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| ASSEMBLY EDITION • ORLANDO, FLA |
 "You might save more
lives working in Africa for a year than you would (otherwise) in your whole
career," says WHO's Timothy Evans, M.D., Ph.D. |
Timothy Evans, M.D., Ph.D., a World Health Organization assistant director general, has an offer he hopes Wonca won't refuse: He wants the organization to create a global health force of family doctors to join WHO's campaign to provide health care to Africa.
Evans spoke yesterday at the Wonca plenary session "Family Doctors in the 21st Century: Embracing the Global Health Imperative." He said WHO needs to recruit more health care workers - especially family physicians - to meet the millennium development goals, or MDGs, set by WHO and the United Nations Development Fund. The MDGs target child mortality, maternal health, tuberculosis, malaria and HIV/AIDS.
To meet the child mortality goal, which is to reduce the number of childhood deaths to two-thirds of the1990 level by 2015, Evans said, "We need to achieve a 4 percent per year decline in child mortality." Currently, only two regions - East Asia and the Pacific, and Latin America and the Caribbean - are on track to reach their child mortality MDG, he said.
Taking sub-Saharan Africa as an example of a country with health care crises, Evans said the 1990 child mortality rate there was more than 175 deaths per 1,000 live births. The latest projections indicate that child mortality in sub-Saharan Africa is declining, but only slightly, and is currently on track to drop to about 160 deaths per 1,000 live births by 2015.
Among the barriers to achieving the MDGs is a lack of health workers, said Evans. "Where there is no doctor, health outcomes are increasingly worse and people die. In the last 25 years, a sense has developed that the poor can do without a doctor."
For example, said Evans, WHO data indicate that there are from nine to 10 health workers for every 1,000 people in the United States and many European nations. Globally, the average is 4.2 health workers for every 1,000 people, but in sub-Saharan Africa, it is 0.8 per 1,000 people.
Evans urged Wonca to promote "family doctors sans frontieres." He said these new global physicians should be trained with special curricula that "focus on populations in the greatest health need." Using this model, Evans said family medicine might develop an accredited subspecialty in global family practice.
In addition to recruiting physicians for global practice, Evans said WHO wanted Wonca to nominate commissioners for WHO's new Commission on Social Determinants of Health. The commission was created to address a fundamental problem facing world health: returning recently treated patients - especially young children - to the subpar living conditions that caused their sickness in the first place. The deadline for nominations is Nov. 15; for further information, e-mail csdh@who.int.
"What good does it do to treat people and then send them back to the conditions that made them sick?" Evans asked.
FP Report is
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Copyright © 2003 by American Academy of Family Physicians.