WHO report says AIDS offers healthcare opportunity
BMJ 2004;328:10 (3 January)
by Fiona Fleck
Dr Lee Jong-wook, director general of the World Health Organiza-
tion, has said that the organisation's goal of getting lifesav-
ing antiretroviral drugs to three million patients with HIV or
AIDS in the developing world by 2005 presents a golden opportu-
nity to put in place desperately needed basic healthcare sys-
In the preface to WHO's annual report on global health Dr Lee
said that funds for tackling the AIDS crisis could in turn es-
tablish lasting health systems for the future treatment and pre-
vention of disease in the developing world.
"A message that runs through these pages is that progress in
health, including rapid and sustainable expansion of emergency
treatments, depends on viable national and local health sys-
tems," Dr Lee said in the report, which was released on 18 De-
"Scaling up anti-retroviral therapy in resource-poor settings
has to be done in such a way as to strengthen health systems
based on primary care," he wrote.
The report concluded that improving primary health care in de-
veloping countries was the key to fighting the spread not only
of the world's biggest killer disease, AIDS, but also a whole
host of other communicable diseases and non-communicable dis-
eases, such as high blood pressure, heart disease, and stroke.
The report, which aims to raise awareness of global health pri-
orities among government health departments and donors, said
that the gap between the state of people's health in rich coun-
tries and poor countries had widened in 2002 because of the
HIV/AIDS pandemic. This, it said, was starkly illustrated by
life expectancies of 85 years among women in Japan and of 36
years among women in Sierra Leone.
Amid the grim assessments, however, the WHO report struck an op-
timistic note, saying that recent success in halting the spread
of severe acute respiratory syndrome (SARS), in virtually eradi-
cating polio, and in radical new treatment for tuberculosis
could show the way forward to tackling AIDS and other epidemics.
It said that rapid response teams of experts sent to areas ex-
periencing an outbreak of SARS had provided a model for WHO's
teams of experts on HIV and AIDS sent to stricken regions, while
simplified treatment for tuberculosis had inspired simplified
treatments for HIV and AIDS in the form of three in one antiret-
The report said international cooperation that helped eradicate
polio in all but seven countries was exemplary and a model for
fighting HIV and AIDS.
The report found that heart disease was the second biggest kil-
ler, after AIDS related diseases. This was because people in de-
veloping countries were living longer and faced an epidemic of
cardiovascular diseases such as heart disease and stroke caused
by smoking, lack of exercise, and unhealthy diets.