World health report

Conquering suffering, enriching humanity

Curing and caring

One crucial and controversial difference between infectious and chronic diseases needs to be recognized. The history of medicine and public health shows that infectious diseases can be cured - eliminate or destroy the infectious agent, and the disease is defeated.

The eradication of smallpox is the supreme example, but many other infectious diseases are steadily being conquered. This could not be achieved without strong community participation - immunization campaigns, for example, cannot succeed without active community support.

Chronic diseases, with a few exceptions, have not so far lent themselves so easily to cure. They are less open to community action. They do not spread from person to person. Every case of chronic disease represents a burden borne by one individual who, depending on circumstances, may or may not have access to treatment or support.

This stark fact demands a realistic response: if the majority of chronic diseases cannot as yet be cured, the emphasis must be on preventing their premature onset, delaying their development in later life, reducing the suffering that they cause, and providing the supportive social environment to care for those disabled by them.

Today there are an estimated 380 million people aged 65 years or more, some 220 million of them in developing countries. By 2020, projections indicate that there will be more than 690 million and 460 million respectively.