Rising temperatures, shifting disease patterns and massive population displacement are placing unprecedented strain on health systems worldwide. At the same time, a critical shortage of trained personnel threatens the capacity of countries to respond effectively.
As climate change accelerates population movements and intensifies existing vulnerabilities, countries across the world—particularly low- and middle-income nations—find themselves navigating a complex mix of old and new health threats. Infectious diseases continue to demand attention, yet noncommunicable diseases (NCDs), mental health conditions and injuries are becoming increasingly dominant contributors to illness and premature death. Managing these overlapping challenges requires innovation, cross-sector collaboration and sustainable investments in prevention, treatment and human resources.
The shifting landscape of global disease burdens
Many emerging countries are currently grappling with what specialists refer to as a “double challenge” in health. They are tasked with sustaining their long-standing endeavors to manage contagious diseases, enhance hygiene, and address epidemics. Simultaneously, swift shifts in societal and environmental factors are fueling an increase in non-communicable diseases (NCDs) like diabetes, high blood pressure, heart ailments, and various cancers. These persistent health issues frequently manifest without immediate symptoms and worsen over time, potentially incapacitating individuals or elevating their risk of premature death.
While NCDs were once thought to primarily affect older adults, global evidence tells a different story. Millions of people die of these conditions before reaching the age of 70, with more than 85% of premature NCD deaths occurring in low- and middle-income countries. The World Health Organization (WHO) identifies several key risk behaviors—smoking, harmful alcohol use, unhealthy diets, excess sodium intake and physical inactivity—that fuel this growing crisis. Tobacco alone is responsible for more than seven million deaths each year, while insufficient exercise contributes to millions more.
Controlling this rising epidemic requires not only behavior change but also scalable strategies such as screening, early detection and improved access to treatment. Many interventions, including basic medications for hypertension and diabetes, are cost-effective when delivered through primary healthcare systems. Several countries have begun taking action. In Kenya, for example, road safety programs and violence-prevention initiatives were launched in response to increasing injuries and NCD-related threats, signaling an important shift toward addressing chronic health risks.
Local Programs and the Impact of Early Detection
A decade ago, a collaborative effort between Kenyan nursing schools and a university in the United States launched the Afya Njema project near Nairobi. Nursing students from both countries worked side by side to screen thousands of community members for common chronic conditions such as high blood pressure, elevated blood sugar and chronic joint pain. Participants received counseling on lifestyle changes and were encouraged to follow up with local clinics.
The initiative proved successful enough that one participating Kenyan nursing college, P.C.E.A. Tumutumu in Nyeri County, continued offering periodic screenings independently. These outreach efforts have since expanded to include HIV testing and nutritional support for young children, including deworming and vitamin A supplementation. Despite the popularity of such programs, patients from rural areas often face financial and logistical barriers to managing chronic illnesses. Many lack health insurance, refrigeration for insulin or consistent access to government-provided medications, which are not always reliably stocked.
Amid these constraints, mobile phones have emerged as an unexpectedly powerful tool. Recognizing the potential of digital communication in low-resource settings, WHO partnered with the International Telecommunication Union to develop Be He@lthy, Be Mobile—a program designed to deliver health information directly to people’s mobile devices. Senegal became the first country to adopt the initiative’s diabetes management program, mDiabetes, particularly to help individuals safely observe fasting during Ramadan. Over time, the program expanded into an annual service with more than 100,000 participants. Similar initiatives later launched in India and Egypt, collectively supporting hundreds of thousands of people.
Addressing the silent burden of mental health
Mental, neurological and substance use disorders impose a significant burden across every region of the world. Despite accounting for an estimated 14% of the global disease load, the vast majority of affected individuals receive no treatment—especially in low-income countries where scarcity of trained professionals and persistent stigma limit access to care.
To help close this gap, WHO developed the Mental Health Gap Action Program (mhGAP), which equips primary care providers with the tools and training to diagnose and manage conditions such as depression, schizophrenia and epilepsy. The program emphasizes that even in resource-limited settings, millions of people could achieve recovery with proper medication, counseling and community support.
The efforts of Jan Swasthya Sahyog in the heart of India illustrate the impact of community-rooted strategies. This organization, which caters to indigenous populations in Chhattisgarh, empowers local health personnel to pinpoint mental health requirements and advocate for scientifically proven therapies. Initially, many residents attribute signs of mental distress to spiritual factors or otherworldly forces. Healthcare professionals such as Manju Thakur are instrumental in gently directing individuals towards medical assistance, all while honoring local customs. Their consistent engagement—including home visits, collective gatherings, and shared narratives of healing—fosters confidence and acceptance within communities that have historically lacked adequate conventional healthcare provisions.
