects of anthropogenic
COVID-19 pandemic, revealing a shadow pandemic of sexual pollution.
gender-based violence and menstrual health inequities [41].
For STIs, the 2019 GBD study depicted an increase in preva-
lence by 58.15% by 2019 from 1990 [42]. Each day, more Cancer
than 1 million people become infected from four curable
STIs: Syphilis, Gonorrhea, Chlamydia, and Trichomoniasis Cancer is a leading cause of death worldwide, accounting for
[36]. By the end of 2021, an estimated 38.4 people were liv- 19.3 million new cancer cases and almost 10.0 million cancer
ing with HIV, and two thirds were from Africa [43]. With the deaths in 2020 [45]. The burden of cancer incidence and mor-
COVID-19 pandemic, the quality and access to services and tality is influenced by various risk factors, including lifestyle
treatment for these diseases have only worsened [3]. habits, environmental factors, and genetics [46]. The lack of
Achieving UHC through improved access to equitable, access to timely access to cancer screening, detection, and
affordable, and nondiscriminatory SRHR information and treatment in many countries contributes to the high mortal-
services is key to improving demographic outcomes and ity rate associated with cancer [45]. Infections also play a
fostering sustainable development. Multistakeholder engage- significant role in cancer incidence, and cancers related to
ments are needed to address these challenges in 2023, infections are potentially preventable. Helicobacter pylori,
particularly through integrating SRHR information and human papillomavirus, and hepatitis B and C viruses are
services into healthcare delivery, educational systems, gen- common infectious agents linked to cancer. However, access
der development, climate action, sociopolitical/community to early identification and treatment of these infections is
engagement, laws, policy design, and implementation. challenging in many developing countries.
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6 of 9 LUCERO-PRISNO ET AL.

