World health report

Conquering suffering, enriching humanity

For richer, for poorer?

Increasingly, health is influenced by social and economic circumstances over which the individual has little control, and over which the conventional health sector also has little sway. As a result, many countries are now experiencing a widening gap in health terms between rich and poor.

The world health report 1995 - bridging the gaps showed that infectious diseases are more prevalent among poorer and rural people, while middle- and upper-income urban dwellers - whose life expectancy is higher - are more exposed to noncommunicable diseases and conditions. Furthermore, as the gaps in life expectancy clearly demonstrate, the poor die young, while the rich die old. In terms of setting global health priorities, therefore, the poor stand to benefit much more than the rich from a continued emphasis on infectious diseases. Shifting priorities significantly away from infectious diseases towards noncommunicable diseases would benefit the rich at the expense of the poor. This would be in direct conflict with the goals of equity in health.

Any further improvements in health thus demand integrated, comprehensive action against all the determinants of ill-health. Countries, particularly in the developing world, can no longer afford to deal with the double challenge of these diseases one after another, as in the past: they must combat them simultaneously, with the help of the international community. These will be challenges reaching far into the future, but they must be confronted today.