Global health agenda for the twenty-fi rst century

The right to the highest attainable level of health is enshrined in the charter of the World Health Organization (WHO) (2002a) and many international treaties. It is this aspiration that spurs the work of the Organization and frames the broader global public health agenda for the twenty-fi rst century. It is a tall order. But the right to health is more important today than ever before given he dramatic evolution in the architecture of global public health and the growing prominence of health within the human security, rights, and development agendas. The past century had witnessed remarkable gains in health, rapid economic growth, and unprecedented scientifi c advances. These advances have led to major improvements in health care in which millions more lives are protected than ever before. Life expectancy at birth has continued to rise, by almost 8 years between 1950 and 1978, and 7 more years since (WHO 2007c). These transformations are unmatched in history. Yet, in spite of this optimistic outlook, the international community faces a demanding health agenda. Many public health problems, both new and old, remain to be solved. Despite progress, nearly 2.6 billion people, especially in fragile states, remain in extreme poverty and live on less than US$2 a day. Nearly 10 million children die before their fi fth birthday, with approximately four million of these deaths occurring during the neonatal period (UNICEF 2007). Nutrition is a major problem with one-third of all children in developing countries underweight or stunted; half the people in developing countries lack access to improved sanitation (World Bank 2007a). Health inequalities are growing wider between and within countries, between rich and poor, between men and women, and between different ethnic groups. These stark numbers reinforce the urgent need for collective global action. The United Nations Millennium Declaration in 2000 committed states to a global partnership to reduce poverty, improve health and education, and promote peace, human rights, gender equality, and environmental sustainability by 2015 (UN 2000). Global health agenda for the twenty-fi rst century