The third priority relates to public health policy, which in the decade of the 1990s has been influenced not only by the health-for-all movement, with its emphasis on equity, but also by political and economic changes in the world at large. At the same time it is recognized that ensuring equal access to health care, a traditional goal of public health authorities, will not necessarily reduce gaps in health status insofar as disease is determined by individual behaviour and by the working and living environment. Any genuine improvement in health will thus call for integrated, intersectoral action in addressing all the determinants of ill-health. The training of health professionals will have to be reoriented accordingly.
The fourth priority is to strengthen national capabilities for emergency relief and humanitarian assistance in the health sector. The new policy of ‘emergency management for sustainable development‘ will provide a bridge between relief work and development proper, the aim being to reduce human suffering and economic loss due to epidemics, complex emergencies and mass population displacements.
The health problems of the future are awesome. Yet much can be done to tackle them with what we know already. In order to succeed the world will have to care more, and try harder, but the situation is not hopeless. Martin Luther King, writing about the civil rights struggle in the United States in the 1960s, said:‘We shall have to repent in this generation, not so much for the evil deeds of wicked people, but for the appalling silence of the good people‘.
Today, as a new generation approaches a new century, it is time for the appalling silence over global health inequities to be broken.
The evolution of WHO
The first World Health Assembly, held in June 1948 and attended by 53 delegates from WHO‘s 55 Member States, approved a programme of work that listed its top priorities as malaria, maternal and child health, tuberculosis, venereal diseases, nutrition and environmental sanitation.
Today, 47 years later, in spite of significant improvements in human health, great burdens of suffering and disease are still with us. Half a century of lessons learned in eradicating and controlling diseases, expanding health care coverage and making the best use of available resources have guided the world community, including WHO, on the way to further progress.
The need for a world health organization
At the end of the second world war the majority of the world‘s people were still living in extreme poverty and suffering from chronic malnutrition, communicable diseases and parasitic infections to name a few. Many existing health services were severely disrupted and huge segments of the population were excluded from them. The imperative need was therefore recognized for a new world body capable of grouping resources for health, concerting health goals and providing a forum for the exchange of health information. The result was the setting up by the United Nations of a specialized agency to fulfil that need - the World Health Organization.
Declaring war on disease
WHO‘s first two decades were dominated by mass campaigns to control diseases such as leprosy, malaria, smallpox, syphilis, tuberculosis and yaws. Between 1950 and 1965, for instance, 46 million patients in 49 countries were successfully treated with penicillin against the tropical disease yaws, making it no longer a significant public health problem in most of the developing world. By 1955 the number of malaria cases worldwide had dropped by at least one-third; but by 1970 eradication of the disease was seen to be impracticable.