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Facts
- World Health Day, 7 April, helps raise awareness of a key global health issues.
- Worldwide, deaths of children under-five years of age declined from 93 to 72 deaths per 1,000 live births between 1990 and 2006.
- A child born in a developing country is over 13 times more likely to die within the first five years of life than a child born in an industrialised country.
- The proportion of children under five who are undernourished declined from 33% in 1990 to 26% in 2006 but there were still over 140 million children in developing countries who were underweight.
- In 2006 there were an estimated 247 million cases of malaria causing an estimated 881.000 deaths, mostly among African children.
- Around the world 33 million people are living with HIV/AIDS, most of them in in Sub-Saharan Africa, where about 60% of adults are women.
- Globally, 9.2 million new cases and 1.7 million deaths from tuberculosis occurred in 2006
Extensively drug-resistant tuberculosis has been recorded in 45 countries.
- Cardiovascular diseases (diseases of the heart and blood vessels that can cause heart attacks and stroke) are the leading causes of death in the world. Healthy diet, regular physical activity and avoiding the use of tobacco would prevent most of these deaths.
- Complications of pregnancy account for almost 15% of deaths in women of reproductive age worldwide
- Mental disorders such as depression are among the 20 leading causes of disability worldwide.
Source: http://www.who.int
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Background
"Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." (World Health Organization) Good health requires provision of health care for prevention and treatment of disease and injury, good nutrition and safe environments. The health of populations has many links with other sectors, such as economic, education, water and sanitation and gender.
Poverty is both a cause and an effect of poor health. The poor suffer more and face more serious consequences from ill health. Developing countries also have less capacity to provide basic health services for their people.
Great gains in health have been made over the last fifty years as the result of improvements in income and education, with accompanying improvements in nutrition, access to contraceptives, hygiene, housing, water supplies, and sanitation. The underlying threats to good health are well known and affordable solutions are frequently available but because of weak government capacity potentially effective policies and programs often fail.
Some of the key health areas are:
Public health systems
Public health aims to prevent illness and injury, control the spread of disease and enhance current and future wellbeing and quality of life of a nation’s population. Activities include health education, provision of drugs, immunisation, and family planning, supply of clean water and sanitation.
Most developed countries spend 5.5% to 8.0% of their GDP on health while the least developed countries spend 1.0% to 3.0%. These differences in expenditure are reflected in the quality of the delivery and responsiveness of the health systems and general health indicators for the population.
Nutrition
Access to sufficient, safe and nutritious food is an important way to prevent disease, strengthen immunity and build better health. Although often invisible, malnutrition affects close to 800 million people worldwide, especially the poor. It maims, cripples, blinds and kills. Young children are especially vulnerable to malnutrition, those surviving may suffer ongoing disease and disability, affecting their ability to learn and develop to their full potential.
Immunisation
Access to immunisation, the protection from diseases by stimulating the body’s own immune system to develop antibodies against subsequent infection or disease varies greatly across the world. A child in a developing country is ten times more likely to die of a vaccine-preventable disease than a child from an industrialised one. Immunisation is among the most cost-effective interventions. Since the 1980s, considerable progress in immunisation against measles, polio, pertussis, diphtheria, tetanus and tuberculosis, has been made, although worldwide average vaccination coverage of children under five fell from 80% in 1990 to 74% in 1999.
Malaria
Malaria is a common and serious tropical disease transmitted by mosquitoes and characterised by high fever. It causes at least 300-500 million cases of acute illness and 1.3 million deaths each year, 90% of which are in Africa. It is the leading cause of deaths in young children and is also particularly dangerous for pregnant women, causing severe anaemia, miscarriages, stillbirths, low birth weight and maternal death. Malaria traps families and communities in a downward spiral of poverty, disproportionately affecting poor people who have limited access to health care and for whom loss of income and education has an ongoing impact. Key interventions to control malaria include: prompt and effective treatment with artemisinin-based combination therapies; use of insecticidal nets by people at risk; and indoor residual spraying with insecticide to control the vector mosquitoes.
HIV/AIDS
The Human Immunodeficiency Virus (HIV) infection causes Acquired Immunodeficiency Syndrome (AIDS) and causes the breakdown of the body’s own system of protection. An estimated 33 million people are living with HIV/AIDS with 95% of global infections in developing countries. HIV/AIDS threatens to reverse years of development and put at risk the political stability and economic security of these countries. It attacks people in their most productive years, destroys communities, and disrupts food production. Heavy burdens are placed on already weak health services. There is no effective cure for HIV. It is a complex social issue which involves changing attitudes and behaviours. Antiretroviral drugs, combined with good nutrition and good health care to fend off opportunistic infections, can limit the effects of HIV.
