Læknablaðið - 15.02.1985, Blaðsíða 52

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LÆKNABLAÐID
met for all. This is in line with the United Nations
General Assembly resolution A/RES/34/58, which
calls upon the relevant bodies of the United Nations
system to coordinate with and support by appropriate
actions within their respective spheres of competence
the efforts of the World Health Organization in
reaching the goal of health for all. If this inter-
dependence is not recognized, both at national and
international levels, efforts to improve health will be at
once more costly and less effective.
Above all, it is only with the firm commitment of
both governments and the people that the action needed
within Member States and the required collaboration
between them can be strengthened sufficiently for the
targets in the European Region to be reached.
1.1. A EUROPE FREE FROM THE FEAR OF WAR
War is the most serious of all threats to health. The
devastation that a war would entail in terms of persons
killed, wounded and permanently disabled simply
defies imagination. The dropping of a one-megaton
atom bomb over a large city would kill more than 1.5
million people and injure as many. It has been estimated
that a »limited« nuclear war, with smaller tactical
nuclear weapons delivering a total of 20 megatons on
military targets in a relatively densely populated area,
would exact a toll of about 9 million dead and seriously
injured, while a full-scale war exploding 10 000
megatons of nuclear bombs would kill 1 150 000 000
people and injure 1 100 000 000, so that more than half
the world’s population would be immediate victims.
The impact of such an event on the world environment
would be immense.
However, it must not be forgotten that conventional
war is also a terrible threat to humanity. The immense
devastation of the Second World War is only a small
indication of what could result from a major inter-
national armed conflict today given the more destruc-
tive »conventional« weapons now available.
However, peace is not just the absence of war. It is
also a positive sense of wellbeing and security for people
of all countries, implying the opportunity to freely
determine their own destiny and fully exploit their
human potential. It assumes the possibility of all
nations actively participating on a basis of equality and
in a true spirit of solidarity and reciprocity in the
development of a more satisfying world for all people.
An important point in this regard is that in Europe, at
the present time, it is not war itself that presents health
problems, but the fear of war. The increasing inter-
national tension in recent years has raised this level of
apprehension to a point which severely hampers the
opportunities for all peoples in the Region to work
together in harmony for a better future.
All these elements contributed to the recent decision
of the General Assembly of the United Nations to adopt
a resolution which stresses once again the urgent need
for the international community to make every effort to
remove the growing threat of war.
There are some things that the health sector can do
that fit in with its basic role and that can help to reduce
international tension. In each country, thehealth sector
should take the lead in promoting close, long-term
collaboration on health problems across national
borders. The bilateral and international research,
meetings and contacts involved, in addition to im-
proving health, will increase understanding and forge
links between individuals, institutions and countries,
thus serving to reduce international tension and demon-
strating the value of mutual cooperation.
Moreover, each national health sector should take
responsibility for creating a better understanding of
what a war, and particularly a nuclear war, would really
mean for health, and thus strengthen the motivation for
peace. By analysing objectively the extent of human
destruction, suffering and disability which a war would
entail in their country, by giving a realistic analysis of
how little its health services would be able to do to treat
the civilian and military casualties, and by making these
facts known and understood by politicians and the
general public, the health sector could help to encou-
rage significantly a more active search for ways of
preventing war from ever breaking out again. At the
international level, the World Health Organization has
taken the initiative in this respect with the adoption by
the World Health Assembly at the later distribution of
the report concerning »Effects of nuclear war on health
and health services«. Such efforts should be continued.
1.2. EQUAL OPPORTUNITY FOR ALL
In the commitment of the Member States of the
European Region to health for all by the year 2000 lies
a fundamental principle of social policy: all human
beings have an equal right to health. That right will be
ensured by providing all the people of the Region with
an equal opportunity to develop health to the full and
maintain it. This principle has two aspects in the
European Region: equity among nations and equity
among the people within each country.
Very large inequalities at present exist among the
countries of the Region. TheEuropean Region includes
countries which have widely different standards of
living. Gross national product per head in 1980 varied
from about US $700 in one Member State to over US
$12 000 in another. Expectation of life at birth varied
among Member States from 55 years to 77 years. In
some richer countries, there is a surplus of hospital beds
and trained health personnel, while in some of the
poorest the basic health infrastructure is still not
complete. These sharp contrasts in health status and
health services are reflected in the differences in the
degree of poverty among the various countries of the
Region and within the individual countries, the richer
nations being in no way exempt from the overall
problem of social inequity. There are similar variations
in other respects, such as sanitation, water supply,
housing and the availability of basic commodities. As is
shown in detail in Chapter 2, these differences in
socioeconomic development also translate into di-
sturbing inequalities in health status.
A key problem in the less privileged countries of the
Region is the lack of funds for investment in the health
sector. A major challenge for the European Region is,
therefore, how to bring about a more concrete policy of
solidarity through which the more fortunate countries
can collaborate more effectively with the less fortunate
ones to ensure development of the health sector. This is
in line with the »Charter of Economic Rights and Duties