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Mental Health: New Understanding, New Hope
2001, approx. 150 pages [Ar, C, E, F, R, S]
The World Health Report 2001
| online edition | press release |
An estimated 400 million people suffer from mental or neurological disorders or from psychosocial problems such as those related to alcohol and drug abuse. Many of them suffer silently. Many suffer alone. Many never receive treatment of any kind. Between the suffering and the prospect of care stand the barriers of stigma, prejudice, shame and exclusion.
In devoting The World Health Report 2001 to mental health, WHO is making one clear, emphatic statement. Mental health neglected for far too long is crucial to the overall well-being of individuals, societies and countries and must be universally regarded in a new light.
This book is a landmark report that aims to raise professional and public awareness of the real burden of mental and neurological disorders and the cost in human, social and economic terms. At the same time it aims to dismantle many of those barriers which prevent millions of sufferers from receiving the treatment they need and deserve.
The report comes at a critical time for the mental health of the world. One person in every four will be affected by a mental disorder at some stage of life.Major depression already ranks fifth in the leading ten causes of the global burden of disease. If projections are correct, within the next 20 years it will have risen to second place. Globally, 140 million people suffer from alcohol dependence. About 50 million have epilepsy; another 45 million have schizophrenia. Between ten and 20 million people attempt suicide every year. One million of them including many who are very young do kill themselves.
The World Health Report 2001 provides a new understanding that offers new hope to the mentally ill. It comes from the great wealth of knowledge that has been gathered, particularly in the last 50 years, of the human brain and the basis of mental illness. The report is about understanding how genetic, biological, social and environmental factors come together to cause mental and neurological disorders as well as physical illnesses.
It is about understanding how inseparable mental and physical health really are, and how their influence on each other is complex and profound. It is about understanding that mental disorders occur in all countries and all societies and that more often than not, they can be treated effectively. And not least, it is about how human understanding can make such a huge difference to the mentally ill.
The report is a comprehensive review of what we know about the current and future burden of all these disorders and their principal contributing factors. It examines the effectiveness of prevention and the availability of, and barriers to, treatment. It deals in detail with service provision and service planning. And finally, it outlines the policies that are urgently needed to ensure that stigma and discrimination are broken down, and that effective prevention and treatment are put in place and adequately funded.
This report is sending a message primarily to those who have the power or the means to make these things happen. Foremost among them are governments, who must recognise that they are just as responsible for the mental health of their citizens as for their physical health. The message is not only for health ministers. Other departments education, employment and legislation among them also have major responsibilities in promoting good mental health. It is a message that goes beyond governments, towards all those in both the public and private domains who can exert a positive influence. Finally, it is a message for all those who have a mental or neurological disorder, and their families. The message is contained in the title of this report. With the new understanding of mental health at our disposal, there really is new hope.
The World Health Report 2000
Health Systems: Improving Performance
2000, xix + 215 pages (available on 21 June in English and
French; Arabic, Chinese, Russian, and Spanish in preparation)
ISBN 92 4 156198 X
Sw.fr. 15./US $13.50
In developing countries: Sw.fr. 10.50
Order no. 1242000
| online edition | press release |
The World Health Report 2000 is an expert analysis of the increasingly important influence of health systems in the daily lives of people worldwide. To an unprecedented degree it takes account of the role of people as providers and consumers of health services, as financial contributors to health systems, as workers within them, and as citizens engaged in their responsible management, or stewardship.
Health systems provide the critical interface between life-saving, life-enhancing interventions and the people who need them. If health systems are weak, the power of these interventions is likewise weakened, or even lost. Health systems thus deserve the highest priority in any efforts to improve health or ensure that resources are wisely used.
In recent decades, health systems have contributed enormously to better health for most of the global population. As the new century begins, they have the potential to achieve further improvements in human wellbeing, especially for the poor.
But very little has yet been done to unravel the complex factors which explain good or bad performance by individual health systems. Given equal resources, why do some succeed where others fail? Is performance simply driven by the laws of supply and demand, or does another logic apply? Why is dissatisfaction with services so widespread, even in wealthy countries offering the latest interventions? If systems need improvement, what tools exist to measure performance and outcomes?
