World health report

Executive summary

General health issues

A global strategy on occupational health was formulated, and country activities supported. Guidelines and monographs were produced on such subjects as the health implications of occupational exposure to organic dust and sensitizing agents as well as selected metals, solvents and pesticides. Since 1976 WHO has evaluated the health risks posed by exposure to some 200 industrial chemicals and other substances. An international collaborative oral health research initiative is being set up in collaboration with the International Dental Federation among others. An international action network was established on noma and other mutilating diseases and accidents of the face. Significant progress was made in meeting the rehabilitation needs of the 35 million persons with disabilities in Africa, using the community-based district health approach. WHO's global data on blindness were updated. Training and research in this field is supported by WHO jointly with NGOs. Quality standards were prepared for small-scale manufacturers of intraocular implants used in cataract surgery.

As a part of activities to promote healthy lifestyles, a school health education resource centre and databases were established as well as two regional networks of health promoting schools. The regions for health network in Europe was expanded to include 20 regions. National tobacco control programmes are supported. Recent Winter Olympic events have been smoke-free, thanks to collaboration between the International Olympic Committee and WHO. WHO provides countries with information and guidelines on the organization of health systems based on primary health care. Technical guidance is given on the formulation of new health policies and strategies and the reorganization of health care financing systems.

WHO promotes information exchange between countries in relation to the development of human resources for health. It has launched an initiative to determine optimum approaches to the training of health personnel under changing socioeconomic conditions. Reviews of public health training and medical education are supported. Fellowships are provided for training in many health and related fields. National, regional and interregional action plans for upgrading nursing and midwifery practice are being drawn up through a network of WHO collaborating centres.

In the field of pharmaceuticals guidelines for drug prescribing are being expanded. National systems for drug registration, surveillance and quality assurance are being established in a number of countries with WHO collaboration. The WHO model list of essential drugs is being revised and updated. Working with bilateral agencies, other United Nations bodies and NGOs, WHO collaborates with 55 countries in framing national policies in such areas as drug selection and legislation. Operational research is carried out on the rational use of drugs. Guidelines, tools and training materials have been prepared on many aspects of drug management.

The WHO Global Commission on Women s Health has drawn up an agenda for action relating to women, health and development. Under the auspices of the commission, a scheme to provide credit and banking facilities to the most vulnerable and disadvantaged is being implemented in Africa. At the 1994 International Conference on Population and Development in Cairo, WHO played a key role in helping to reach a consensus and transcend political and religious differences. This was made possible by the Organization's medical and ethical credibility and its inclusive approach to health.

Together with UNDP, WHO promotes recognition of health and environment concerns in national plans for sustainable development and has given financial and technical support to six countries for this purpose. WHO has been designated task manager for the "health chapter" of the 1992 United Nations Conference on Environment and Development (UNCED). In collaboration with several United Nations bodies it has prepared a progress report on health, environment and sustainable development, stressing the importance of reform with respect to community development, environmental health, national decision-making and national accounting. Materials produced by WHO included guidelines on the operation of poisons control facilities, 15 health and safety guides, and over 200 international chemical safety cards providing basic information on the diagnosis and treatment of poisonings. Training and research on the broad topic of health and environment are supported.

WHO worked with 26 countries in greatest need in planning and implementing health reforms as part of an overall effort for strengthening of national managerial capabilities. A third report on progress towards health for all by the year 2000 was prepared for submission to the WHO governing bodies in 1995. Research on health futures was organized; and assessment of the global health situation and trends in priority diseases and conditions continued. A total of 184 nongovernmental organizations are now in official relations with WHO. The growing awareness among Member States of the need to improve health care delivery systems, and a notable interest on the part of the World Bank to promote improvements in the social sector, provided a timely opportunity to forge closer links between WHO, the Bank and governments. Collaboration was also strengthened with the five major regional development banks. The traditional good working relations with UNICEF, UNFPA, FAO, ILO and UNESCO continued.

WHO continues to strengthen national capacity for emergency preparedness and relief. Technical expertise and emergency medical supplies were provided to a number of countries including Afghanistan, Angola, Burundi, Iraq, Rwanda, Somalia, Sudan and some new independent states in 1994. WHO cooperated closely with the European Union on assistance for the countries of former Yugoslavia. Ten joint missions were undertaken with WFP for the organization of food aid in support of human resources development.

Handbooks and guidelines in different fields of health technology were produced. Progress was made in developing portable laboratory instruments, solar-run equipment and other types of appropriate technologies.

Up-to-date, authoritative health information is provided to all Member States through a large number of publications, a series of widely-distributed periodicals, electronic networks and library services. WHO facilitates access by countries to a number of databases containing information on such subjects as communicable diseases and HIV/AIDS. For many health workers in developing countries, WHO materials are often the only source of reliable information on health.