World health report


Core values for a global health partnership

Achieving national and global health objectives requires new resources and unprecedented levels of cooperation among multilateral agencies, national authorities, communities, the private sector and other stakeholders. Such a mobilization must be based on rigorous science, but also on a clear ethical vision.

An ethical vision in global health draws inspiration from the Constitution of the World Health Organization, drafted in 1946. Then, as today, the world was deeply concerned with questions of security. Indeed, "to maintain international peace and security" was the primary purpose assigned to the United Nations. But the founders of WHO and the United Nations system saw clearly the relationship between security and justice. Neither of these two values can endure without the other. People who had lived through the Second World War, witnessing the effects of nationalism, ethnic hatred, and the disregard of human dignity pushed to their extremes, understood this interdependence. The preamble to its Charter makes clear that the mission of the United Nations to protect security depends on the establishment of "conditions under which justice … can be maintained".

The founders of the international system more than half a century ago grasped the close connection between health -- understood as "a state of complete physical, mental and social well-being" -- and the core values of justice and security. The WHO Constitution identifies the "enjoyment of the highest attainable standard of health" as "one of the fundamental rights of every human being without distinction". A crucial part of justice in human relations is promoting equitable access to health-enabling conditions.

During the last decades of the 20th century, health and security were often separated from each other in national and international debates. Increasingly, however, the connections between these two domains are re-emerging. The United Nations Security Council and national bodies acknowledge, for example, the growing security impact of HIV/AIDS. The threat of new infections demands new forms of cooperation between security and public health.

As globalization accelerates, the interdependence of nations is perceived clearly. Treating others justly is now both a moral imperative and an aspect of wise security policy. This World Health Report shows how SARS has brought interdependence and the need for international cooperation strongly to the fore. But the basic principle extends to many other areas of public health concern.

Population health contributes crucially to economic and social development. This is reflected, for example, by the importance accorded to health issues in the United Nations Millennium Development Goals. These goals are central to WHO's agenda and to this report. Health is both a goal in itself and a key development input towards other goals.

This report is not comprehensive. It focuses on selected themes, mentioning many other important subjects only tangentially. Mental health, tuberculosis, malaria, malnutrition and reproductive health will clearly remain crucial focus areas for WHO, although they receive limited attention here. Similarly, the human impact on the natural environment and the health consequences of environmental change for human populations are given little direct attention. However, these processes will significantly shape health patterns, and the demands on health care systems, in the years ahead.

The purpose of this World Health Report is to encourage action for health improvement, especially for the poor and disadvantaged. This is no longer the time for academic debate: the moral imperative is for urgent action. Cooperation between governments, international institutions, the private sector and civil society spurred remarkable public health progress in the 20th century. In an increasingly interdependent world, such collaboration across political and sectoral boundaries is more vital than ever. This report urges every reader, whether inside or outside public health institutions, to share in the task of shaping a healthy, equitable and sustainable future for all.