GENEVA Major inequalities in health and life expectancy persist worldwide, according to an independent World Health Organization commission which on Thursday called for all countries to offer universal health care.
Huge discrepancies also exist within countries, including Scotland where a boy born in the poor Glasgow suburb of Calton can expect to live to 54, 28 years less than one born in affluent Lenzie, just across town, it said.
"The health inequities we see in the world are absolutely dramatic in their scale," Michael Marmot, a WHO health researcher, who chaired the commission, told reporters.
"Between countries we have life expectancy differences of more than 40 years. A woman in Botswana can expect to live 43 years, in Japan 86 years."
The Commission on Social Determinants of Health, composed of 19 independent experts, handed over its three-year study to the World Health Organization, a United Nations agency.
"Social injustice is killing people on a grand scale," it declared.
Marmot, head of the epidemiology and public health department at University College London, said the report recommended universal health care systems should be available to people regardless of their ability to pay.
"Virtually all advanced countries have universal health care systems but we don't think that should be limited to high-income countries," he added.
INABILITY TO PAY
The sustainability of health care systems is a concern for all countries, amid growing "commercialization" of services, according to the commission. It favored financing health care through general taxation and/or mandatory universal insurance.
Each year, more than 100 million people worldwide are pushed into poverty due to catastrophic health care costs, it said.
"We are distressed by the reports of health care simply being unavailable to people because of inability to pay. We see that throughout low- and middle-income countries," Marmot said.
Health care is also a key issue in the U.S. presidential campaign, with both Democrat Barack Obama and Republican John McCain proposing to fix what they call a broken system.
Some 15.3 percent of Americans had no public or private health insurance in 2007, down from 15.8 percent in 2006, according to the latest U.S. figures released on Monday. A total of 45.7 million people were uninsured, down from 47 million.
In the United States, minorities are more likely to be diagnosed with late-stage breast cancer and colorectal cancer than whites, the report said. In Indonesia, maternal mortality is three to four times higher among the poor than the rich.
Margaret Chan, WHO director-general, said WHO's Executive Board would examine the report at its January meeting and submit proposals to the annual meeting of its 193 member states in May.
"The importance of prevention continues to grow, partly because of escalating health care costs. We simply cannot afford the way we go about doing health care nowadays without tackling and doing more prevention," she said.
Nobel laureate Amartya Sen, former U.S. Surgeon General David Satcher, former Chilean president Ricardo Lagos Escobar and former Mozambique health minister Pascoal Mocumbi served on the commission.
(Editing by Richard Balmforth and Dina Kyriakidou)