Preventing cancer mortality is one of the SDGs for Diabetes

reducing premature mortality caused by noncommunicable
diseases. The factors contributing to cancer-related DALYs Diabetes is a serious and potentially debilitating condition
are age, tobacco, alcohol, dietary risks, environmental pollu- with costly complications to individuals, families, healthcare
tion, obesity, and occupational risks [47]. Screening and early systems, and national economies. Globally, an estimated 536
detection require increased awareness of the first signs of can- million people are living with diabetes, with 783 million indi-
cers among the general public and improved accessibility and viduals projected to have the disease by 2045 [55]. According
access to diagnostic services. Correct and timely diagnosis to WHO, approximately 95% of all adults with diabetes have
of cancers followed by effective treatment can preserve the Type-2 diabetes, with an expected increase in percentage in
quality of life of many. However, the costs of cancer thera- coming years [56]. Although Type-1 diabetes is a significant
pies remain prohibitively high in many countries. For those health concern, the GBD caused by Type-2 is much greater
with terminal stages of cancer, there is a strong need for pal- due to its higher prevalence, association with preventable
liative care treatments to relieve the symptoms and suffering risk factors, and numerous complications. About 80% of
of patients and their families. adults with diabetes live in LIMCs [57]. Despite diabetes long
being associated with overweight and obese individuals, the
increasing prevalence among non-overweight patients, partic-
Climate change ularly those of Asian and African ancestry, presents a peculiar
challenge [58].
The World Health Organization identifies climate change Prioritizing diabetes in 2023 is vital, as the present scope
as the most significant health threat facing humanity in the of food insecurity, economic downturn, and health sys-
intermediate term [48]. With increasing temperatures and tems changes increase the risk of this disease. A global
other climate change-related environmental issues, the global shift in health systems paradigms for prevention and care
disease profile is changing. First, more infectious diseases efforts is essential to stem the tide of Type-2 diabetes mel-
are emerging and/or reemerging in certain regions, such as litus (T2DM) and its complications. Increased investment
dengue in North and South America and Ebola in Africa. in patient self-management education and support is inte-
The climate is becoming increasingly suitable for the growth gral to preventing and reducing the risk of complications and
of disease vectors such as Aedes aegypti, with transmission the impact of chronic disease. Effective T2DM management
increasing by almost 10% between 1950 and 2018 [49]. Addi- requires addressing contributing socioeconomic factors, pro-
tionally, climate change also results in more frequent and moting global equity, and expanding access to diabetes care
severe environmental disasters. The 2022 monsoon flooding in LMICs. These measures will ensure access to necessary
in Pakistan affected over one third of the country’s popula- care for T2DM, enable equitable distribution of healthcare
tion and was thought to be particularly severe due to climate resources and lead to better health outcomes.
change [50]. Heat waves are also becoming more common,
with a UNICEF report estimating that 23% of children (538
million) are exposed to high heat wave frequency, and by CONCLUSION
2050, 1.6–1.9 billion children will be affected, threatening
their health and well-being [51]. Heat waves are associated Identifying the top public health challenges is key to devel-
with greater risks of respiratory and cardiovascular diseases, oping responsive, effective, and sustainable health delivery
reduced access to quality food and nutrition, and a higher risk systems. As the conundrum of global health challenges
of mortality [51]. A study found that the odds of heat stroke expands, a high degree of prioritization, financial investment,
hospitalization increase by 37% for every additional day of international cooperation, and collaboration in tackling these
heat wave exposure, highlighting the serious impact of heat challenges is needed to accomplish 2030 universal health-
waves on the health outcomes of older adults [52]. care targets. This calls for a clear agreement among public
Despite these impacts of climate change, the inclusion of health decision-makers, the private health sector, and opinion
health into climate management programs (and vice versa) leaders to drive the implementation of country-specific mea-
is still minimal. Health has only been included as a global sures for healthcare. These top 10 challenges are expected
goal on climate adaptation at the 27th UN Climate Change to dominate globally in 2023 and must therefore take some
Conference of Parties (COP27) in 2022 [53]. The real impact precedence in global health efforts. Leveraging research, fos-
of this decision on the climate health landscape remains to be tering the evolution of scientific knowledge, and increasing
seen. In addition, although the WHO includes health-specific technical capacities must be done as early as possible to
climate financing as one of the 10 key components of climate- produce sustainable interventions that can effectively adapt
resilient health systems [54], a separate funding facility for to both current and emerging public health issues. With the
health within the climate financing framework has yet to be COVID-19 pandemic underscoring the importance of invest-
pledged. Because of this, climate change remains one of the ing in public health infrastructure and systems, global efforts
top public health challenges that must be dealt with utmost must be started now before these public health challenges
urgency. become their own public health emergencies.
 27692450, 2023, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/puh2.86 by Cochrane Poland, Wiley Online Library on [03/12/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
TOP 10 PUBLIC HEALTH CHALLENGES 7 of 9

AU T H O R C O N T R I B U T I O N S Philip Baba Adongo https://orcid.org/0000-0002-0614-

Data curation; project administration; supervision; 4756
writing—original draft; writing—review and editing: Mohamed Hindolo Samai https://orcid.org/0000-0002-
Deborah Oluwaseun Shomuyiwa. Data curation; project 1427-9482
administration; writing—original draft; writing—review and Fernando B. Garcia Jr https://orcid.org/0000-0002-6730-
editing: Thinley Dorji. Writing—original draft; writing— 2180
review and editing: Goodness Ogeyi Odey, Adriana Viola Joselito F. Villaruz https://orcid.org/0000-0002-7762-4220
Miranda, Isaac Olushola Ogunkola. Data curation; for- Indika Mahesh Karunathilake https://orcid.org/0000-
mal analysis; writing—original draft; writing—review and 0001-9772-116X
editing: Yusuff Adebayo Adebisi. Writing—original draft; Hao Li https://orcid.org/0000-0002-5155-4033
Writing—review and editing: Junjie Huang. Writing—review Patrick Alain Azanza https://orcid.org/0009-0006-0589-
and editing: Sarawut Thepanondh, M. D. Lamawansa, Sam- 6442
rawit Solomon, Lydia Aziato, Philip Baba Adongo, Indika Ian Findlay https://orcid.org/0009-0006-7787-1076
Mahesh Karunathilake, Hao Li, Martin C. S. Wong, Joseph Martin C. S. Wong https://orcid.org/0000-0001-7706-9370
Christian Obnial, Patrick Alain Azanza.
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