SUNS  4362 Thursday 28 January 1999

Geneva, Jan 26 (IPS) -- The strategy of the new management at the World Health Organisation (WHO), appear to rest on the premise of the universal community facing critical survival problems, while development programmes overlook the countries of the South.

The health sector is being forced to fight the consequences of measures adopted in other areas of society, said WHO director, Gro Harlem Brundtland, referring to "increasingly accentuated inequalities" throughout the world.

She told the WHO executive council of plans she has sketched out in her first six months as head of the entity.

The report described an international situation made up of "dramatic events" like the increase in poverty and the inequality between countries and within each country, and global warming, which has serious consequences for the Earth and human health.

Strictly on the health front, the world is poorly armed to confront the epidemics and the deadly threat of scourges like aids, malaria and tuberculosis.

The consumption of tobacco, alcohol and high-fat foodstuffs has increased as a consequence of the globalisation of commerce and marketing.

Another negative factor for the WHO is the statement that the rich countries are ever less willing to support international development action.

The South carries the weight of 90% of the total disease burden while handling only 10% of the world's health resources.

Faced with these "dramatic" facts, no decision-maker, however protected from these critical survival issues, can escape the reality, warned Brundtland.

But the report recognised there was the potential to "make a difference," although this is largely dependent on "political will."

The WHO admitted having underestimated the importance of investments in health for the promotion of development and progress, along with the rest of the international health community.

Improvements in health in the poor countries causes an increase in the per person gross national product, while in the rich countries, it reduces the overall costs for society.

"These situations have been hidden from us," lamented Brundtland.

As the head of the WHO, with the budgeting problems of the multilateral institution, Brundtland recommended "reminding the prime ministers and finance ministers that they are also health ministers."

The WHO drafted a project spending plan for the 2000-2001 period with a budget of 1.8 billion dollars, including an ordinary budget of 842 million with zero growth in real terms compared with 1998-1999.

The rest of the demands will be covered with other funds, which the WHO directors hope will reach 19 percent in order to reach the needed 958 million.

Brundtland, who is trying to convince the member states, claimed the WHO budget has been reduced 20 percent in real terms during the last 20 years.

"I don't see how we can fulfil our mandate and do what the member states expect from us if, at the same time, we have to downsize WHO which, by the way, in fact has a budget lower than of many university hospitals in developed countries," she said.

The WHO calculated the difference in dollars between a real zero growth budget and a nominal zero growth budget at more than $30 million at present rates.

If this is blocked, some items of the budget would have to go. "I cannot see how we can cut back our ambitions for world health," said Brundtland.