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In: La population du monde: enjeux et problemes, edited by Jean-Claude Chasteland and Jean-Claude Chesnais. Paris, France, Institut National d'Etudes Demographiques [INED], 1997. 435-60. (Travaux et Documents Cahier No. 139)The author clarifies the conceptual framework of the study of populations health in an attempt to understand the notions of demographic transition and epidemiological transition. World Health Organization (WHO) statistics are then noted, followed by the presentation of WHO data on the global health situation. Estimated numbers of all cases of morbidity and mortality worldwide by cause are presented for 1993. Where possible, the prevalence, incidence, and number of long-term handicaps caused by each ailment are presented in addition to the number of deaths caused. According to data collected by WHO, approximately 51 million people died worldwide in 1993, of which almost 24% were in developed countries and 76% were in developing countries. The most important groups of illnesses were infectious and parasitic diseases, and causes of maternal, perinatal, and neonatal mortality, responsible for about 40% of all mortality during the year. 99% of these latter deaths occurred in the developing world. Then, circulatory system diseases, chronic lower respiratory system illness, and cancer were together responsible for about the same number of deaths, with the numbers of such deaths divided almost equally between developed and developing countries. External causes, such as accidents, suicides, and homicides caused near to 4 million deaths, or 8% of the overall total. These causes of morbidity and mortality are discussed, followed by consideration of likely future trends for the world s predominant ailments.
WORLD HEALTH FORUM. 1997; 18(2):107-15.In 1996, the World Health Organization (WHO) identified the following issues for consideration as it designed its new strategy to achieve "health for all" in the 21st century: the determinants of health, health patterns in the future, intersectoral action, essential public health functions, partnerships in health, human resources for health, and the role of the WHO. Because ethical considerations play a vital role in developing the strategy, the WHO sought the input of the Council for International Organizations of Medical Sciences in this regard. As understanding of the role and nature of medical ethics has deepened in the past decades, new ethical questions are continually being raised by changing patterns of disease and health care and by technological advances. The new health-for-all strategy must, therefore, give prominence to the consideration of equity, utility, equality, and human rights. In order to attain justice, the equilibrium between equity and equality should be maintained. Cultural diversity will also inform notions of equity. The principles of primary health care contained in the WHO's Alma-Ata Declaration also need to be strengthened to place proper emphasis on the need for information systems, decision-making mechanisms, and support systems. The most important activities the WHO is applying to its effort to renew its "health for all" strategy are 1) clarifying the concepts; 2) strengthening links to related fields; 3) working in partnership with countries, regions, and organizations; and 4) promoting the dissemination of information and ideas. The WHO's renewed strategy must bring clarity, practicality, and effectiveness to global health activities while fostering an understanding of the moral issues that contribute to human well-being.