The World Health Report 1999 Initiative is supporting and leading this approach. We will pay more attention to the delivery of high quality health care for children, ado- descents and women WHO is committed to making progress on the issues of population and reproductive health-with a special focus on maternal mortality and adolescent sexual and reproduc- tive health We will put the spotlight back on immunization as one of the most cost-effective health interventions We need to intensify our efforts to reduce the enormous burden of malnutrition, espe- cially in children. We will continue to support countries in their quest for access to affordable and high quality essential drugs We will work to see that mental health -and particularly the neglected scourge of depression-is given the attention it deserve We need to be better at responding to increasingly diverse kinds of emergencies and humanitarian crises We will develop our capacity within WHO-and in collaboration with others-to give advice on crucial health care financing issues. And we need to be able to deal more effectively with intersectoral issues- particularly the threats to health that result from environmental causes Let me focus on two of our key initiatives: Roll Back Malaria and the Tobacco Free Initia- tive. The world health report 1999 devotes a chapter to each of these Malaria and underdevelopment are closely intertwined. Over 40% of the worlds popu lation live where there is a risk of malaria. The disease causes widespread premature death and suffering, imposes financial hardship on poor households, and holds back economic rowth and improvements in living standards. Malaria flourishes in situations of social and environmental crisis, weak health systems and disadvantaged communities Its ability to develop resistance makes malaria a formidable adversary. Available and effective interventions -such as insecticide-treated bednets-fail to reach the people with the greatest burden of malaria. Capacity for malaria control is inadequate in endemic coun- tries, where health systems are often weak. Better implementation of current knowledge, and new products and technologies are all needed to break down the barrier to human progress which malaria poses. Overcoming these problems is a challenge for leadership, a challenge to be met by the Roll Back Malaria project Successful malaria control involves strengthening health systems. Weak health syste and uninvolved communities are part of the malaria problem. Because malaria is an acute condition with a rapid natural history, easy access to health care of good quality is vital in its management. Extemally driven initiatives, by-passing local and national health systems, are neither sustainable nor supportive of malaria control and health development. Many countries have begun the process of reforming their health system to improve perfo ance Malaria control, like the better management of all illnesses, needs to build on and support these changes Through strengthened health systems, total malaria deaths could halved-500 000 deaths could be averted annually -for about USl billion per ye additional spending a new willing to collaborate has been demonstrated. The Organization of African Unity, the World Bank and WHOs African Region have already planned a major African Initiative on Malaria which is expected to spearhead Roll Back Malaria in Africa. Roll Backxii The World Health Report 1999 Initiative is supporting and leading this approach. • We will pay more attention to the delivery of high quality health care for children, ado￾lescents and women. • WHO is committed to making progress on the issues of population and reproductive health – with a special focus on maternal mortality and adolescent sexual and reproduc￾tive health. • We will put the spotlight back on immunization as one of the most cost-effective health interventions. • We need to intensify our efforts to reduce the enormous burden of malnutrition, espe￾cially in children. • We will continue to support countries in their quest for access to affordable and high quality essential drugs. • We will work to see that mental health – and particularly the neglected scourge of depression – is given the attention it deserves. • We need to be better at responding to increasingly diverse kinds of emergencies and humanitarian crises. • We will develop our capacity within WHO – and in collaboration with others – to give advice on crucial health care financing issues. • And we need to be able to deal more effectively with intersectoral issues – particularly the threats to health that result from environmental causes. Let me focus on two of our key initiatives: Roll Back Malaria and the Tobacco Free Initia￾tive. The world health report 1999 devotes a chapter to each of these. Malaria and underdevelopment are closely intertwined. Over 40% of the world’s popu￾lation live where there is a risk of malaria. The disease causes widespread premature death and suffering, imposes financial hardship on poor households, and holds back economic growth and improvements in living standards. Malaria flourishes in situations of social and environmental crisis, weak health systems and disadvantaged communities. Its ability to develop resistance makes malaria a formidable adversary. Available and effective interventions – such as insecticide-treated bednets – fail to reach the people with the greatest burden of malaria. Capacity for malaria control is inadequate in endemic coun￾tries, where health systems are often weak. Better implementation of current knowledge, and new products and technologies are all needed to break down the barrier to human progress which malaria poses. Overcoming these problems is a challenge for leadership, a challenge to be met by the Roll Back Malaria project. Successful malaria control involves strengthening health systems. Weak health systems and uninvolved communities are part of the malaria problem. Because malaria is an acute condition with a rapid natural history, easy access to health care of good quality is vital in its management. Externally driven initiatives, by-passing local and national health systems, are neither sustainable nor supportive of malaria control and health development. Many countries have begun the process of reforming their health system to improve perform￾ance. Malaria control, like the better management of all illnesses, needs to build on and support these changes. Through strengthened health systems, total malaria deaths could be halved – 500 000 deaths could be averted annually – for about U$1 billion per year of additional spending. A new willingness to collaborate has been demonstrated. The Organization of African Unity, the World Bank and WHO’s African Region have already planned a major African Initiative on Malaria which is expected to spearhead Roll Back Malaria in Africa. Roll Back