MESSAGE FROM THE DIRECTOR-GENERAL hese are dangerous times for the well-being of the world. In many regions, some of the most formidable enemies of health are joining forces with the allies of poverty to impose a double burden of disease, disability and premature death on many millions of people. It is time for us to close ranks against this growing threat Reducing risks to health, the subject of this years World health report, has been a preoc- cupation of people and their physicians and politicians throughout history. It can be traced ack at least 5000 years to some of the world's earliest civilizations. But it has never been more relevant than it is today. Virtually every major advance in public health has involved the redt on or the elimination of risk. Improvements in drinking-water sup- plies and sanitation during the 19th and 20th centuries were directly related to the control of the organisms that cause cholera and other diarrhoeal diseases Mass immunization programmes eradicated the scourge of small ox from the planet and have reduced the risk to individuals and whole populations of infectious diseases such as poliomyelitis, yellow fever, measles and diphtheria by providing protection against the causative agents. Countless millions of premature deaths have been avoided as a result egislation enables risks to health to be reduced in the workplace and on the roads, whether through the wearing of a safety helmet in a factory or a seat belt in a car. Sometimes laws, education and persuasion combine to diminish risks, as with health warnings on cigarette packets, bans on tobacco advertising, and restrictions on the sale of alcohol Dr Gro harlem brundtland The result is that, in many ways, the world is a safer place to- day. Safer from what were once deadly or incurable diseases. Safer from daily hazards of waterborne and food-related illnesses. Safer from dangerous consumer goods, from acci dents at home, at work or in hospital i. But in many other ways the world is becoming more dangerous. Too many of us are ving dangerously whether we are aware of that or not. I believe that this World health eport is a wake-up call to the global community. In one of the largest research projects WHO has ever undertaken, it tries to quantify some of the most important risks to health and to assess the cost-effectiveness of some of the measures to reduce them The ultimate goal is to help governments of all countries lower these risks and raise the healthy life expectancy of their populations The picture that is taking shape from our research gives an intriguing -and alarming insight into current causes of disease and death and the factors underlying them. It shows how the lifestyles of whole populations are changing around the world, and the impact ofOverview ix hese are dangerous times for the well-being of the world. In many regions, some of the most formidable enemies of health are joining forces with the allies of poverty to impose a double burden of disease, disability and premature death on many millions of people. It is time for us to close ranks against this growing threat. Reducing risks to health, the subject of this year’s World health report, has been a preoc￾cupation of people and their physicians and politicians throughout history. It can be traced back at least 5000 years to some of the world’s earliest civilizations. But it has never been more relevant than it is today. Virtually every major advance in public health has involved the reduc￾tion or the elimination of risk. Improvements in drinking-water sup￾plies and sanitation during the 19th and 20th centuries were directly related to the control of the organisms that cause cholera and other diarrhoeal diseases. Mass immunization programmes eradicated the scourge of small￾pox from the planet and have reduced the risk to individuals and whole populations of infectious diseases such as poliomyelitis, yellow fever, measles and diphtheria by providing protection against the causative agents. Countless millions of premature deaths have been avoided as a result. Legislation enables risks to health to be reduced in the workplace and on the roads, whether through the wearing of a safety helmet in a factory or a seat belt in a car. Sometimes laws, education and persuasion combine to diminish risks, as with health warnings on cigarette packets, bans on tobacco advertising, and restrictions on the sale of alcohol. The result is that, in many ways, the world is a safer place to￾day. Safer from what were once deadly or incurable diseases. Safer from daily hazards of waterborne and food-related illnesses. Safer from dangerous consumer goods, from acci￾dents at home, at work or in hospital. But in many other ways the world is becoming more dangerous. Too many of us are living dangerously – whether we are aware of that or not. I believe that this World health report is a wake-up call to the global community. In one of the largest research projects WHO has ever undertaken, it tries to quantify some of the most important risks to health and to assess the cost-effectiveness of some of the measures to reduce them. The ultimate goal is to help governments of all countries lower these risks and raise the healthy life expectancy of their populations. The picture that is taking shape from our research gives an intriguing – and alarming – insight into current causes of disease and death and the factors underlying them. It shows how the lifestyles of whole populations are changing around the world, and the impact of Dr Gro Harlem Brundtland MESSAGE FROM THE DIRECTOR-GENERAL