Integrating disease control : The challenge

There is sufficient global experience and evidence, dating back to the immediate post World War II period of reconstruction, that political, administrative and operational integration is the most appropriate approach to an equitable provision of health care. Despite the remarkable improvements in health over the past fifty years, many people in least developed countries today have a life expectancy of less than fifty years, and more than 10 million children will never see their fifth birthday. To the populations in these areas, the burden of ill health, disease and inequality are greatest. An integrated approach may be the way forward in most cases, to provide the much needed health prevention and care for these populations. It can strengthen primary health care systems, and requires that scarce health resources be redistributed, and provides a better chance of achieving sustainable results. The question that each programme manager must ask is how best can this be achieved. Integration means many things to many people. There are many issues and concerns to consider, but also many positive examples of successful integration, to draw upon. This document is based on insights from experiences and raises many questions that need to be answered through a research and development approach. It identifies practical knowledge about integrated control and its benefits. It emphasises on-going programmes coordinated by the World Health Organization and draws on the experience of successful programmes.