These are some of the many questions addressed in this report. Drawing upon a range of experiences and analytical tools, the report traces the evolution of health systems, explores their diverse characteristics, and uncovers a unifying framework of shared goals and functions.
Using this as a basis for analysis, the report breaks new ground in presenting an index of health system performance based on three fundamental goals: improving the level and distribution of health, enhancing the responsiveness of the system to the legitimate expectations of the population, and assuring fair financial contributions. As the report convincingly argues, good performance depends critically on the delivery of high-quality services. But it relies on more than that. Health systems must also protect citizens from the financial risks of illness and meet their expectations with dignified care.
The report goes on to show how the achievement of these goals depends on the ability of each system to carry out four main functions: service provision, resource generation, financing, and stewardship. Chapters devoted to each function offer new conceptual insights and practical advice on how to assess performance and achieve improvements with available resources.
In doing so, The World Health Report 2000 aims to stimulate a vigorous debate about better ways of measuring health system performance and thus finding a successful new direction for health systems to follow. By shedding new light on what makes health systems behave in certain ways, WHO also hopes to help policy-makers understand the many complex issues involved, weigh their options, and make wise choices.
The World Health Report 1999
Making a Difference
1999, xxi + 121 pages (English and French)
ISBN 92 4 156194 7
Sw.fr. 15./US $13.50; in developing countries: Sw.fr. 10.50
Order no. 1241999
| online edition | press release |As this century draws to a close, The World Health Report 1999 Making a Difference challenges the international community to examine the difference health can make in humanity's continuing progress. Issued by WHO Director-General Dr Gro Harlem Brundtland as WHO itself undergoes comprehensive reform, the report shows how the pursuit of lasting improvements in health, when supported by vision and leadership, can also secure considerable social and economic gains. It gathers the arguments and evidence that give health messages their persuasive power in the formulation of national policies and the direction of international aid.
The report explains how lessons learned from past successes and failures can guide a more targeted and pragmatic approach to current and emerging health challenges. It warns of the unprecedented complexity of these challenges, and offers strategic directions for tackling them in the next decade. Clear conclusions emerge. Despite recent spectacular progress in disease control and extended life expectancy, more than 1 billion people today have not shared in these gains. Meanwhile, the threat posed by infectious diseases is being accompanied by the growing prominence of noncommunicable diseases, which are far more complex and costly to manage.
Consequently, health systems can no longer afford to allocate resources to interventions of low quality or low efficacy related to cost. Spontaneous, unmanaged growth in any country's health system cannot reliably ensure that the greatest health needs are met. In defining priorities and selecting interventions, decision-makers must focus their efforts on areas where the return in health gains is demonstrably greatest. In contrast to a classic "universalism" that advocated government finance and provision of all services for everyone, the report and WHO argue for a "new universalism". This would maintain government responsibility for financing and leadership, while recognising government's own limits. Public finance for all entails that not all things can be publicly financed. Private sector provision of publicly financed services is compatible with government responsibility for health for all, but requires a clear regulatory role of governments.
WHO must also focus on priorities. While actively engaged across the full range of health problems, WHO targets two particular areas in order to reform work methods and cooperation with other partners: Roll Back Malaria and the Tobacco-Free Initiative. The report describes the problems of malaria and tobacco major representative elements of the double burden of disease and indicates how timely action can make a difference. Both projects advocate using cost-effective technologies and innovative partnerships. They also serve as pathfinders, showing how, when priority problems are identified and addressed with vision, moral courage, and sound technologies, WHO leadership can make a difference even when resources are limited.
The World Health Report 1998
Life in the Twenty-first Century: A Vision for All
1998, 230 pages [E, F]
ISBN 92 4 156189 0
Sw.fr. 17.-/US $15.30; in developing countries: Sw.fr. 10.-
Order no. 1241998
What will life be like in the 21st century? Will the world continue to grow healthier, with ever more diseases conquered by scientific advances, and life expectancy extending even longer? Or will new diseases and failing drugs cancel out these gains? If populations live longer, will these extra years be healthy and productive or merely an extended sentence of suffering? Will continuing population growth finally stifle the planet's life, depleting finite resources, polluting beyond repair, and making megacities and urban slums the home for more and more? Or will better family planning options - and mounting deaths from AIDS - reverse recent trends?