Population displacement, climate shifts, and vulnerable healthcare infrastructures
Human displacement has reached unprecedented levels, with more than 70 million people forced from their homes due to conflict, violence, persecution and increasingly, environmental disasters. As climate change intensifies droughts, floods and storms, the number of people displaced for environmental reasons now surpasses those fleeing conflict in some regions, according to estimates from the Red Cross.
The United Nations Refugee Agency (UNHCR) spearheads worldwide initiatives aimed at safeguarding and assisting uprooted communities. Its operations encompass a broad spectrum, from offering accommodation and medical services to formulating strategies for disaster readiness. These duties become especially challenging in nations already grappling with scarce resources and societal unrest.
A vivid example comes from Colombia, where local seniors living in a community care center opened their doors to Venezuelan families fleeing severe hardship. What began with shared meals gradually evolved into a deeply human exchange: older Colombians rediscovered a sense of purpose by supporting the newcomers, while young Venezuelans helped care for their hosts. Experiences like this highlight the empathy and adaptability required of communities hosting displaced populations—an increasingly common reality as environmental and political pressures continue to rise.
Innovation, technological advancements, and the demand for fitting solutions
As global understanding of health issues expands, the effective implementation of appropriate solutions continues to be a challenge. Sophisticated technological devices introduced into remote regions frequently malfunction due to a lack of maintenance support. For example, cutting-edge laboratory instruments can become inoperable if replacement components are hard to find or if local personnel are not adequately skilled. Consequently, pragmatic advancements specifically developed for settings with limited resources offer more potential than technologies originally conceived for affluent nations.
One such example is the development of an inhalable measles vaccine, which requires no refrigeration and is easier to distribute in hot climates and remote regions. Yet even innovations like this face hurdles: manufacturers may hesitate to invest in production if profit margins appear small compared with existing products, such as injectable vaccines.
The global healthcare workforce crisis
Perhaps the most urgent challenge confronting health systems is the worldwide shortage of healthcare workers. WHO projects a deficit of 18 million health professionals by 2030, a shortfall that will disproportionately affect low-income nations. In some countries, reliance on foreign-trained workers has become the norm—Uganda’s healthcare workforce is nearly 40% foreign-trained, while South Africa draws many professionals from the United Kingdom. Meanwhile, other nations experience a continuous “brain drain,” losing locally trained staff to better-resourced health systems abroad.
Bolstering community health worker initiatives stands out as a highly potent method for bridging workforce deficits. These individuals, who may be volunteers or semi-professionals, typically reside in the very communities they assist, delivering vital services like maternal health support, vaccination assistance, and patient monitoring. The WHO underscores that their function ought to supplement, rather than substitute, the contributions of qualified professionals. Adequate instruction, oversight, and remuneration are crucial for optimizing their effectiveness.
Organizations such as Last Mile Health have taken this mission further by developing free digital training programs for both community health workers and policymakers. Their initiatives offer practical case studies from countries like Rwanda, Ethiopia, Brazil and Bangladesh, demonstrating how well-supported community health systems can transform access to primary care.
Emerging technologies and entrepreneurial solutions
Health innovations tailored for environments with limited resources are steadily increasing. Last Mile Health provides community health workers with mobile instruments for patient enrollment, sending referrals, and aiding clinical choices. Concurrently, the potential of drones in healthcare provision keeps generating enthusiasm, despite their present functionalities being largely confined to minor operations like aerial surveying or transporting light goods.
Entrepreneurial endeavors are also contributing to the acceleration of innovation. The Solve program at MIT assists innovators tackling pressing global health requirements, offering financial backing and expert mentorship. A noteworthy initiative created a robust silicone wristband that tracks newborns’ vital signs—an economical, long-lasting solution ideal for remote clinics. The Bill & Melinda Gates Foundation also plays a role by financing research focused on crucial global health challenges identified by specialists in the domain, thereby nurturing avenues for scientific advancements that might otherwise remain unfulfilled.
Building resilience for the future
The global health challenges ahead are complex, interconnected and continually evolving. Climate change, demographic shifts, technological limitations and workforce shortages all intersect to create pressures that no single sector can solve alone. Meeting these challenges requires sustained commitment, innovative thinking and collaborative action across governments, communities and international partners.
Progress hinges on drawing lessons from prior setbacks—like the improper use of antibiotics or missed chances for immunization—and focusing on interventions that are both impactful and readily available, while also being culturally sensitive. Furthermore, it necessitates investing in human capital: educating healthcare professionals, assisting local communities, and enabling individuals to take charge of their well-being through resources spanning from mobile communications to public health education.
As the world continues to navigate an era defined by uncertainty and rapid change, strengthening global health systems remains essential not only for preventing disease but for ensuring dignity, security and well-being for populations everywhere.
