Changing lifestyle choices an enduring challenge for improving global health – UN

18 January 2010

Despite progress on many fronts to improve global health, the world still faces persistent challenges, from insufficient funding and capacity to the resistance by many to make needed lifestyle changes, the head of the United Nations health agency warned today.

“Persuading people to adopt healthy behaviours is one of the biggest challenges in public health,” UN World Health Organization (WHO) Director-General Margaret Chan told the agency’s Executive Board at the opening of this year’s main meeting, highlighting alcohol abuse and the marketing of unhealthy foods to children, with an estimated 44 million pre-school youngsters overweight or obese. “We have to take action.”

On the positive side she cited progress “in big-picture trends,” such as HIV/AIDS, tuberculosis, malaria, vaccines and immunization, and the health of children. “The progress is sometimes fragile, threatened by factors ranging from drug resistance to uncertain funding for the future,” she said. “But the trends are definitely positive. While optimism about the malaria situation must be cautious, this is the first time, in decades, that we are getting some good news.”

Vitamin A supplementation has also been implemented as a life-saving measure in 66 of 68 countries with a high burden of child deaths, while measles deaths have dropped by 78 per cent since 2000, showing that measles eradication is achievable. “If we want to do this, we can,” Ms. Chan stressed, noting that 98 per cent of reported tuberculosis were now being treated in proven programmes.

Formalized standards in child growth have been adopted by more than 100 countries, leading to increased investment in programmes to reduce under-nutrition.

But she added: “We are still not doing enough to improve life for the most vulnerable and the poorest of the poor. At the international level, the picture is mixed, and the African region must continue to be a focus of particular concern.”

Turning to the challenges, Ms. Chan stressed that funding to sustain progress is precarious, even more so for scaling up efforts, with the shortage of doctors, nurses, and other personnel needed to do the job measured in the millions. Countries lack fundamental laboratory capacity, unsafe practices in hospitals abound, contributing, among other issues, to the spread of viral hepatitis, and blood supplies are likewise often unsafe, of poor quality, or inadequate.

Countries lack critical support, too, from regulatory and enforcement bodies, without reliable systems for data collection and information management. “This is the absolute foundation for setting national priorities and monitoring progress,” she said.

Health services in the public sector are plagued by stock-outs, poor working conditions, and staff shortages. “In the private sector, the price of generic medicines is, on average, more than 600 per cent higher than their international reference price,” she added. “This is not a pretty picture, but this is the reality. This is what insufficient capacity means, also in costs.”

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