The world health report

Global health improvement and WHO: shaping the future

A world torn by gross health inequalities is in serious trouble. The global health community can do much to reduce suffering and death among vulnerable groups. WHO is changing its way of working, alongside member states and financial and technical partners, to reach key national health goals and strengthen equity. The most urgent objectives include the health-related Millennium Development Goals, the 3 by 5 target in HIV/AIDS treatment (to provide 3 million people in developing regions with access to antiretroviral treatment by the end of 2005), and addressing the growing epidemics of non-communicable diseases. The key to achieving these objectives is strengthening of health systems guided by the values of Health For All.


To shape a better future for the global community, health gaps between rich and poor need to be closed. To achieve progress in health equity, strong ethical and scientific leadership is needed in the sphere of international health. WHO is the only agency with responsibility for improving the health of all populations. At its best, WHO unites effective measures at country level with the exercise of worldwide authority and coordination functions. It bonds the most advanced science to a normative commitment to justice and human rights.

Of course, as an intergovernmental organisation accountable to 192 member states, WHO also faces unique difficulties. Tensions emerge between WHO's need to be responsive to the agendas of member states and its mandate to provide leadership based on scientific evidence. Likewise, the interests of different countries clash. When such difficulties arise within WHO, they must be resolved through painstaking compromise, rather than by unilateral executive decision. Yet democratic processes remain preferable to any known alternative, when we are concerned with the promotion of such fundamental rights as health. As we focus on overcoming global health inequalities, it is more important than ever that strategies be debated in a forum in which all countries are heard. The ambitious programmes WHO is launching will need substantial new resources. We must be clear about this. Military hardware is expensive. So is building equitable health infrastructure. Neglect of the latter leaves the world less just and ultimately less secure. As of this writing, funding must still be secured for the bulk of WHO's projected expenditures on 3 by 5, as for numerous other crucial programmes we want to initiate or continue in the years ahead. We must rely on member states and other donors to supply these urgently needed resources. Yet I am confident that the money will come. The crucial thing is to get started. As 3 by 5 and other initiatives begin to show results-in deaths averted, quality of life and economic productivity restored, families and communities preserved-the resources to continue this work will be forthcoming.

The global community must confront today's emergencies while laying sustainable foundations for a healthier future. This means synergising targets such as 3 by 5 with the broad scale-up of equitable, integrated health systems that can meet the needs of communities and make quality health services available to everyone. No single institution can accomplish such a task. But, working closely with countries and partners, WHO will lead the way. 20 years with WHO in countries, regions, and headquarters give me a clear sense of the challenges we face on the ground, but also of this organisation's unique strengths-above all the skills, dedication, and ethical commitment of its people. Working together, WHO and its member states and partners will shape a better future in global health.

LEE Jong-wook is Director-General of WHO.