Will we conquer malnutrition, obesity, drug abuse, poverty, depression, and the common cold? Will we eradicate polio, leprosy, measles and other ancient foes? Will deaths from heart disease and cancer finally begin to decline? And when science surely delivers spectacular new therapeutic tools, who will be able to afford them? Will the gaps between the health of rich and poor grow ever wider?
These are some of the many questions addressed in The World Health Report 1998: Life in the 21st century - A vision for all. Issued as the World Health Organization marks its 50th anniversary, the report takes an expert look at health trends over the past five decades, assesses the current global situation, and predicts how health conditions, diseases, and the tools for managing them will evolve up to the year 2025. Using the latest data gathered and validated by WHO, the report paints a picture of a world poised to achieve unprecedented good health - if the lessons learned during recent decades are understood and heeded.
The World Health Report 1997
Conquering Suffering, Enriching Humanity
1997, vi + 162 pages [E, F]
ISBN 92 4 156185 8
Sw.fr. 15.-/US $13.50; in developing countries: Sw.fr. 9.-
Order no. 1241997
The World Health Report 1997: Conquering Suffering, Enriching Humanity provides an expert assessment of the world health situation in all its complexity, giving particular attention to the problems posed - in developing and industrialized countries alike - by chronic diseases. Compiled by the World Health Organization, the report combines the latest global health statistics with profiles for each of the major chronic diseases, offering pertinent details about causes, risk factors, global and regional trends, and current and future prospects for prevention, treatment, cure, and rehabilitation.
The report opens with an overview of recent trends that have made chronic diseases the focus of particular concern in every part of the world. These include population ageing, which puts more people at risk of developing chronic conditions late in life, global population growth, and the rising prevalence of unhealthy lifestyles - characterized by inappropriate diet, inadequate physical exercise, and smoking. The report also explains why these trends call for an urgent review of several traditional attitudes towards health. Key issues raised include the need to combat chronic and infectious diseases simultaneously, rather than sequentially, as in the past; knowledge that many chronic diseases have infectious causes, which reinforces the need for simultaneous action; and the tremendous burden of suffering and disability caused by chronic diseases, which makes health expectancy more important than life expectancy.
This general discussion is followed by a profile of the state of world health at the end of 1996, including a concise analysis of global economic, political, social, and demographic trends relevant to health in general and chronic diseases in particular. Also included are the most up-to-date statistics on life expectancy, mortality by age group and sex, and causes of death and disease.
Against this background, the report turns to an in-depth analysis of all the chronic diseases that are major causes of death or avoidable ill-health and disability. These include each of the eight most common cancers, circulatory diseases, asthma, diabetes and other metabolic disorders, hereditary diseases, musculoskeletal diseases, and mental and neurological disorders. For each disease, the report gives a brief description of clinical features, estimates the global numbers affected, and identifies the main risk factors. Drawing on the latest scientific knowledge, the report also explains current and future methods of prevention, detection, diagnosis, and treatment - whether concerning genetic influences that are being probed in research laboratories or recommendations for a healthy diet.
Noting the relatively small number of risk factors shared by many of these diseases, the report points to major opportunities for prevention through the use of coordinated strategies and integrated packages of disease-specific interventions. Though the focus is on global problems and global solutions, these profiles also offer individuals the best available advice on protecting their own health, particularly in the absence of a cure for most chronic diseases.
To show the way forward, the report describes the wide range of ongoing WHO activities aimed at combatting chronic diseases, infectious diseases, and a host of other factors that threaten world health. The final chapter, on charting the future, estimates future trends for selected diseases and identifies six priority areas where international action can help combat chronic diseases and thus reduce the enormous suffering and disability that they cause.
The World Health Report 1996
Fighting Disease, Fostering Development
1996, vi + 137 pages [E, F]
ISBN 92 4 156182 3
Sw.fr. 15.-/US $13.50; in developing countries: Sw.fr. 9.-
Order no. 1241996
The World Health Report 1996: Fighting disease, Fostering development provides an expert assessment of the world health situation in all its complexity, giving particular attention to infectious diseases. Compiled by the World Health Organization, the report combines the latest health statistics with an analysis of the many factors that have shaped the current situation - and created an unprecedented crisis.
