Fifty-Fifth World Health Assembly opens today - Strong momentum created on public health must intensify and expand
10 May 2002 - "THE WORLD IS LIVING DANGEROUSLY" WARNS BRUNDTLAND
Geneva - Dr Gro Harlem Brundtland today credited delegates from World Health Organization (WHO) Member States for their efforts in moving health to the forefront of the world agenda, and welcomed the real increase in funding earmarked for public health worldwide.
"We have triggered a change. Now we are taking it forward," declared the WHO Director-General as she addressed representatives of WHO’s 191 Member States, including numerous Ministers of Health. Delegates have converged in Geneva for the annual week-long WHO supreme governing body meeting, the World Health Assembly. They will discuss and debate a range of major international public health issues, and define future policy for the Organization.
The realization that health is a prerequisite for economic growth, stability and peace has moved those outside traditional circles of professional health workers to demand and work towards improved health for the world's people. "Prime Ministers and Presidents, rock singers and sports stars, business leaders, share our position," said Dr Brundtland.
Achievements include: the 99% reduction in poliomyelitis cases; agreed targets and strategies to fight AIDS, tuberculosis and malaria which are responsible for over 5 million deaths annually; more widespread immunization against childhood illnesses with 8% increases in some countries; unity of nations as they negotiate a forthcoming framework convention on tobacco control and a greater emphasis on mental illness as a major cause of suffering and disability.
The world lives dangerously
Despite the encouraging new attention of the international community toward health, daunting challenges remain. There are worrying indications that changes in human behaviour around the world are leading to negative health impacts. This autumn, the World Health Report, one of WHO's largest undertakings, will quantify some of the most important risks to health and will assess the cost-effectiveness of measures to reduce them.
"The world is living dangerously: either because it has little choice, or because it is making wrong choices about consumption or activity," said Dr Brundtland.
At one end of the risk factor scale lie poverty, under nutrition, unsafe sex, unsafe water, poor sanitation and hygiene, iron deficiency and indoor smoke from solid fuels. These are among the ten leading causes of disease and are much more common in the poorest countries and communities.
At the other end of the risk spectrum, high blood pressure and high cholesterol, strongly linked to cardiovascular and cerebrovascular disease, are also closely related to excessive consumption of fatty, sugary and salty foods. Obesity is a serious health risk. The consequences of tobacco use and excessive alcohol consumption are deadly. These factors dominate the wealthier countries, but their prevalence in developing communities is increasing, leaving poorer countries to cope with the double burden of infectious and noncommunicable diseases.
Concerted and evidence-based action is urgently needed to reduce these risks particularly - among children and teenagers - in order to prevent disease.
Dr Brundtland said she would be launching a new initiative to promote healthy environments for children at the World Summit for Sustainable Development in Johannesburg in September. Moreover, WHO will reinvigorate its work on diet, food safety and nutrition.
Chaired by Ministers of Health, four parallel roundtables will take place within the Assembly tomorrow to discuss risks to health. They will focus on monitoring, communicating and reducing these risks.
Intensified action required on diseases of the poor
The new global commitment to health has been translated into concrete progress: additional resources and mechanisms to move new funds quickly; effective strategies to achieve precise goals in defined time limits; and mobilization and coordination of a variety of partners. Particular emphasis has been on three diseases associated with poverty--HIV/AIDS, tuberculosis and malaria.
New HIV/AIDS programmes, applicable even in resource-poor settings, use an integral approach, combining prevention, diagnostics, treatment and care. Great strides have been made in making medicines accessible to a much larger number of patients than previously.
These encouraging developments, however, are just a start. "We need continued reduction in prices of medicines and other commodities, and expansion of quality services to the millions in need. We must scale up our effort even if the struggle seems beset with political and institutional minefields," urged Dr Brundtland. She said that fully planned projects are ready to start within weeks if more money starts to flow, and that the absorption capacity of countries far outstrips the available funds.
Health systems need to be improved
Another great challenge is the creation of better health systems that are fairly and sufficiently financed and respond to needs and expectations. Dr Brundtland announced the establishment of two new initiatives: one provides guidance on health care financing in different settings; the other will improve human resources in national health systems, particularly in the poorly financed ones, which suffer as a result of relentless recruitment of health workers to places where the pay is better.
WHO is focusing increasingly on individual countries, both in terms of assisting the development of national capacity, as well as improving WHO country teams.
In the coming years WHO will give added emphasis to taking exceptional action for health in emergency and crisis situations throughout the world. This involves assembling information on health situations and responses, working in synergy with all concerned partners and improving access to essential health commodities, equipment and personnel.
WHO continues to assist national authorities in reconstruction of the health sector in Afghanistan, and is currently working to get more medical supplies into the Palestinian territories where the health systems urgently need to begin functioning again.
"Let me add the voice of public health in support of all who are urging all parties in the current [Middle East] conflict to move towards peace and away from confrontation," declared Dr Brundtland.
The full text of the Address by Dr Gro Harlem Brundtland, Director-General, to the Fifty-fifth World Health Assembly, Geneva, 13 May 2002 is available at: http://www.who.int/director-general/
The full agenda and documentation for the current Assembly can be found at: http://www.who.int/gb/