AFRO-NETS> WHO Report - News Analysis

[Dr Sigmund de Janos <dejanos@home.com>]

WHO Report - News Analysis
--------------------------

News Organisations Dissect 1999 World Health Report 

"Health care must be rationed if serious disease is to be conquered," 
the London Times reports in its coverage of the World Health Organiza-
tion's newly released 1999 World Health Report. Labeling the WHO's con-
clusion a "radical change in direction," the newspaper notes that the 
UN agency now maintains that "it does not make economic sense to try to 
provide comprehensive medical services for everyone. Instead, poorer 
countries should be helped to carry out low cost programs to tackle 
illnesses such as malaria, while wealthier countries should learn how 
to prioritize the care they offer." 

David Nabarro, manager of the WHO's Roll Back Malaria initiative, de-
fended the conclusion: "We have left the dark tunnel of naivety and 
reached the light of reality. You can't think about health care without 
thinking about available resources. Economic issues are now at the cen-
ter of health." Nabarro said developing nations must "stop spending 
money on expensive specialist projects and must concentrate instead on 
cheap immunization programs" (Ian Murray, London Times, 12 May).

Longevity Revolution To Burden Poor Countries
The WHO report notes that as average lifespans increase world-wide, de-
veloping countries can expect to see a rise in the number of non-
communicable diseases often associated with ageing. Such ailments "ac-
counted for 81% of all illness in high-income countries" last year, 
compared to only 39% in developing countries. "The developing world is 
going [to] get the same burden added to the one they already have, as 
people live longer and as they even take on new habits such as smoking 
tobacco," WHO Director-General Gro Harlem Brundtland said (Associated 
Press, 11 May). 

The WHO is urging poor countries to dedicate more resources to health 
care, noting that Indonesia, Sudan and Sri Lanka each spend less than 
2% of gross domestic product on health care, compared with 9% in the 
United States, France and Switzerland (Agence France-Presse, 11 May). 

Measuring Disease Burden 
The Financial Times notes that the WHO report "tries to reassess the 
global burden of disease using a method known as disability-adjusted 
life years (DALYs), where one DALY is one last year of healthy life." 
Using this approach, the report underlines the impact of mental ill-
ness: "Depression emerges as the fourth largest cause of disability 
globally, affecting rich and poor nations alike, while alcohol abuse 
has become a big problem among adult men in developed countries" (Fran-
ces Williams, Financial Times, 12 May). 

The Global Tobacco Fight
The health report targets tobacco as one "priority" issue, calling for 
"a world-wide ban on all tobacco advertising, regular tax increases on 
cigarettes and better access to substitutes such as nicotine patches" 
(Stephanie Nebehay, Reuters/Philadelphia Inquirer, 12 May).

Brundtland "said yesterday she expected ministers at the World Health 
Assembly which begins on Monday to launch negotiations on a framework 
convention on tobacco control to be concluded by 2003" (Williams / Fi-
nancial Times). 

The convention "would aim to halt the spread of tobacco and tobacco 
products by promoting tobacco-free economies, stopping smuggling and 
implementing other measures" (Nebehay, Reuters/Philadelphia Inquirer).

Dr Sigmund de Janos
Senior Consultant
Tel: +1-613-731-3461
Fax: +1-613-731-3286
mailto:dejanos@home.com

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