Water and sanitation
Around 1.8 million people die every year from diarrhoeal diseases caused by lack of safe drinking water and adequate sanitation. At any one time about one-half of all people in developing countries are suffering from diseases associated with water. Diseases may be caused by drinking water contaminated by human or animal waste, insects which breed in water or parasites. The energy expended carting water long distances also has a health and time cost on women and children. Improved access to water and a knowledge of hygiene and management practices can lead to improved health.
Australia's responses
The aim of the Australian aid health policy is to work with developing countries to improve the health of the poor. Australia helps countries develop better quality, cost effective and community focused health systems that are sustainable and that lead to better health outcomes in the long term. There is a strong focus on primary health care and disease prevention which targets the major causes of child and maternal mortality and morbidity; family planning and HIV/AIDS prevention and care activities.
The aid program also provides support in areas that underpin good public health systems such as national health policy development and planning, disease surveillance systems, and pharmaceutical supply and regulation.
The aid program also helps rebuild health systems in post conflict situations, such as East Timor and the Solomon Islands.
See also: http://www.ausaid.gov.au/keyaid/health.cfm
The global agenda
The Millennium Development Goals
The Millennium Development Goals
At the 2000 UN Millennium Summit, 189 world leaders from rich and poor countries committed themselves to a set of eight time-bound targets. Goals focus on reducing poverty and hunger, child mortality and the spread of disease and improving education and gender equality,
The first six goals specifically are related to health:
Goal 1: Eradicate extreme poverty and hunger
Goal 2: Achieve universal primary education
Goal 3: Promote gender equality and empower women
Goal 4: Reduce child mortality
Goal 5: Improve maternal health
Goal 6: Combat HIV/AIDS, malaria and other diseases
http://www.un.org/millenniumgoals/
Strengthening health systems
Many projects aim to strengthen health systems as a means of improving efficiency in the management and use of health resources. In most countries, health sector reforms have included:
- organisational reforms - restructuring of the ministry of health and decentralisation of planning, budgeting authority, control of financial resources and responsibility for implementation of program activities;
- health financing reforms - cost sharing, user fees, and public and private health insurance mechanisms;
- increased partnerships with communities and private health-care providers.
The Expanded Programme on Immunization
WHO's Expanded Programme on Immunization began in 1974. It targets mainly six communicable diseases of childhood (polio, diphtheria, tuberculosis, pertussis (whooping cough), measles and tetanus) and has reduced these diseases among children under five from about 23% in the mid-1970s, to about 80% today. To fully immunise a child against the six diseases costs about US$17, making immunisation one of the most affordable interventions available. Those who miss out tend to be people living in remote locations, urban slums and border areas.
The Global Fund to Fight AIDS, Tuberculosis and Malaria
The United Nation’s Global Fund to Fight AIDS, Tuberculosis and Malaria was created to dramatically increase resources to fight three of the world's most devastating diseases, and to direct those resources to areas of greatest need. Funds raised will support proven interventions against the three diseases. It will provide over 500,000 people living with HIV/AIDS with anti-retroviral treatment and provide medical and educational support for half a million children orphaned due to AIDS. It will also enable the detection and treatment of two million additional cases of tuberculosis, and deliver 20 million combination drug treatments for drug-resistant malaria.
Roll Back Malaria
Roll Back Malaria (RBM) is a global partnership founded in 1998 by the World Health Organization (WHO), the United Nations Development Programme (UNDP), the United Nations Children's Fund (UNICEF) and the World Bank with the goal of halving the world's malaria burden by 2010. The RBM partnership includes national governments, civil society and non-governmental organisations, research institutions, professional associations, UN and development agencies, development banks, the private sector and the media. RBM was founded in response to a growing concern by governments, particularly in Africa, about the continuing and increasing burden of disease and death due to malaria.
HIV/AIDS
The World AIDS Campaign has been established to support, strengthen and connect campaigns that hold leaders accountable for their promises on HIV and AIDS.
The World Bank is working with its partners to:
- Prevent the further spread of HIV/AIDS among vulnerable groups and in the general population;
- Promote countries' health policies and multi-sectoral approaches (eg by working in education, social safety nets, transport and other vital areas);
- Expand basic care and treatment activities for those affected by HIV/AIDS and their families, as well as for children whose parents have died of AIDS and other vulnerable children.
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