World Health Report 1999 (The)
Making the Difference
World Health Report
World Health Organization
ISBN-13    9789241561945 ISBN-10    9241561947
Order Number    12401999 Format    E-book collection (PDF)
Price    CHF    15.00 / US$    18.00 Developing countries:    CHF    10.50
English     1999        142   pages
Table of contents
Related Publications
Translation(s) available
As this century draws to a close, The World Health Report 1999 - Making a Difference challenges the international community to examine the difference health can make in humanity's continuing progress. Issued by WHO Director-General Dr Gro Harlem Brundtland as WHO itself undergoes comprehensive reform, the report shows how the pursuit of lasting improvements in health, when supported by vision and leadership, can also secure considerable social and economic gains. It gathers the arguments and evidence that give health messages their persuasive power in the formulation of national policies and the direction of international aid.
The report explains how lessons learned from past successes and failures can guide a more targeted and pragmatic approach to current and emerging health challenges. It warns of the unprecedented complexity of these challenges, and offers strategic directions for tackling them in the next decade. Clear conclusions emerge. Despite recent spectacular progress in disease control and extended life expectancy, more than 1 billion people today have not shared in these gains. Meanwhile, the threat posed by infectious diseases is being accompanied by the growing prominence of noncommunicable diseases, which are far more complex and costly to manage.

Consequently, health systems can no longer afford to allocate resources to interventions of low quality or low efficacy related to cost. Spontaneous, unmanaged growth in any country's health system cannot reliably ensure that the greatest health needs are met. In defining priorities and selecting interventions, decision-makers must focus their efforts on areas where the return in health gains is demonstrably greatest. In contrast to a classic "universalism" that advocated government finance and provision of all services for everyone, the report - and WHO - argue for a "new universalism". This would maintain government responsibility for financing and leadership, while recognising government's own limits. Public finance for all entails that not all things can be publicly financed. Private sector provision of publicly financed services is compatible with government responsibility for health for all, but requires a clear regulatory role of governments.
WHO must also focus on priorities. While actively engaged across the full range of health problems, WHO targets two particular areas in order to reform work methods and cooperation with other partners: Roll Back Malaria and the Tobacco-Free Initiative. The report describes the problems of malaria and tobacco - major representative elements of the double burden of disease - and indicates how timely action can make a difference. Both projects advocate using cost-effective technologies and innovative partnerships. They also serve as pathfinders, showing how, when priority problems are identified and addressed with vision, moral courage, and sound technologies, WHO leadership can make a difference - even when resources are limited.