So where to prioritize? It really matters. There is no doubt that the halving of child deaths since 1990 is largely a result of the sustained focus on child survival over the period and the wider availability of effective technologies especially vaccines, as well as improvements in levels of education, incomes, water, sanitation, and hygiene.
In contrast, the major global efforts to control HIV/AIDS among women and to end maternal mortality have a long way to go, and there has been very little attention paid to cardiovascular diseases, cancers, chronic respiratory and kidney diseases, diabetes, and mental health among women.
If we could start over, what would a global priority list for women’s health look like?
If we followed the GBD, here is what the list would look like:
1. A massive new effort to reduce NCD deaths among women under 70 by one-third, prioritizing heart disease, stroke, COPD, diabetes, and chronic kidney disease;
2. Doubling down on existing efforts to end deaths among women and children from the “big 5” infectious diseases – HIV/AIDS, tuberculosis, pneumonia, diarrhea, and malaria;
3. Continued strong focus on ending preventable maternal and newborn deaths;
4. Expansion of the effort to reduce cancer deaths among women under 70 by one-third, especially breast, cervical, and lung cancers; and
5. Introduction of a well-funded global health agenda to promote mental health, prioritizing a one-third reduction in suicide among women, and ramping up the effort to discover new prevention, diagnosis, and treatment technologies for Alzheimer’s disease.
The exact order won’t be the same in every country as disease burdens differ. For example, Africa will need to prioritize the fight against the leading infectious diseases and maternal/newborn deaths because they cause the vast majority of deaths among women and girls. High-income countries will need to prioritize non-communicable diseases, but not always the same ones. And many middle-income countries in Asia, for example, will need to be active on both.