From Polio To Poverty To Sex Ed: 9 Predictions For 2018

What kind of year will 2018 be?

Our blog covers global health and development, so we're not going to make any predictions about North Korea or Middle East peace or who will design Meghan Markle's dress.

What we do have to offer: prognostications about a variety of issues, including the fight to wipe out polio, the dark side of drones and the #MeToo movement.

Wild polio will be finished by June, but cases caused by vaccine won't

"For the wild virus, I hope to interrupt transmission in the next few months," says Dr. Michel Zaffran, who directs polio eradication at the World Health Organization. "Given the low, low number of cases we had in 2017 [just 20], we have an extraordinary chance to finish off polio in Pakistan and Afghanistan between now and May or June."

"Unfortunately, we had two large outbreaks of vaccine-derived polio in 2017," Zaffran says. "And because we're still using the oral vaccine [which can mutate and cause vaccine-derived polio], we could still have new outbreaks caused by the vaccine in some places."

— Michaeleen Doucleff

Health workers will be in even shorter supply

The World Bank and World Health Organization released a report revealing that over half of the world's 7.3 billion people lack access to essential health services, like prenatal care, vaccines and treatment for high blood pressure. "What's worse is that the world lacks the health workers needed to close this gap," says Dr. Raj Panjabi, the founder of Last Mile Health, whose 300 community health workers care for people in rural Liberia.

His prediction: "In 2018, the world will continue to experience the greatest health worker shortage in history — lacking more than 7 million health workers," a shortfall that is forecast to more than double to 18 million health workers by 2030.

"As we enter 2018, illness is universal and health care is not."

— Marc Silver

More people will be guaranteed a "universal basic income"

That's the idea that a government pays each of its citizens — regardless of their income or employment — a minimum amount of money to live on. According to advocates, this is the fastest way to fight poverty and inequality. Pilot projects have been launched in Namibia, India, the Netherlands and elsewhere with positive results, including small-business growth, higher employment rates, reduced malnutrition and increased school attendance. Studies have also shown this practice can be less costly than existing welfare programs. Though governments have been slow to implement the idea, Anit Mukherjee, a fiscal policy fellow at the Center for Global Development, is "absolutely confident more countries will announce universal basic income" in 2018.

"The architecture for UBI transfers is now in place," Mukherjee said. "Essentially, every household in the world will be covered with a mobile phone in the next year, and they will be covered with some form of financial account. There will also be [fewer] than 500 million people without identification. There were no channels before to get that money to people, but now there's no holding back."

— Joanne Lu

The poor could get poorer

Anit Mukherjee of the Center for Global Development sees two reasons for pessimism. Curbs on global migration through counterterrorism measures mean fewer people from poorer countries will be able to work abroad and send remittances, or cash to families back home. And as the climate changes and makes it harder for, say, farmers to farm and communities to defend against natural disasters, the ability to travel to other places to earn money becomes more critical.

Remittances can be crucial "for housing, for school fees, for medical services," says Mukherjee. "But both in terms of human movement as well as financial movement, there's going to be a significant drop. The result is that people in the developing world who depend on remittances will be squeezed out."

— Joanne Lu

Sex ed will be harder

With the U.S. "global gag rule" in effect, funds to any family planning group abroad that "promotes" abortion will be withdrawn. This is expected to have a chilling effect on the ability to offer family planning education and services.

Meanwhile, misinformation will continue to flow. A group of mothers ages 15 to 19 in Kenya told Jane Otai, an adolescent health adviser with the international nonprofit Jhpiego, that they had been told that once they began menstruating, they were "ripe" for having babies and that if they don't get pregnant, their uterus could "rot." That is a new one for Otai, who says that the challenge in 2018 will be for local educators to step up their sex ed efforts, although she adds, "if the churches, teachers and governments are still very conservative, it will continue just the same way as before."

— Courtney Columbus

Beware of drones and robots

"In the coming year, there is the question of cyberattacks, unmanned drones and robots as well," says Thomas Glass, the former head of communications in Afghanistan for the International Committee of the Red Cross. He predicts the targeting and hacking of vital civilian infrastructures. And, he says, the use of drones and robots in battle could have grave consequences. "The risk of using tools where you can fight from a distance sometimes makes it more difficult to make that distinction [between combatants and civilians] on the ground. It makes killing your opponent a little easier," says Glass.

— Sasha Ingber

More aid workers will share their #MeToo stories

The #MeToo movement will bring the issue of sexual harassment to the fore at international charities and humanitarian organizations, says Adva Saldinger, an editor at Devex, a media company that covers international development.

In November, Devex and The Guardian launched separate investigations on sexual harassment in the workplace, inviting aid, charity and humanitarian workers to share their experiences. The investigations come after a year of allegations. In February, female aid workers spoke of rape and assault in the field. In May, The New York Times reported that U.N. peacekeepers allegedly have been sexually assaulting citizens in countries across Africa for years. And in November, Save the Children fired 16 staff members over reports of sexual harassment in 2017.

"There has been an assumption that in industries doing good or in organizations that work on women's rights, sexual harassment or assault isn't an issue," says Saldinger, one of the architects of the #AidToo investigation. "You'd think they'd be sensitive to these issues. But that's not always true. What we're hearing is that it's endemic and pervasive."

— Malaka Gharib

Aid groups will figure out how to get along without big cash from the U.S.

Humanitarian organizations won't be able to rely on the U.S. as a major donor to emergency relief funding in 2018, says Dr. Paul Spiegel, a physician and former senior official at the U.N. High Commissioner for Refugees. Given the Trump administration's anti-migration and anti-refugee stance, the "U.S. is likely to reduce development and humanitarian funding overall," he says.

"The lack of sufficient funding will create innovations in humanitarian interventions that will have long-lasting and positive effects," says Spiegel, now the director of the Center for Humanitarian Health at the Johns Hopkins Bloomberg School of Public Health. He predicts that governments in Europe as well as private philanthropists and foundations will step up to fill the gap, as they've done for family planning programs after the U.S. cut funding to the U.N. Population Fund.

Relief groups will need to develop creative ways to deliver aid more efficiently and effectively with a limited amount of humanitarian funding — cash aid, for example, could help to achieve this.

And governments that host large amounts of refugees, like Iran, will have to rely on their own national budgets — not outside aid — to pay for health and education services for refugees.

— Malaka Gharib

The world will not become a safer place

The humanitarian crises that plague the world today as a result of war and violence will continue in 2018, says Paul Spiegel. "The current geopolitical climate will continue to become worse and cause new crises without solving current ones," he says, pointing to conflicts in countries like Burundi, the Central African Republic, Iraq, Syria and Yemen. "I don't see a resolution to those, frankly."

—Malaka Gharib

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