Executive summary
Health agenda for the 21st century
The World Health Report 1998 and its three predecessors have helped create a comprehensive map of the major issues that have dominated world health in the second half of the 20th century. The priorities for international action recommended in these four reports chart the future for health action in the 21st century.
The World Health Report 1995 - Bridging the gaps, identified poverty as the greatest cause of suffering and showed the widening health gaps between rich and poor. It recommended using available resources as effectively as possible and redirecting them to those who need them most.
The World Health Report 1996 - Fighting disease, fostering development identified three main priorities: completing the unfinished business of eradication and elimination of specific diseases; tackling "old" diseases such as tuberculosis and malaria, and the problems of antimicrobial resistance; and combating newly-emerging diseases.
The World Health Report 1997 - Conquering suffering, enriching humanity stressed the importance of health expectancy over life expectancy in the context of chronic noncommunicable diseases. Its main recommendation was the integration of disease-specific interventions into a comprehensive chronic disease control package incorporating prevention, diagnosis, treatment, rehabilitation and improved training of health professionals.
This year's report has shown the major developments and achievements in health in the past 50 years and described the economic trends, population trends and social trends which will influence health in the early 21st century. Substantial gains have been made in life expectancy and in infectious disease control; these need to be safeguarded.
On the unfinished agenda for health, poverty remains the main item. The priority must be to reduce it in the poorest countries of the world, and to eliminate the pockets of poverty that exist within countries. Policies directed at improving health and ensuring equity are the keys to economic growth and poverty reduction.
Safeguarding the gains already achieved in health depends largely on sharing health and medical knowledge, expertise and experience on a global scale. Industrialized countries can play a vital part in helping solve global health problems. It is in their own interests as well as those of developing countries to do so.
Increased international cooperation in health can be facilitated by a managed global network making use of the latest communication technologies. Global surveillance for the detection of and response to emerging infectious diseases is essential. As a result of increased global trade and travel, the prevention of foodborne infections in particular is of increasing importance. Wars, conflicts, refugee movements and environmental degradation also facilitate the spread of infections as well as being health hazards in themselves.
Enhancing health potential in the future depends on preventing and reducing premature mortality, morbidity and disability. It involves enabling people of all ages to achieve over time their maximum potential, intellectually and physically through education, the development of life skills and healthy lifestyles.
The implications of healthy ageing - the physical and mental characteristics of old age and their associated problems - need to be better understood. Much more research is required in order to reduce disability among older age groups.
Concern for the older members of today's society is part of the intergenerational relationships that need to be developed in the 21st century. These relationships, vital for social cohesion, should be based on equity, solidarity and social justice.
The young and old must learn to understand each other's differing aspirations and requirements. The young have the skills and energies to enhance the life quality of their elders. The old have the wisdom of their experience of life to pass on to the children of today and of coming generations.