Growing inequalities to dominate next decade of global public health but opportunities remain: Dr Margaret Chan

The next decade of the global public health landscape is expected to be dominated by growing inequalities driven by rising geopolitical competition, food and energy insecurity, inflation and a slowing economic recovery, as well as climate change, among other forces.

But while the COVID-19 pandemic has sharpened the impact of these inequalities on different segments of society and between countries, there remain overarching opportunities for a healthier, more inclusive and sustainable world, said Dr Margaret Chan, Founding Dean of the Vanke School of Public Health at Tsinghua University.

Dr Chan, who is also Emeritus Director-General of the World Health Organization (WHO), was speaking on the topic of “Shaping the Future of Global Public Health” at the NUS Distinguished Speaker Series on 7 July 2023. Her lecture was delivered a day after she was conferred the Honorary Degree of Doctor of Science at the main kick-off ceremony of the 2023 Commencement season in recognition of her outstanding contributions in transforming the global landscape of public health.

Painting a picture of the post-COVID outlook, Dr Chan said the road ahead would be difficult for many countries amid expectations of austerity measures, halted health projects, reduced philanthropy, and a decrease in aid from rich countries in support of poorer ones. The world would also see more health crises related to emerging and new conflicts, increased migration, a lack of food and energy insecurity, and the challenge of climate change.

Despite these challenges, there are benefits that can also be realised through investments in areas such as artificial intelligence and digital technologies to reduce costs; green and environmentally-friendly solutions to mitigate energy insecurity; and agriculture and food technologies to counter the negative impact of climate change, she noted.

Offering a word of optimism, she said: “History has shown us that we must keep our hopes up. We must take responsibility and work even harder in difficult times… In short, a positive attitude and human ingenuity work wonders in times of adversity.”

Turning to the United Nations (UN) 2030 Agenda for Sustainable Development — a plan of action consisting of 17 goals aimed at addressing the world’s challenges across the economic, social and environmental dimensions – Dr Chan highlighted four broad prospects for public health.

The first, she said, was in strengthening global health governance to address the deficiencies exposed by the COVID-19 pandemic. In this regard, member states of the WHO, the UN’s health agency, must cooperate to ensure that it has the authority, flexibility and resources to carry out its mandate, such as coordinating with stakeholders and partners in global health assistance to facilitate capacity-building in developing countries.

Secondly, countries must demonstrate leadership by ensuring the protection and health of its people through strengthening their local healthcare systems, boosting disease surveillance and pandemic preparedness, and improving health services.

Thirdly, health equity must be prioritised to narrow the gap between the rich and poor. “Leaving no one behind in any society is all about fairness and justice… The current pandemic highlights our collective failure to vaccinate the vulnerable and the poor globally,” prolonging the pandemic with an unacceptable loss of lives and suffering, Dr Chan said. In the long run, measures to increase the manufacturing capacity and stockpiling of vaccines in developed and developing countries must be considered.  

Finally, opportunities must be created for the young and future generations to participate in global health and sustainable development. Dr Chan noted that the younger generations are the forces driving new frontiers in global health such as in the basic and life sciences, and in technological innovations. “Gender equality, fairness, justice, and diversity are their characteristics,” said Dr Chan, adding that the Generation Z demographic is also more likely to understand and appreciate the issues related to environmental protection, social inclusion and climate change.

An NUS alumna, Dr Chan has been at the forefront of the global health scene, combatting health emergencies such as the H5N1 avian influenza and Ebola outbreaks in her previous roles as Hong Kong’s Director of Health and former Director-General of WHO. Widely recognised for her efforts in strengthening the world’s health systems, she is also a leading advocate of universal health coverage and prioritising women’s health.

Learning from the COVID-19 experience

In his welcome remarks at the event, NUS President Professor Tan Eng Chye acknowledged how the world, recently mired in the throes of the COVID-19 pandemic, was forced to confront uncomfortable questions about health inequity, systemic poverty, and class and gender disparities.

“The world needs to collectively learn from our COVID-19 experience, if we are to emerge stronger, more unified and more resilient when the next public health challenge emerges, whatever shape it takes,” he urged.

He also shared how NUS is contributing to the public health scene, such as a research cluster developing interventions and technologies to promote healthy and active ageing, and a Biomedical Science and Translational Medicine cluster that develops new drugs, diagnostics, and devices for the prevention and treatment of diseases.

Dr Chan also fielded questions during a question-and-answer segment moderated by Professor Teo Yik Ying, Dean of the Saw Swee Hock School of Public Health (SSHSPH). 

The session saw her sharing her experiences in her career as director-general at WHO and the difficulties and opportunities in providing a platform for member countries and stakeholders to negotiate and consult on common health challenges.

The importance of open dialogue around mental health and wellbeing and her insights on the digitalisation of public health were among the other topics discussed at the two-hour session.

Dr Chan also reflected on her fond memories at NUS, where she earned her Master of Science in Public Health and Occupational Medicine in 1985, recalling the community as “a close-knit team of people”, including classmates that she remains friends with to this day. “After my graduation, I came back on an annual basis because one of my loves is durian,” she said to laughter from the audience.

Watch Dr Margaret Chan's full lecture and Q&A session on “Shaping the Future of Global Public Health” at the NUS Distinguished Speaker Series event. 

Read also the NUS News story on her conferment of the Honorary Degree of Doctor of Science at the main NUS Commencement 2023 ceremony.