By showing where we stand today in the fight to control infectious diseases, the report aims to help the world comprehend both the alarming implications of recent trends and the need for immediate action. Over 50 old and new diseases - from malaria, tuberculosis, and cholera to AIDS, plague and the mysterious Ebola haemorrhagic fever - are profiled in terms of their incidence, causes, opportunities for control, and impact on health and socioeconomic development.
The report opens with a profile of the state of world health at the end of 1995, including a concise analysis of global economic, political, social, and demographic trends relevant to health in general and infectious diseases in particular. Also included are the most up-to-date statistics on life expectancy, mortality by age group and sex, and causes of death and disease.
Against this background, the report turns to an in-depth analysis of infectious diseases. General problems considered include the emergence of several new diseases, the spread of epidemics, a sharp rise in antimicrobial resistance, and the growing number of hospital-acquired infections.
The most extensive section analyses over 50 diseases organized according to mode of transmission: person-to-person, contaminated food and water, insect bites, and contact with animals. By focusing on the way diseases spread, the report is able to trace how the present situation arose and identify the human interventions needed for prevention or control.
Throughout this analysis, the picture that emerges is one of a world poised to conquer some diseases soon, yet gravely threatened by many others, losing its arsenal of effective drugs, creating more and more opportunities for diseases to emerge or flourish, and above all paying a high price for past complacency.
As the report repeatedly argues, the price of continued complacency will be higher yet, especially since socioeconomic development cannot move forward so long as so many of the world's people are disabled by disease.
To show the way forward, the report explains what WHO is doing to fight disease and foster development by combating these and many other problems. A final chapter, on charting the future, describes the precise actions needed to eradicate or eliminate diseases such as poliomyelitis, leprosy, neonatal tetanus, and guinea-worm infection, to tackle old diseases such as tuberculosis and malaria, and to cope with several newer threats to health.
The World Health Report 1995
Bridging the Gaps
1995, 120 pages [C, E, F]
ISBN 92 4 156178 5
Sw.fr. 22.-/US $19.80; iIn developing countries: Sw.fr. 15.40
Order no. 1241995
The World Health Report 1995: Bridging the Gaps documents the attributed causes of ill-health and death for each age group throughout the human life span, around the globe. Analytical as well as descriptive in its approach, the report also explores the root causes of health problems and what can be done to solve them. Issues covered range from the causes of infant mortality to the health impact of global climate change, from the importance of poverty and lack of knowledge to the projected toll of the AIDS pandemic.
While progress is evident for some diseases in some countries, others show trends that are deeply disturbing. As the report reveals, today's global health situation is characterized by ominously widening gaps between rich and poor, between one population and another, and between age groups. Knowledge and technologies continue to advance, but fairness is lost when their benefits are distributed. Though many countries have already reached the health targets set by WHO for the year 2000, in some parts of the world, life expectancy is actually decreasing and populations lack access to even the most basic health care.
For virtually all the major diseases that kill children or cut short the lives of adults, the picture that emerges is one of immense suffering easily prevented or treated by technologies that already exist and cost surprisingly little to implement. As the report makes abundantly clear, the gaps that need to be bridged include the discrepancy between knowing exactly what should be done and finding the will and resources to do it. Facts and figures gathered in the report also underscore the fundamental importance of health to socioeconomic development: when the poor are made more healthy, they can earn more and become less poor.
By ranking the major causes of death and ill-health, and showing how they can be prevented, The World Health Report 1995: Bridging the Gaps provides a solid foundation for priority setting and action - and challenges the world conscience to face the difficult ethical issues raised by so much preventable suffering
"... a useful reference work... provides a
concise but comprehensive, well-written survey of world population health problems,
together with graphs, statistical tables and index..."
"... a welcome report ... clearly written and
beautifully produced ... provides a wealth of useful information..."
Transactions of the Royal Society of Tropical Medicine and Hygiene