The first wealth is health,” American philosopher Ralph Waldo Emerson wrote in 1860.
Emerson’s quote, cited by Harvard economist and health expert David E. Bloom in this issue’s lead article, reminds us that good health is the foundation on which to build—a life, a community, an economy.
Humanity has made great strides, developing vaccines and medical techniques that allow us to live longer, healthier lives. Other developments—such as increased access to clean water and sanitation—have helped beat back long-standing ills and pave the way for better health.
But the story is not one of endless progress. As we went to press, the world was dealing with the worst outbreak of the Ebola virus on record, a grim reminder of our vulnerability and of the distance yet to go. And, though not often the subject of headlines, the great disparities in health—evident, for example, in the a 38-year gap in life expectancy between Japan (83 years) and Sierra Leone (45 years)—raise issues of equity and point to the need to press forward on multiple fronts.
In this issue, we’ve assembled a lineup of accomplished authors to look at global health from a variety of angles. They look at today’s health systems—the amalgam of people, practices, rules, and institutions that serve the health needs of a population—and at the economics behind them.
In his broad-ranging article, Bloom underscores the role good health plays in an individual’s or household’s ability to rise, or stay, above the poverty line. Several articles explore health care spending: Victoria Fan and Amanda Glassman examine the shift in public health spending from central governments to states and cities; and Benedict Clements, Sanjeev Gupta, and Baoping Shang take a look at whether the recent slowdown in public health spending in advanced economies is permanent.
We offer several reports from the front lines: health ministers from Colombia and Rwanda discuss major challenges in their jobs, and the CEO of a pharmaceutical company looks at impediments to developing drugs to fight emerging diseases. Another special feature considers four major health threats of the 21st century.
Elsewhere in this issue, Maureen Burke profiles 2012 Nobel Prize winner Alvin Roth, and Picture This offers insight into our increasingly urbanized world.
Illustration: pp. 42, 43, ThinkStock Images; p. 44, Michael Gibbs; p. 45, ThinkStock Images and Michelle Martin/IMF.
Photography: Cover, Narinder Nanu/AFP/Getty Images; p. 2, Noah Berger; p. 6 Jodie Coston/Getty Images; p. 12, William Campbell/Corbis; p. 16, Ministerio de Defensa de España/Corbis; p. 17, Michael Prince/Corbis; p. 18, Edward Rozzo/Corbis; p. 19, Science Stills/Visuals Unlimited/Getty; p. 21, Herminso Ruiz; p. 23, Amélie Benoist/BSIP/Corbis; p. 26, Stéphane Saporito, WHO; p. 28, WHO; p. 30, Karen Kasmauski/Corbis; p. 33, Stephanie Novak; p. 34, Jaipal Singh/epa/Corbis; p. 37, ThinkStock Images/Getty Images; p. 38, Violetta Markelou; p. 39, Tim Martin/ Getty Images; p. 42, Frederic Soltan/Corbis; p. 43, Stephen Jaffe/IMF; p. 47, G.M.B. Akash/Panos; p. 52, Greg A. Syverson/Getty Images; pp. 56, 57, Michael Spilotro/IMF.