The worldwide health crisis

The shrinking world, combined with economic hardship, rapid urbanization and environmental factors, has given a wide range of diseases a new lease of life. Population movements and ease of travel help to spread epidemics; respiratory infections, diarrhoeal diseases and TB prosper in densely populated urban areas - and in refugee camps; untreated water and poor sanitation are the major factors in the high incidence of water-borne diseases; and the rise in average temperatures means that malaria is now found at higher altitudes and in countries where it was previously unknown.

Newly emerging diseases such as Ebola and other haemmorhagic fevers are becoming more common. HIV/AIDS will most probably remain one of the major public health concerns of the coming decade. Meanwhile, certain infectious diseases are re-emerging. Not only are they back with a vengeance, but the development of drug-resistant bacteria is now further complicating treatment. TB has become a serious threat to public health, and together with malaria has been identified by WHO as one of the major global challenges of the future. There has been a marked increase in the incidence of diphtheria, particularly in countries of the former Soviet bloc.

At the same time, as a result of the increased burden of disease and economic constraints, health care institutions find it increasingly difficult to meet even patients' basic needs. The cocktail therapy for HIV costs $15-20,000 a year per person, while the annual per capita health budget in many countries is only $10-20. The prophylactic use of AZT to reduce the risk of vertical transmission to infants during birth costs $50 per woman. Even that amount far exceeds the national capacity in most developing countries, particularly in Africa.

Many of the world's current health problems are related to poor water and sanitation. It is not only in the burgeoning slums that basic amenities are lacking, for access to water is deteriorating everywhere. This precious commodity, on which all life depends, needs to be used carefully and wisely. The Federation is therefore increasing its attention and resources in this domain.

The Federation and National Societies have also made significant contributions to the control of epidemics. During the Ebola crisis in the former Zaire in 1995, before the outbreak was finally suppressed, five volunteers themselves died from contact with the disease. In response to a diphtheria epidemic in Ukraine, Belarus and the Baltic States in 1995-1996, the Federation and the concerned National Societies joined forces with UNICEF and WHO to implement a massive immunization campaign reaching 23 million people. Similar successful operations have been conducted to control meningitis in Africa and measles, showing that National Societies do have the necessary capacity and are of tremendous value to their governments.

Good health practices

Containing epidemics when they arise is all well and good, but there is truth in the old adage that prevention is better than cure. Education is the first step towards bringing about the behavioural changes necessary to stop the occurrence or spread of disease. Drinking safe water, building latrines, protecting food from insects, using mosquito nets, limiting alcohol consumption, changing nutritional habits - these are all things that we as individuals can do to improve our own health.

One of the Movement's greatest strengths lies in its volunteers, a vast human resource, and in its grassroots presence, which makes it enormously effective as a means of communication. National Societies can play a very dynamic role in health education and the promotion of a healthy lifestyle.

Many countries where HIV/AIDS is prevalent cannot afford to provide treatment or a long-term hospital stay. The sick person is therefore left in the care of the family, which is ill prepared to take on the task of nursing. One role for Red Cross and Red Crescent workers is to visit terminally ill patients in their homes and show their carers how best to meet their needs, thereby contributing to "death with dignity". However, the surest way of stemming the spread of HIV/AIDS is still to promote knowledge leading to changes in behaviour.

TB is linked to poverty, poor living conditions, poor nutrition and certain behavioural patterns. As well as providing direct treatment, National Societies can help to alleviate the root causes. This can be done in a number of ways: through health education, nutritional assistance (e.g soup kitchens), and ensuring that patients complete their full course of treatment, since failure to do so is the major cause of development of drug-resistant strains of the disease.

National Societies can also promote the timely and proper use of health services. All the technology, training and refrigeration of vaccines will serve no purpose if a mother does not bring her child to the health centre for immunization. National Society volunteers can spread the word and, if necessary, act as partners to the health authorities on any monthly vaccination days.

Cholera and other diarrhoeal diseases can be prevented by improving hygiene and providing safe drinking water. Here again, National Societies can play a vital role, in terms both of promoting hygiene measures and teaching people how to administer oral rehydration salts.

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