WHO tells governments to focus on basic health care

By Laura MacInnis

GENEVA (Reuters) - Nearly 60 million women will give birth without any medical assistance this year, the World Health Organization (WHO) said on Tuesday in a report calling for an overhaul of how health care is financed and managed globally.

The United Nations agency said in its annual World Health Report that the billions of aid dollars devoted to fight specific epidemics like AIDS had distracted attention from providing comprehensive care to mothers and children.

The difference in life expectancy between the richest and poorest countries still exceeds 40 years, said the report, whose launch coincided with a global financial crisis that could freeze aid flows and squeeze government budgets for health care.

Some 58 million of the 136 million women who will have babies this year will lack medical help during and after their births, it said.

Increasingly specialized and technical medicine in wealthy nations has also excluded and impoverished millions of patients, exposing failures of "laissez-faire" governance in health, according to WHO Director-General Margaret Chan.

"We are, in effect, encouraging countries to go back to the basics," Chan said in an introduction to the WHO report.

The report estimated that focusing more on disease prevention and health promotion -- through vaccine and nutrition-boosting programs -- could cut the global burden of infirmity by 70 percent.

And despite huge foreign aid sums earmarked for programs fighting AIDS, tuberculosis, malaria, and other killer diseases in developing countries, the WHO said quality care remained scarce outside of those specific areas.

"Disproportionate investment in a limited number of disease programs considered as global priorities in countries that are dependent on external support has diverted the limited energies of ministries of health away from their primary role," it said.

MEDICAL CARE FRAGMENTED

Medical care in the rich world has also become dangerously fragmented, according to the report. It said front-line health workers ought to better assess patients' overall needs instead of referring them to costly specialists.

"This contributes to inefficiency, restricts access, and deprives patients of opportunities for comprehensive care," it said. "In far too many cases, people who are well-off and generally healthier have the best access to the best care, while the poor are left to fend for themselves."

Profit-driven care has also increased the use of unnecessary tests and procedures, prompted more frequent and longer hospital stays, driven up overall costs, and excluded those who cannot pay, the Geneva-based agency found.

Annual government spending on health worldwide varies from just $20 to more than $6,000 per person.

More than 100 million people a year fall below the poverty line because of personal health expenditures, and as many as 5.6 billion people have to pay for more than half of their health expenditures themselves.