Health for all by the year 2000

WORLD HEALTH DAY 1981 Health for all by the year 2000 by Dr Halfdan Mahler Director-General of the World Health Organization Only those who celebrate World Health Day in the year 2000 will be able to judge if those in the gener- ation that preceded them were realists or dreamers when, in 1977, they decided in the Health As- sembly of WHO to launch the move- ment for health for all by the year 2000. Few could have foreseen then to what extent this move would fire the imagination of people throughout the world. The fact that it did showed how timely the call was to bring about a social revolution in community health. Old ways of deal- ing with health problems had proved to be highly inadequate in countries at all stages of development, and the inequalities in health status and in the distribution of health re- sources throughout the world were intolerable. The situation today is that nearly one thousand million people are trapped in the vicious circle of pover- ty, malnutrition, disease and despair that saps their energy, reduces their work capacity and limits their ability to plan for the future. For the most part they live in the rural areas and urban slums of the developing coun- tries. The depth of their deprivation Better sanitation will improve their chance of survival. We must make Health for All suc- ceed; the children of today, and of tomorrow, will never forgive us if we do not. (Photo WHO/A.S. Kochar ) can be expressed by a few statistics. Whereas the average life expectancy at birth is about 70-75 years in the developed countries, it is only about 45-55 in most developing countries. Of every 1,000 children born into poverty in the least developed coun- tries, 200 die within a year, another 100 die before the age of five, and only 500 survive to the age of 40. What, then, is health for all? The World Health Assembly referred to it as the attainment by all the people of the world of a level of health that will permit them to lead a socially and economically productive life. This implies that the level of health of all people should be at least such that they are capable of working produc- tively and of taking an active part in the social life of the community in which they live. To bring this about will require reforms, not only in the health sector but also of a political, social and eco- nomic nature. A more equitable dis- tribution of resources for health can be the first of a series of such reforms in all sectors. The health delivery system itself has become a neglected child. In keeping with the principle of paying greater attention to the underprivileged, urgent action is needed to change that situation. Hence, the health infrastructure must be reorganized so as to play a leading role in forging together the different health programmes into one unified system, however tough the struggle New hope is dawning for the world's poor. Cover design by Peter Davies IX ISSN 0043-8502 World Health is the official illustrated magazine of the World Health Organization. Editor: John Bland Deputy Editor: Christiane Viedma Art Editor: Peter Davies News Page Editor: Peter Ozorio World Health appears ten t imes a year in English. French. Portuguese. Russian and , Spanish. and four times a year in Arabic and Persian. Articles and photographs not copyrighted may be reproduced provided credit is given to the World Health Organization. Signed articles do not necessarily reflect WHO's views. World Health. WHO. Av. Appia. 1211 Geneva 27. Switzerland. Contents Health for all by the year 2000 by Halfdan Mahler 3 Small beginnings by Jitendra Tuli Family planning in the year 2000 by Tabitha Standley 7 and Alexander Kessler 10 Success story by Paul Harrison 14 Health for all 20-21 Rural health team by Liesl Graz 22 Women's dispensary by Christiane Viedma 28 So many like her by Vicki Hammer 33 Health is a way of life I 36 You(lg World Health 37 News Page 38 ~ '•~ . _, ~: ~-­ ·~····,~ \ , '"" ~~····~-->~: \. .... , .,.., ·~ " / Village health workers like these in Peru (left) and Sri Lanka (above) are bringing health care to all, in an acceptable and affordable way, and with the full involvement of the community. (Photos WHO/ Y. Pouliquen and WHO/A .S. Kochar) will be. And it must do so not only in the big cities- that is difficult enough- but also, and particularly, in rural areas and urban slums. Once this is achieved, it will mean that there will be a fair distribution among the population of whatever health resources are available. Essen- tial health care will become accessible to all individuals and families , in an acceptable and affordable way, and with their full involvement. The International Conference on Primary Health Care held in Alma- Ata, USSR, in 1978 issued a Declara- tion which stated that Primary Health Care is the key to attammg health for all by the year 2000. It also identified eight essential elements of primary health care. These are: edu- cation concerning prevailing health problems and the methods of pre- venting and controlling them ; pro- motion of food supply and proper nutrition ; an adequate supply of safe water and basic sanitation ; maternal and child health care, including fami- ly planning ; immunization against the major infectious diseases; preven- tion and control of locally endemic diseases ; appropriate treatment of common diseases and injuries ; and the provision of essential drugs. The Alma-Ata Conference also called for urgent and effective national and international action to develop and implement primary health care throughout the world and particularly in developing countries in a spirit of technical cooperation and in keeping with a new interna- tional economic order. The Member States of WHO were quick to respond to the call. The strategies they are now engaged in working out will in turn be supported by strategies at regional and global level, and these will be converted into plans of action to be carried out over the next two decades. The highest United Nations forum, its General Assembly, has welcomed these efforts and has called on the entire interna- tional community to support them. All this augurs well for the growing national and international movement to attain health for all by the end of this century. In spite of the difficult security situation in many parts of the world and the disturbing economic climate, the growing political commit- ment of governments and the enthu- siastic support of people everywhere can turn the dream into a reality . • 5