PCL 13- Limitations in Bringing Positive Changes to the Global Health

Limitations in Bringing Positive Changes to the Global Health

1. One important reason for this is the lack of functional health systems due to a shortage in the health workforce, management incompetence, inadequate infrastructure, and health care financing. The World Health Report 2006 estimates a global deficit of 2.3 million doctors, nurses, and midwives. Critical health workforce shortages exist in fifty-seven countries, of which thirty-seven are in sub-Saharan Africa.

2. Emphasis on vertical or disease-specific programmes such as HIV/AIDS, malaria, and tuberculosis may have further weakened the already fractured health systems, thus making delivery of general health care in low-income countries that much more difficult. Unfortunately, neither the governments of these countries nor the global donor community have invested adequately in capacity building.

3. There are more challenges facing global health. Prominent among these are the development of microbial resistance to antibiotics and disinfectants, along with the prevalence, in epidemic proportions, of non-communicable diseases and injuries in low- and middle-income countries

4. Worldwide gaps in income, opportunities and health outcomes, which motivated the quest for greater fairness in 1978, are actually greater today than at any time in recent history. Life expectancy between the richest and poorest countries differs by more than forty years. Annual government expenditure on health ranges from as little as $20 per person to more than $6,000.

5. All around the world, the costs of health care are escalating.

6. Phenomenal increases in international air travel have made emerging and epidemic-prone disease a much larger menace.

7. Universal trends, like urbanization, demographic aging, and the marketing of unhealthy lifestyles have sparked a sharp increase in chronic diseases like heart disease, stroke, cancer, and diabetes. Long considered the close companions of affluent societies, these diseases now impose around 80 per cent of their burden on low- and middle-income countries. The requirements of life-long treatment strain already weak systems of care and add to the costs.

8. Growing numbers of the frail elderly further increase the demands on health systems, the health workforce, and for social welfare.