WHO board reviews 'health for all by year 2000' strategy.

WHO Board reviews "Health for All by Year 2000' Strategy

The first global evaluation of the World Health Organization's "Strategy for Health for All by the Year 2000' was reviewed by the 31-member Executive Board of the World Health Organization (WHO)(Geneva, 8-22 January). The Board also demanded action to protect the rights of non-smokers and to prevent and control the spread of the Acquired Immune Deficiency Syndrome (AIDS).

The Board also asked for a special report on health and development in Africa, for review by the special session of the United Nations General Assembly on the critical economic situation in Africa in May.

Noting that 86 per cent of Member States had reported on evaluation of their national health strategies, the Board urged all Member States to work towards reducing "socioeconomic and related health disparities among people'.

Recognizing difficulties resulting from the ongoing economic crisis, the Board asked WHO's Director-General, Dr. Halfdan Mahler, to intensify further support to the least developed countries, with particular emphasis on rationalizing and mobilizing additional financial resources for strengthening their health infrastructure.

The health sector will face "unprecedented demands from a rapidly growing population, especially in African, Latin American and Eastern Mediterranean countries', the global report predicted. "Mortality and morbidity patterns are changing in the developing countries as diseases associated with underdevelopment persist and chronic illnesses and environmental health problems associated with the developed world emerge.'

The draft report, which synthesizes data supplied to WHO by 140 countries, is to be reviewed by the World Health Assembly in May.

Smoking control: The Board unanimously urged those member States which had not yet done so to implement smoking control strategies to ensure that non-smokers received effective protection, to which they were entitled, from involuntary exposure to tobacco smoke, in enclosed public places, restaurants, transport and places of work and entertainment. The Board stated that "enforced smoking'--the inhaling of other people's smoke--"violates the right to health of non-smokers, who must be protected against this noxious form of environmental pollution.'

A report on tobacco use before the Board said that cigarette smoking was responsible for 90 per cent of all cases of lung cancer, 75 per cent of chronic bronchitis and emphysema, and 25 per cent of cases of ischaemic heart disease, as well as for a number of other types of cancer, pregnancy complications and respiratory diseases in children exposed to passive smoking.

Whereas in most industrialized countries the smoking habit was decreasing and becoming socially less acceptable, in developing countries it was increasing, fuelled mainly by "intensive and ruthless promotional compaigns' on the part of tobacco companies, the report stated. Because of the "immense suffering' and health hazards caused by tobacco use, WHO felt that "tobacco production cannot be defended any more than the production of other, even more remunerative crops, such as coca, opium poppy or cannabis'.

AIDS: The Board also urged countries to share information on AIDS incidence and called upon WHO to expand information exchange on the disease, to develop a simple and inexpensive test for the virus, to advise countries on the provision of safe blood and blood products, and to assist them in developing national programmes to contain AIDS.

The Board also reaffirmed that the goal of providing immunization for all children of the world by 1990 remained a global priority and urged an increase in funding for the United Nations Development Programme/World Bank/ WHO Special Programme for Research and Training in Tropical Diseases.

Regions: In considering the global health strategy, the Board was briefed on recent regional developments:

Regional Director Dr. Gottlieb Lobe Monekosso stated that the crisis in Africa jeopardized progress towards "Health for All'. Problems included high population rates, foreign indebtedness, illiteracy, drought, famine and disease. The year 1986 had been designated as the "African Year of Immunization', the aim of which was to intensify immunication programmes throughout the continent.

Regional Director Dr. Carlyle Guerra de Macedo reported that the serious economic situation in Latin America and the Caribbean had had a negative effect on the health sector. In 1985 some 120 million people were without regular access to basic health services, but infant mortality continued to decline and immunizations had increased.

Regional Director Dr. Jo Eirik Asvall highlighted the change in attitude on the part of countries of Europe regarding the "Health for All' movement. Most countries had previously felt that the movement was of greater relevance to developing countries; now almost one third of European countries were instituting national "Health for All' policies.

River blindness campaign continues

The World Health Organization/ World Bank campaign to eliminate river blindness (onchocerciasis) in West Africa--the largest health programme in sub-Saharan Africa-- entered its third phase in February, extending services to three more nations--Guinea, Guinea-Bissau, Sierra Leone. River blindness is caused by a parasitic worm transmitted by blackfly bites.

The Onchocerciasis Control Programme was begun in 1974 in seven countries--Benin, Burkina Faso, Ghana, Cote d'lvoire, Mali, Niger and Togo. Its first two phases focused on destroying the blackfly larvae by aerial spraying of insecticide on breeding grounds in rivers and streams. Transmission has been halted in 90 percent of the area and no new cases of the disease have been reported. In the third phase, to last through 1991, aerial spraying will continue, as will the search for an effective drug to prevent and treat the disease.

Dr. Hussein Abdul-Razzaq Gezairy, Regional Director for the Eastern Mediterranean, indicated that efforts in the region had been particularly focused on furthering national self-reliance in every aspect of planning, implementing, managing and evaluating health and health-related activities. There had been a particular emphasis on development of national health manpower and training and teaching activities.

Regional Director Dr U Ko Ko noted that cancer, cardio-vascular diseases and other diseases of developed countries were threatening to emerge as major public health problems in countries of Asia that had achieved higher levels of lif expectancy. Malnutrition and nutritional deficiency disorders borne by water, food and vectors continued to be major causes of death. Infant mortality rates, however, had decreased.

Regional Director Dr. Hiroshi Nakajima emphasized that priority would be given in the Western Pacific to reducing social injustice through socioeconomic development now that signs of a slowing growth rate were becoming noticeable in most countries of the region. Disease control was being approached through primary health care and emphasis had been placed on developing human resources through training at the national level.

Photo: Turkish children awaiting immunization during that country's recent 10-day nation-wide immunization drive.

Photo: An elderly villager in Upper Volta, victim of "river blindness'.