A Suffering Humanity

A survey of global health has concluded that a billion people--one in five--are diseased, in poor health or malnourished, according to the United Nations World Health Organization. The report underscores the importance of a greater commitment to public health, particularly in sub-Saharan Africa, South Asia and Latin America.

“This is a preventable tragedy because the developed world has the resources and technology to end common diseases worldwide, Dr. Hiroshi Nakajima, WHO director general, commented. “The missing ingredient is the will to help the developing countries. Simply, the rich countries must transfer technology, health manpower and money because the poorest countries can’t help themselves.”

Health expenditures in the poorest nations average $5 per capita compared with $400 or more in the industrialized nations of the West. An increase of as little as $2 per person would cover the cost of global child immunization and remedies for many of the most prevalent diseases, including diarrheal and acute respiratory infections, tuberculosis, malaria, schistosomiasis and sexually transmitted diseases.

Some 60% of the world’s children are now vaccinated against polio, tetanus, measles, diphtheria, pertussis and tuberculosis, but the diseases still kill almost 3 million children each year. Oral rehydration therapy to reduce the risk of death from diarrheal infection has been adopted by public health services in most nations, but the therapy still only reaches about one-third of the children at risk. Pneumonia kills an estimated 4 million children a year because they do not have access to the inexpensive antibiotic treatment that could save their lives.

Not all of the problems are focused in the developing nations alone. The spread of sexually transmitted diseases in developed industrialized nations, notably the United States, has been dramatized in recent reports. It is now estimated that 5% of teen-agers and young adults worldwide contract a sexually transmitted disease each year. Gonorrhea, syphilis, chancroid, chlamydia, genital warts and two incurable diseases, genital herpes and acquired immune deficiency syndrome (AIDS) are increasing in many regions of the world, “aggravated by the greater mobility of populations and the breakdown in traditional mores, increasingly leading to multiple sex partners,” according to the report.

Malaria remains a major scourge in 100 nations of the world, with no progress evident. Half the world’s population is at risk from it. In 76 developing nations, schistosomiasis, a debilitating tropical disease spread by water-borne parasites, afflicts an estimated 200 million people.

Nakajima notes in his report the progress that has been made: Smallpox has been eliminated, and polio is likely to be eradicated by the end of the century. But he prefers, quite correctly, to focus on what needs to be done, not on what has already been done. “We cannot rest on our laurels, waiting for things to change,” he said. “We need to act now.”