Press Release WHO/10 19 January 1998   DR NAKAJIMA: "THE TASK AHEAD REMAINS FORMIDABLE" 101ST SESSION OF WHO EXECUTIVE BOARD OPENS IN GENEVA  At the opening of the 101st session of the World Health Organization's (WHO) Executive Board, Dr Hiroshi Nakajima, WHO Director-General, in his speech reminded his audience that 1998 is a special year for the Organization. "WHO will be 50 years old this year. As we celebrate this 50th anniversary, we can look back with legitimate pride to the many health gains which together we have achieved for the benefit of all the peoples of the world. At the same time, fully aware of our responsibilities for the present and future generations, we must assess emerging global health challenges and ensure that our policies and structures are well adapted and will enable us to meet the expectations of the peoples whom we exist to serve." He pointed out that throughout the 50 years of its existence, WHO has been tackling issues which are still of major concern for the Organization and its 191 Member States. Immunization, infectious and parasitic diseases, malnutrition, hygiene and sanitation, basic health infrastructure, education and training for health workers, and the development or reconstruction of health services firmly remain WHO's main priorities. "Yet the scope of the challenges we face, and our approaches to dealing with them, have changed considerably", said Dr Nakajima. Immunization programmes have seen a dramatic change in the last fifty years. It was only in 1974 that global immunization coverage against childhood diseases stood at a mere 5%. Twenty years later, it soared to 80%. In the meantime, the world has witnessed the biggest ever public health victory - smallpox was declared eradicated in 1980. Currently, WHO is leading the global fight against poliomyelitis and is well on course to rid the world of this crippling disease by the year 2000. Measles and neonatal tetanus are the next targets for elimination. The Children's Vaccine Initiative is focusing on the development of user-friendly and affordable multi-purpose vaccines. A number of tropical diseases are clearly on the retreat. Within a ten year period, between 1985 and 1996, the global prevalence of leprosy was reduced by 82%. The global incidence of dracunculiasis which used to be counted in millions of cases dropped to only 130 000 cases. In eleven Western African countries, onchocerciasis is no longer a public health problem and 1.5 million previously infected people are no longer in danger of going blind from this disease, also known as river blindness. Launched in 1991, the elimination of the transmission of Chagas disease is gathering pace and making remarkable progress in Latin America.  Reviewing the current infectious diseases situation, Dr Nakajima pointed out that "Fifty years ago, it seemed self-evident that science and technology meant progress, and that progress was irreversible. Such assumptions have been called into question by the emergence of new infectious agents, new environmental health hazards, and drug resistance. Outbreaks have occurred of diseases such as plague, cholera, dysentery, E coli 0-157 infections, viral haemorrhagic fevers of the dengue, Ebola, Hanta, yellow fever and Rift Valley type, bacterial and viral meningitis, transmissible spongiforum encephalopathies and, more recently, avian type influenza A(H5N1) in humans". The universal rise of noncommunicable diseases such as cancer, cardiovascular diseases, diabetes and mental health disorders continue to cause much of the suffering and disability worldwide. Among the major factors influencing the onset of these diseases, Dr Nakajima singled out lifestyles, environmental hazards, genetic predisposition and the global ageing of the world's population. "A vast amount of epidemiological data on these diseases have been generated worldwide through research coordinated by WHO", he said. "Cost-effective interventions and strategies are available. Success will depend increasingly on our ability to communicate with the public about the need to adopt health-conducive lifestyles". Although from the very beginning WHO was concerned with environmental matters, called in those days "environmental hygiene", it was in the course of the last two decades that environmental health became firmly placed at the forefront of the world's agenda with "such issues as air and water pollution, urban and industrial development, occupational hazards, climate change, and chemical and food safety being hotly debated both by the general public and by governments". Looking into the future development of health services, Dr Nakajima said that while they "will continue to carry out disease prevention and control activities using traditional approaches, they will also include the public health applications of new knowledge and technology such as genetics, molecular biology, immunology and diagnostic imaging. Rapidly evolving areas of science and medical practice such as organ transplantation, cloning, genetic engineering and clinical research have major ethical and social implications for our humanity. WHO provides a forum within which international consensus can be built with regard to the many crucial issues that arise in these areas". Referring to the reform process in WHO, Dr Nakajima spoke of "focusing on further improving accountability and efficiency" of the Organization. "The major elements of reform which the Board will be considering at this session are related to the review of the Constitution and regional arrangements of the World Health Organization as well as the revised proposals for WHO's representation and cooperation mechanisms at country level". Assessing the first fifty years, Dr Nakajima said that Aas a vital part of the United Nations system, WHO has done an impressive amount to promote health and peace worldwide." But he warned that "the task ahead of us remains formidable. This must prompt us to act with renewed determination, mobilizing our resources and efforts to further advance our common goal of making health accessible to all". Related story:        101st Session of the Who Executive Board Opens on Monday (16 January, 1998) For further information please contact Valery Abramov, Health Communication and Public Relations, WHO, Geneva. Tel. (+41 22) 791 2543. Fax (+ 41 22) 791 4858. Email abramovv@who.ch All WHO Press Releases, Fact Sheets and Features as well as other information on this subject can be obtained on Internet on the WHO home page http://www.who.ch