Emerging risks
One challenge to health is adapting to the effects of climate change. The rise in temperatures will create new environmental conditions that will make it easier for vectors to arrive that are capable of transmitting infections only found in tropical countries until now. Among the new vectors in Catalonia is the tiger mosquito, which can spread the chikungunya, dengue and Zika viruses. In order to prevent this, mosquito populations must be controlled. This is being done in some wetland areas, such as Empordà. When a case of one of these infectious diseases is detected, the patient’s surroundings are inspected for mosquitos. “Luckily, these mosquitos don’t go far,” says the public health secretary, Dr Joan Guix, who warns about letting water accumulate in recipients as small as a bottle top. Yet, it’s not just mosquitos. Climatic changes also modify the migratory routes of birds, which also carry diseases. And if that wasn’t enough, droughts and flooding threaten drinking water supplies as well as harvests. “All this and more could happen. That’s why this year we hope to set up an office to study and combat the risks to public health due to climate change,” says Guix.
The problem of sugar
Over 51% of adult Catalans are overweight or obese. Among children the figure is 21%. This raises the risk of cancer, cardiovascular disease, diabetes, and so on. It is closely linked with physical exercise and diet, and it is these two areas that need most work. So far, the tax on sugary drinks has reduced sales by 20%. “It’s an example of a strategy that must be followed. In this case, a measure by the Ministry for the Economy has ended up having a significant impact on health, and this is an important achievement,” says Guix.
Doctors prescribing physical activity as therapy is a measure we will see more of, together with others that are being implemented to encourage healthy eating, such as supervision of school meals. Another important challenge is introducing dieticians into primary care, not only to help patients, but also to work alongside professionals.
New addiction law
New addiction legislation will also be needed, as today’s law dates back to 1985. “It will have a completely different focus and also introduce a damage-reduction strategy. A heroin addict who injects, apart from having a problem with the drug, also has a high chance of getting hepatitis and HIV. We have to supply this person with new syringes, orally-taken methadone and centres where they can inject safely,” says Guix.
One concern is a resurgence in smoking tobacco, particularly rolling cigarettes. “Young people think it’s not as dangerous because they make their own, but it’s actually worse. The e-cigarette is also very worrying. The tobacco industry continues to look for new markets,” Guix says. He also thinks that smoking will be banned in cars, not only for the health benefits but also for safety reasons. Meanwhile, the future legislation will also take into account other addictions, for example, setting distances between schools and gambling establishments.
Resistant bacteria
The WHO warns that by 2050 resistance to antibiotics could prove more lethal than cancer. “We have not been careful enough when administering antibiotics, not only to humans, but also to livestock. Great care must be taken with how we use these medicines and we must only use them when they are required,” says Guix. In fact, Spain is the country that prescribes the most antibiotics in Europe, in many cases without any need to do so or with many patients not taking them correctly. To avoid resistance, infections must be avoided, through such things as hygiene measures, vaccination, and so on. At the same time, there is a need to develop new antibiotic drugs and then to ensure we use them sensibly.
dossier Health