A global perspective of health, vintage 1979.
Discussion focuses on the global state of health as an introduction and background for deliberations. There are several dramatic indications of the worsening state of global ill health, particularly in developing countries. During the past 2 decades a cholera pandemic has spread extensively in Asia and Africa. During this same time, in large areas of South Asia and Central America, bacillary dysentery has spread extensively. It too had been virtually absent from the world scene for the preceding 50 years. Like cholera, this pandemic took its greatest toll from the most deprived populations. The largest outbreaks of typhoid fever ever recorded in the literature have occurred in the current decade. Malaria has reemerged as a major public health problem in the poorest parts of Asia, Africa, and Central and South America. Diseases such as measles, diphtheria, tetanus, and polio, for which vaccines have been long available, persist as major public health problems. These diseases, especially the epidemic and pandemic diseases, may be considered public health indicators. Their resurgence in recent years after decades of quiescence is symptomatic of a state of global ill health. It is significant that developing areas have been rather exclusively affected. In recent times, seemingly, the world has been divided into epidemic prone areas and areas essentially free of the major infectious diseases. This health disparity is underscored by some startling statistics on infant mortality. The industrialized nations currently enjoy the lowest infant mortality ever, but the rate is higher than ever in most of the developing areas of Africa, Asia, and Latin America. 3 major demographic changes that have primarily affected the poor and a major economic upheaval are largely if not totally responsible for the worsening state of global ill health: the population explosion, urbanization, and migration. The fundamental problem is usually the quality of life and the common denominator is the search for a better way of life. This conference devoted to human resources for technology transfer in primary health care deals with a new direction in health care under the able leadership of the World Health Organization (WHO) and other UN agencies which have the potential to change the situation. WHO's slogan is adequate health care for all by the year 2000. The start is with a new working premise, i.e., that health is quality of life, not just freedom from physical and mental burdens.