Bill Gates reveals the biggest public health threats over the next 10 years

Bill and Melinda Gates have released their first-annual "Goalkeepers" report, a celebration of key milestones in public health and a look at which issues are still most pressing.

The wins include sizable declines in childhood mortality and HIV infection rates, while the ongoing struggles include family planning and equality for women.

In a recent conference call with reporters, Bill Gates named infectious and chronic disease as the two biggest public health concerns in the coming decade.

"The chronic diseases, including things like diabetes or Alzheimer's, neurological conditions, they are increasingly what the big problem is," Gates said. "In a lot of the still-developing countries, you have infectious disease, whether it's malaria, diarrhea, pneumonia, [tuberculosis], HIV, still in very large numbers."

Many of the chronic diseases found in developed or still-developing countries stem from environmental factors, some of which are poorly understood. 

In developed countries, for instance, rates of Alzheimer's and dementia have been on the rise for years. In the US, the Centers for Disease Control estimate total numbers will triple by 2050. Scientists have yet to pin down specific causes for the rise, however, and often attribute the increase to factors like genetics, diet, and social engagement.

Other chronic diseases are more straightforward. The greatest killers in the US, for instance, are heart disease and cancer, which collectively are responsible for some 1.2 million deaths each year. Gates said the biggest burdens in these developed countries are research and development costs for creating more effective drugs.

Already, researchers are making inroads toward smarter, more accurate cancer diagnostics. Some American labs have even created experimental blood tests that can diagnose cancer months earlier than the current gold-standard techniques.

"I think you can be pretty hopeful there'll be big progress there," Gates said.

Infectious diseases are a different breed. Disease-carrying insects — like mosquitoes that infect people with malaria — sit beside unclean drinking water, unsanitary living conditions, and poor sexual health practices as major drivers of illness. In these cases, Gates said the burden lay on governing bodies and foundations such as his own to deliver aid to developing nation, while research efforts work on permanent solutions, such as vaccines.

"There isn't the same type of market, the same type of opportunity to charge for drugs there," he said.

As a result, developing countries in East Africa and Central America rely more on outside funding and aid.

One of the biggest concerns for Gates moving forward is HIV. Considerable progress has been made in the last 15 years to slow HIV's growth globally, but funding is slowing down. In the report, Gates expressed concern that a swelling African population could cause the number of new cases to skyrocket in the coming years.

"That's a scary prospect," he wrote. "Without R&D investments, we won't have the new discoveries that will make it easier to prevent the transmission of HIV."

RELATED: The best books, according to Bill Gates

The best books, according to Bill Gates
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The best books, according to Bill Gates

When Breath Becomes Air 

Gates' review: "I’m usually not one for tear-jerkers about death and dying—I didn’t love The Last Lecture or Tuesdays with Morrie. But this book definitely earned my admiration—and tears." 

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I Contain Multitudes 

Gates' review: "In the end, I Contain Multitudes is a healthy corrective. Yong succeeds in his intention to give us a “grander view of life” and does so without falling prey to grand, unifying explanations that are far too simplistic."

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The Heart 

Gates' review: "When Melinda recommended the book to me, she said, “It’s different from most of the books you read.” And that’s true—but part of the reason for that is that it’s different from most books."

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Homo Deus: A Brief History of Tomorrow 

Gates' review: "Harari’s new book is as challenging and readable as Sapiens. Rather than looking back, as Sapiens does, it looks to the future. I don’t agree with everything the author has to say, but he has written a thoughtful look at what may be in store for humanity."

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Hillbilly Elegy: A Memoir of a Family and Culture in Crisis

Gates' review: "Through deeply personal stories like these, Hillbilly Elegy sheds light our nation’s vast cultural divide—a topic that has become far more relevant than Vance ever dreamed when he was writing this book." 

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Born A Crime: Stories From A South African Childhood 

Gates' review: "In fact, Noah’s mother emerges as the real hero of the book. [...] If my mother had one goal, it was to free my mind,” he writes. Like many fans of Noah’s, I am thankful she did."

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A Full Life: Reflections At Ninety 

Gates' review: "A Full Life feels timely in an era when the public’s confidence in national political figures and institutions is low. It is true that President Carter made unforced errors during his time in office. But when you read this book and have a chance to meet him in person, you can’t help but conclude that Carter is a brave, thoughtful, disciplined leader who understands the world at a remarkable level and who has improved the lives of billions of people through his advocacy for human rights and global health."

Photo credit: Amazon 


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