Global considerations affecting the health agenda of the 1990s

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Abstract
The author explains why global problems , both known and unknown and unpredictable , are going to affect the health sector in the next few decades even more than they do today . Five examples are given of global health-related dilemmas that must be faced : ( 1 ) the worldwide aging of the population and the changing morbidity trends and physician supply needs this creates ; ( 2 ) rising worldwide poverty , which has a direct relation to health status and has some new causes in this century ; ( 3 ) ethical dilemmas , such as those resulting from new reproductive and life-prolonging technologies ; ( 4 ) the need for adequate and affordable health care systems ( the Canadian system is described and several misconceptions about it are clarified ); and ( 5 ) the need to allocate scarce resources to meet practically infinite health care demands . The author concludes by listing some of the important actions that must be taken if we are to deal effectively with the dilemmas fostered by global problems : ( 1 ) people must be taught that their health status is the result of many factors in addition to their health care ( e . g ., socioeconomic status , lifestyle , the environment ); ( 2 ) medical education must be refocused to prepare physicians to deal with global challenges ; ( 3 ) there must be greater international cooperation ( e . g ., working together to share research and implement strategies to control AIDS ); ( 4 ) countries must invest in worldwide efforts , such as family planning and primary education ; and ( 5 ) international partnerships must be created to develop worldwide strategies , such as a global drug strategy .

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