Need for change of paradigm

The 2008 report of World Health Statistics was released by WHO, that underlines the increasing need in the change of paradigm of organisation of health services:

The global burden of disease is shifting from infectious diseases to noncommunicable diseases, with chronic conditions such as heart disease and stroke now being the chief causes of death globally, according to a new WHO report published today. The shifting health trends indicate that leading infectious diseases – diarrhoea, HIV, tuberculosis, neonatal infections and malaria – will become less important causes of death globally over the next 20 years.World health statistics 2008 is based on data collected from WHO's 193 Member States. This annual report is the most authoritative reference for a set of 73 health indicators in countries around the world. These are the best available data and they are essential for painting the global picture of health and how it is changing.

"We are definitely seeing a trend towards fewer people dying of infectious diseases across the world," said Dr Ties Boerma, Director of the WHO Department of Health Statistics and Informatics. "We tend to associate developing countries with infectious diseases, such as HIV/AIDS, tuberculosis and malaria. But in more and more countries the chief causes of death are noncommunicable diseases, such as heart disease and stroke."The statistical report documents in detail the levels of mortality in children and adults, patterns of morbidity and burden of disease, prevalence of risk factors such as smoking and alcohol consumption, use of health care, availability of health care workers, and health care financing. It also draws attention to important issues in global health, including:Maternal mortality: in developed countries, nine mothers die for every 100 000 live births, while in developing countries the death rate is 450 and in sub-Saharan Africa it is 950.Life expectancy trends in Europe: life expectancy in eastern Europe increased from an average of 64.2 years in 1950 to 67.8 years in 2005, representing an increase of only about four
years compared with 9 to 15 years for the rest of Europe.

Health-care costs: 100 million people are impoverished every year by paying out of pocket for health care.Coverage of key maternal, neonatal and child health interventions: four out of 10 women and children do not receive basic preventive and curative interventions and at current rates of progress it will take several decades before this gap is closed.World health statistics 2008 is the official record of data produced by WHO's technical programmes and regional offices in close consultation with countries and in collaboration with researchers and development agencies. In publishing these statistics, WHO underlines continuing health challenges and provides an evidence base for strategies to improve global public health.

Chronic conditions require life-style changes that can be facilitating the change of paradigm where the affected persons are seen as a resource and are supported to organise themselves in groups and organisations that acquire information and skills for their own care. Such groups and organisaitons become partners of health services and part of multisectoral teams in helping all persons newly diagnosed with chronic conditions to take better care of themselves.