8. Improving the Health of Populations: Lessons of Experience

Abstract

The large and unprecedented improvements in the health of human populations over the last 50 years—including the virtual elimination of some of the world's most deadly and debilitating diseases—have been attributed in part to economic growth, rising incomes, and better living conditions. Nevertheless, the discovery and diffusion of new methods of disease prevention and treatment are critical factors underlying these health gains. The challenge facing both researchers and policy makers is to ensure that the fruits of scientific and technological progress reach people in developing countries who most stand to benefit.

Successes in international health—involving both communicable and noncommunicable diseases as well as curative and preventive care—include: control of Chagas' disease, onchocerciasis, trachoma, tobacco use, and tuberculosis; diarrhea treatment; total or near elimination of Guinea worm, polio, and smallpox; HIV/AIDS prevention; reduced maternal mortality; and salt fluoridation and salt iodination. These successes—spanning Africa, Asia, Latin America, and the Caribbean—were brought about by a variety of cost–effective interventions, ranging from mass drug administration and childhood immunizations to diagnostic and therapeutic health services and from behavioral changes to environmental controls.

The success of any given intervention often depends on a government's willingness to use its legislative or regulatory authority to achieve positive health outcomes. Strong leadership and program management as well as realistic financial arrangements influence the successful deployment of cost–effective interventions to improve the lives and health of people throughout the world, no matter their socioeconomic or political setting.