NEW PRESCRIPTION FOR 21st CENTURY: WHA

Addressing the 45th World Health Assembly last week, World Health Organization director-general Hiroshi Nakajima called for a radically altered approach to health in the 21st century. He stressed that the traditional narrow view of health care has to be discarded in favor of a new and more flexible framework to cope with the deep political, social and economic uncertainty and changes of the post cold-war period.

In his keynote address to over 1,200 delegates in Geneva, Dr Nakajima said the prerequisite for health and human development in a changing world is continuous and effective participation by the people - "our greatest resource" - with a widening of their practical options. This has implications for individual countries as well as for the work of the WHO, he said. Self-sustaining health care activities in every village or urban neighborhood in every country is the national and global target.

Dr Nakajima outlined his plans for a flexible framework capable of dealing with a changing world. What must be worked out, in cooperation with WHO member states, is an apppropriate balance of care, prevention and development, which are the key to ensuring sustainable peace and security. Such a balance is necessary to deal with urgent needs but not at the expense of long-term development. In order to have common goals and principles pursued throughout the world, they must be made meaningful for all peoples and cultures, within their own value systems. "We must be careful not to confuse universality of principles with uniformity of action," he said. Global action is essential, but it should be expressed so that in national programs it is relevant to, and respectful of, local cultures.