Looking ahead / by Sang Tae Han

Looking ahead by Dr Sang Tae Han Regional Director for the Western Pacific, WHO K n the Western Pacific Region of WHO, we see the beginning of the 1990s as a time for both consolidation and reorienta-tion of activities. The new decade should be a time of preparing for health in the 21st century. In terms of activities, this means a major shift of emphasis towards the improvement of human resources which is the key to ensuring health in the future. It calls for a reorientation of the basic education of new health personnel, and continuing training for the existing workforce. Such an emphasis will ensure that the health systems and programmes remain rel- evant and appropriate to changing needs. Countries must train a broad range of their health workforce and acquire a wide variety of technologies. It is equally important, however, to select particular health problems and deal with them as thoroughly as possible. Problems spawned by industriali- sation and urbanisation will demand increasing attention because such developments are going on every- where in the Region. They are causing drastic changes in our physical environment and in people's beha- viour, and this in turn has profound effects on health. In this Region, we plan to be more aggressive in our approach to environ- mental issues. In addition to providing technical information on the proper handling and disposal of hazardous wastes, we will carefully document the deleterious effects of toxic wastes on fragile ecosystems like those of our small South Pacific atolls. As we work with governments to minimise air and water pollution, we will need to define the specific prin- ciples by which growth and develop- ment are kept within the limits of available environmental resources. Some of the present disease prob- lems will probably be under control towards the middle of the next decade. We expect, for example, to have eradicated poliomyelitis from the Region by 1995. There should also be some leprosy-free areas in the Pacific by then, which will pave the way for total control of this disease. Innovative approaches to malaria prevention, W ORLD HEALTH. November 1989 such as the use of insecticide-treated mosquito nets , are also being developed, and should alleviate many of the difficulties now faced by national control programmes. If the current hard work on technologies applied to hepatitis B vaccine production and its control activities continues, countries of the Region may very well be prepared not only to combat that disease but also to develop the techno- logies needed to deal with newer threats such as HN infection. At the same time, we will have to maintain our long-term efforts to prevent and control the older and more familiar diseases such as tuberculosis, acute respiratory infections and the major childhood diseases. Dr Sang Tae Han, Regional Director Like other regions, the Western Pacific will have a very large elderly population in the years to come. Our developed and newly-industrialised countries are closely following the population trends of Japan, where it is estimated that 15 per cent of the population will be over the age of 65 by the year 2000. The developing countries also have a steadily growing elderly population. In addition, during the process of urbanisation, nuclear families are replacing the traditional extended family networks, making the care of the elderly, the chronically ill and the disabled a good deal more complicated. New ways of solving these problems must therefore be developed. Accompanying this trend will be major changes in disease patterns, calling for reallocation of health resources. For instance, rising stand- ards of living are usually accompanied by an increase in non-communicable diseases. Health promotion will be a prominent feature of our work in the areas of tobacco, alcohol and drug abuse, nutrition, and the prevention and control of degenerative and neo- plastic diseases. With all these changes, the resources needed for health will conti- nue to increase and the systems needed for managing them will be more complex. Financing of all aspects of care, especially the trained person- nel, will be an increasingly pressing concern. Consequently, planning and management must become major skills of health workers at all levels. This issue of World Health gives only some glimpses of the many international efforts and cooperative undertakings that are going on with a view to preventing disease and pro- moting health in the Western Pacific Region. • ~Cy~ S. T. Han, MD, Ph.D. Regional Director 3 0 ~