key: cord-0004565-f3lr0lwj
authors: nan
title: Plans and prospects for the 2020s: Beyond peak health?
date: 2020-02-25
journal: PLoS Med
DOI: 10.1371/journal.pmed.1003075
sha: 3bb907cbe9deee5e9585de1c0c7f04d15a82fafd
doc_id: 4565
cord_uid: f3lr0lwj

The PLOS Medicine editors discuss prospects for health and development in the coming decade.

needs to take place, by whom and even, remarkably, when. How can the doctrine of economic growth, on which many of the tangible and psychological elements of societies depend, be reconciled with the accompanying destructive environmental hazards? The times of global consensus and compromise embodied in the Paris Climate agreement of 2016, seeking to limit the increases in global temperatures and hence their adverse effects [6] , have given way to a period of uncertainty and disunity-an era of "me" rather than "we".

Recall "peak oil", the notion that oil production-yielding fuels essential for most forms of transportation to this day, and with many other apparently indispensable industrial useswould reach a maximum and thereafter decline owing to diminishing success in exploration [7] . Although it seems that a global peak has not yet, and may never be, reached, one can imagine that the consequences of progressive oil scarcity could be dramatic, leading to challenging readjustments of societies and economies to develop alternative sources of energy and reduce reliance on environmentally damaging fuels. Today, it seems ludicrous that warnings of a possible peak of oil production in the late 20 th century did not stimulate research and the development of large-scale alternatives alongside the quest for more oilfields.

Despite the positive vision embodied by the SDGs, could "peak health" have already been reached? Although the analogy with peak oil may be debatable, there are signs that life expectancy in the United States and United Kingdom has reached a plateau, and may be declining [8] . Health inequalities abound. It is anticipated that improved disease prevention and health provision in developing countries will continue to deliver improvements in life expectancy and reductions in life-years lost to disability and ill health but, in all countries, new health challenges will undoubtedly emerge. We must hope that progress in population health does not slip into reverse gear in the coming decades, driven by factors that could include the transition to non-communicable diseases, vaccine hesitancy, environmental stressors, and anticipated but unpredictable hazards such as antimicrobial resistance. When today's leaders return to the paradigm of consensus from that of confrontation, high on their to-do lists should be to work together to find an area of convergence between economic progress, environmental stabilization and continued improvement in human health and wellbeing, all of which can be assessed with meaningful indicators. Must we wait until the gains in health made over recent decades are lost?

Sustainable Development Goals: Decade of Action

End TB Strategy: Global strategy and targets for tuberculosis prevention

Hepatitis: Combating hepatitis B and C to reach elimination by 2030

World Health Organization. Urgent health challenges for the next decade

Growing at a slower pace, world population is expected to reach 9.7 billion in 2050 and could peak at nearly 11 billion around 2100

United Nations Climate Change. The Paris Agreement

Nuclear energy and the fossil fuels

Recent trends in life expectancy across high income countries: retrospective observational study