Outlook for the future

Outlook tor the future lthough a positive start has been made in the quest for Health for all, the prevailing and forecast economic situation will continue to challenge policy-makers as they seek a balance between economic and social goals. The health sector will face unpre- cedented demands from a rapidly growing population, especially in bur- geoning cities ringed by swelling slums. Shifting mortality and morbid- ity patterns, increased life expectancy, different social conditions, modified lifestyles and an ever-changing envi- ronment will create additional or new health care needs. Technological sol- utions to major health problems will have greater application in the future-but cannot solve everything. Solidarity among countries, at least in health matters, is expected to gain greater acceptance . But the achieve- ment of Health for all by the year 2000 in those countries that are in economic quandaries, or those facing grave environmental hazards or social and political disturbances, will indeed be a Herculean task. For WHO's Member States, political commitment to equity will remain a fundamental prerequisite for reaching the goal, and enlightened leadership will be needed to correct disparities. Support and commitment will be required from non-governmental organizations, professional groups and individuals-not least, to counteract public apathy. Limited resources will call for efficacious management of health systems based on reliable infor- mation and effective decentralisation. The integrated delivery of primary health care components, and a rational review of functions, technology and resources at all levels will serve to instill confidence in communities and professional groups. Research, par- ticularly with regard to applying health technology at the first level of contact, will need greater attention and sup- port. Financial requirements for health will have to be carefully esti- mated and wisely spent, and there will be a search for external financing. WHO itself will be called upon to furnish the right kind of technical cooperation to boost the national health managerial capacities of Member States. This will include mak- ing available all pertinent information for preparing, strengthening and evaluating national strategies for WoRLD HEALTH, October 1986 We have always been space travellers. For we ,are the local embodiment of a Cosmos grown to self-awareness. We have be- gun to contemplate our origins: starstuff pondering the stars ; or- ganized assemblages of ten bi l- lion billion billion atoms consider- ing the evolution of atoms; trac- ing the long journey by which. here at least. consciousness arose. Our loyalties are to the species and the planet. We speak for Earth . Our obligation to survive is owed not just to ourselves but also to that Cosmos, ancient and vast. from which we spring. from Cosmos, by Carl Sagan. Copyright 1980 by Carl Sagan Productions, Inc. Health for all. WHO will also face the challenge of promoting and supporting the research and development requir- ed to put the strategies into action. The Organization will need to take vigorous action to help countries to W oRLD HEALTH, October 1986 mobilise financial resources-espec- ially the least developed countries. When the ancient Greeks consulted the prophetess of Delphi for an oracu- lar statement about their future, she was not really expected to articulate clear answers to questions. Her delib- erately vague replies left room open for the choice of several options. The efforts of the Member States and the support given by WHO over the past six years clearly illustrate where their choice lay, and reflect their shared will to adopt, adapt and employ Health for all strategies. The Seventh Report on the World Health Situation reaffirms the validity of the strategies in both developing and developed countries and guaran- tees that the momentum will be kept up. The national evaluation reports which it contains will enable each country to define where the major emphasis should lie in the future, and what changes or actions will be most essential in order to achieve all the objectives in the remaining years before the turn of the century. • Quizzical, despairing or confidently smiling -the children of today will be the young citizens of the year 2000. Health for all is their best hope for a socially and econom- ically productive life. Photos WHO/Zafar and (below) WHO/H. Anenden 27