World health report

Executive summary


Adults

Since 1971, WHO has specifically highlighted the family as the core unit for health care, leading to the concept of family health. By safeguarding the health of mothers and that of workers, the family unit is able to protect the health of dependent children and elderly.

By the late 1980s and early 1990s it was clear that, with increasing co-infections with HIV and the spread of multidrug-resistant strains, the tuberculosis epidemic was growing worse. In 1991, the World Health Assembly called for the strengthening of district-centred tuberculosis programmes and the widespread implementation of directly observed, standardized, free, short-course chemotherapy (DOTS). In 1993, the World Health Assembly declared a global tuberculosis emergency. The DOTS strategy is being used to document and manage the cure of cases of tuberculosis, thus reducing the sources of infection in the community.

In the 1980s, WHO spearheaded the emergency response to alert world authorities to national epidemics of HIV/AIDS. Since 1986, the Organization has helped Member States to establish or strengthen their national AIDS programmes; to carry out rapid assessment; to improve diagnostic, laboratory and blood screening capacity; and to plan national activities and long-term response based on reliable projections. The development of a cheap, safe and effective vaccine is a priority although the outlook is extremely long term, at least 10 years. WHO in collaboration with UNAIDS has three major roles in this area: supporting and coordinating research; negotiating with industry to ensure that the products of research will be available to those most in need; and seeking mechanisms to encourage vaccine research which is commercially far less attractive than research on new drugs.

The majority of occupational diseases can be prevented through action in the work environment, improvement of working conditions and the reduction of harmful exposure. WHO's work on occupational health dates back to 1950, when it set up with ILO a joint committee on the subject. At the beginning of the 1990s, WHO set up a new agenda for work, development and health, which led to the Global Strategy for Occupational Health for All. Member States are urged to devise national programmes, with special attention to full occupational health services. WHO promotes health in the workplace in a wider sense through the concept of the healthy company or healthy organization.

Special concerns of women. Many WHO programmes are now addressing women's needs, and the Organization is developing a policy on gender and health which should facilitate this work. Some regional offices are undertaking the collection of data to develop country women's health profiles. In 1997, WHO produced information packs which include the most up-to-date prevalence data, and has worked with professional associations to raise awareness of these issues. A multicountry study on violence against women in families, looking at prevalence, health consequences and risk and protective factors, was launched, covering countries from all regions.

The Global Commission on Women's Health focuses on three key areas: education for the health of girls and women; violence against women; and maternal morbidity and mortality. Activities at the country and regional levels have focused on data collection, literature reviews and research endeavours in areas where gaps in knowledge about women's health exist.

WHO's activities in reproductive health in 1997 include the expansion of the research initiative on the role of men in reproductive health; publication of data from the WHO collaborative study of cardiovascular disease and steroid hormone contraception; the completion of data collection - and initiation of final analysis - of a large postmarketing surveillance study of Norplant contraceptive implants; and the launching of several regional initiatives on the subjects of female genital mutilation, the increasing rate of Caesarean section and the quality of antenatal care.

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