Message from the Director-General Todays global health situation raises urgent questions about justice. In some parts of the world there is a continued expectation of longer and more comfortable life, while in many others there is despair over the fail ure to control disease although the means to do so exist This contrast is starkly evident in lack of access to HIVIAIDS treatment, which led me, earlier this year, to declare a global health emergency. WHO decided to take this rare measure after evaluating the global situation and finding that only 5% of those in the developing world who require LEE Jong-wook antiretrovirals(ARVs)are getting them. In sub-Saharan Africa, only 50 000 of the 4 million people in need have access to ARVs. This spells catastrophe, not only for the societies hardest hit but for the world as a whole. Our first step to respond to this crisis must be to reach 3 by 5-3 million people in developing countries on antiretrovirals by 2005 Major disparities also exist in areas such as child mortality. Of the more than 10 million children under 5 years old who die every year, almost all are in developing countries A world marked by such inequities is in very serious trouble. We have to find ways to unite our strengths as a global community to shape a healthier future. This report on the world's health, my first since taking office, gives some initial indications of how to do it. A message that runs throughout these pages is that progress in health, including rapid and sustainable expansion of emergency treatments, depends on viable national and local health systems. Scaling up ARv therapy in resource-poor settings has to be done in such a way as to strengthen health systems based on primary health care. In most countries, there will be only small and short-lived advances towards acceptable standards of health without the develop- ment of health care systems which are strong enough to respond to current challeng To lend impetus to this process WHO is now making results in countries its main objective. Effective action to improve population health is possible in every country but it takes local knowledge and strength to turn that possibility into reality. We have learnt this through suc cesses such as controlling the SARS epidemic and major advances in the polio eradication campaign, and we have learnt it through setbacks as well, such as the continuing rise of AIDS, TB and malaria. All of these lessons have prepared us for the task aheadMessage from the Director-General Today’s global health situation raises urgent questions about justice. In some parts of the world there is a continued expectation of longer and more comfortable life, while in many others there is despair over the fail￾ure to control disease although the means to do so exist. This contrast is starkly evident in lack of access to HIV/AIDS treatment, which led me, earlier this year, to declare a global health emergency. WHO decided to take this rare measure after evaluating the global situation and finding that only 5% of those in the developing world who require antiretrovirals (ARVs) are getting them. In sub-Saharan Africa, only 50 000 of the 4 million people in need have access to ARVs. This spells catastrophe, not only for the societies hardest hit but for the world as a whole. Our first step to respond to this crisis must be to reach “3 by 5” – 3 million people in developing countries on antiretrovirals by 2005. Major disparities also exist in areas such as child mortality. Of the more than 10 million children under 5 years old who die every year, almost all are in developing countries. A world marked by such inequities is in very serious trouble. We have to find ways to unite our strengths as a global community to shape a healthier future. This report on the world’s health, my first since taking office, gives some initial indications of how to do it. A message that runs throughout these pages is that progress in health, including rapid and sustainable expansion of emergency treatments, depends on viable national and local health systems. Scaling up ARV therapy in resource-poor settings has to be done in such a way as to strengthen health systems based on primary health care. In most countries, there will be only small and short-lived advances towards acceptable standards of health without the develop￾ment of health care systems which are strong enough to respond to current challenges. To lend impetus to this process WHO is now making results in countries its main objective. Effective action to improve population health is possible in every country but it takes local knowledge and strength to turn that possibility into reality. We have learnt this through suc￾cesses such as controlling the SARS epidemic and major advances in the polio eradication campaign, and we have learnt it through setbacks as well, such as the continuing rise of AIDS, TB and malaria. All of these lessons have prepared us for the task ahead. LEE Jong-wook Overview 3