FIFTH REPORT - World Health Organization

24 FIFTH REPORT ON THE WORLD HEALTH SITUATION
Financing and administration
Financing may constitute an obstacle for two
reasons. The first is the overall insufficiency of financial
resources, the second the inadequacy of budgetary
procedures and accounting methods. In those countries
where the administration has not managed to put
into operation a system to identify the real costs,
financial institutions such as social insurance and
occupational accident insurance, or private individuals,
pay according to a scale of charges that are usually
lower than the actual cost of the services; thus they
do not contribute as much as they could and should
to meet medical expenditure.
Habits and customs
In many countries, even among the developed
countries, quack treatment is still popular, by tradition
and also because it costs less. This has regrettable
consequences because it delays contact between the
patient and the official health service; patients suffering
from disorders that healers or traditional doctors
cannot cope with lose valuable time and may resort
to scientific medical care only at an advanced stage of
their illness, when it is too often incurable.
But the existence of a large number of healers and
traditional doctors can be an advantage if arrangements
can be made to use them as medical auxiliaries
after relatively short training. First, they are able to
alleviate cheaply many symptoms arising from benign
conditions; and secondly, they can be trained to perform
vaccinations, apply dressings and give injections
correctly, and participate in health programmes. In
the rural regions, particularly, they can make a substantial
contribution to the protection and promotion
of the health of the population.
Social and economic conflicts
Social conflicts within a country hamper the development
of health campaigns by paralysing transport and
provoking strikes. Wars between countries can have
the same effect as regards civilian populations; on the
other hand, the increased resources available to the
military authorities sometimes make effective health
surveillance possible. Nowadays we no longer see
epidemics deciding the outcome of a war, as was
frequent in the past.
More insidious, perhaps, is the influence of economic
conflicts. Whatever discrepancies may be apparent
between economic development and the improvement
of social conditions, it is probable that if growth were
halted, health programmes would be delayed and
sometimes even regress. The fear has been voiced
that fuel restrictions may jeopardize the eradication
of smallpox, for example, which remains technically
attainable by 1975 provided that the surveillance
teams can continue their rounds without interruption.