The world health report 1999 : Making a difference

CONTENTS
MESSAGE FROM THE DIRECTOR-GENERAL vii
Progress and Challenges viii
A Corporate Strategy for WHO xi
Improving health outcomes xi
Supporting health sector development xiv
A more strategic approach to our work in and with countries xv
Forging more influential partnerships xvii
Repositioning WHO for the 21st Century xviii
PART ONE
MAKING A DIFFERENCE IN PEOPLE’S LIVES :
ACHIEVEMENTS AND CHALLENGES xxi
CHAPTER 1:
HEALTH AND DEVELOPMENT IN THE 20TH CENTURY 1
The 20th Century Revolution in Human Health 1
The precipitous decline in mortality 2
Demographic transition 3
Sources of mortality decline 5
Health and Economic Productivity 7
Macroeconomic evidence 8
Microeconomic analysis 9
Pathways of influence 10
CHAPTER 2:
THE DOUBLE BURDEN:
EMERGING EPIDEMICS AND PERSISTENT PROBLEMS 13
Emerging Epidemics of Noncommunicable Diseases and Injuries 14
Noncommunicable diseases 15
Injuries 17
Persistent Problems of Infectious Diseases and Maternal
and Child Disability and Mortality 19
The unfinished agenda 20
The persisting and evolving challenges 21
The Avoidable Burden of Disease 22
PART TWO
MAKING A DIFFERENCE IN THE 21ST CENTURY 29
CHAPTER 3:
MEETING THE CHALLENGES: HEALTH SYSTEMS DEVELOPMENT 31
Achieving Greater Efficiency 33
Setting priorities 35
Re-thinking incentives to providers 36
Renewing Progress towards Universal Coverage 37
Risk sharing 38
Health care coverage 39
Policy choices 40
New universalism 43
Providing for the Future: the Role of Research and Development 43
CHAPTER 4:
ROLLING BACK MALARIA 49
The Challenge of Malaria 49
The health burden 49
The economic burden 51
The diverse and changing nature of the disease 51
Malaria Control: Past, Present and Future 53
Control strategies, 1950–1990s 53
Current technology for effective interventions 55
Future control strategies and research needs 58
A Global Programme to Roll Back Malaria 61
CHAPTER 5:
COMBATING THE TOBACCO EPIDEMIC 65
The Health and Economic Costs of Tobacco Use 65
Health consequences of tobacco 66
The economic costs 68
Obstacles to Tobacco Control 69
Lack of information on risks 69
Tobacco use is an addiction 69
Tobacco dealers make enormous profits 70
Principles of Control 72
Creating a “fair information” environment 72
Using taxes and regulations to reduce consumption 73
Encouraging cessation of tobacco use 74
Building tobacco control coalitions, defusing opposition to control measures 74
Tobacco Control: what some countries have achieved 75
WHO’s Tobacco Free Initiative 76
CHAPTER 6:
MAKING A DIFFERENCE 81
PART THREE
STATISTICAL ANNEX 85
Explanatory notes 86
Annex Tables;
Index