Alternative projections of mortality and disability by cause 1990–2020

BS Levy

D Pedersen

G MacQueen

J Grademann

Peter Knoll

Siroos Mirzaei

International Journal for Equity in Health

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International Journal for Equity in 
Health
Open AccessCommentary
Challenge of the world order and its implications for health 
personnel
Siroos Mirzaei*1,2 and Peter Knoll1
Address: 1Institute of Nuclear Medicine, Wilhelminenspital, Vienna and 2Hemayat-Organisation for support of survivors of war and torture,Vienna
Email: Siroos Mirzaei* - siroos.mirzaei@wienkav.at; Peter Knoll - peter.knoll@wienkav.at
* Corresponding author    
Non-governmental medical organizations, including
amnesty international medical groups, Physicians for
Human Rights, and the World Health Organisation
(WHO), have for years tried to forge a link between health
and peace. Undermining of the rights and dignity of peo-
ple creates implication for the health of the community
and for the responsibilities of its health workers.
These efforts need more fundamental support. The
unfolding of a "new world order" can stimulate fresh
thinking on a variety of important issues. The Global Bur-
den of Disease Study [1] predicts war will reach the list of
10 most frequent causes of loss of disability-adjusted life-
years by the year 2020. But, despite the growing number
of armed conflicts throughout the world, not enough
attention has been paid to the local patterns of distress
and the long-term health impact and psychosocial conse-
quences of political violence against individuals or com-
munities [2]. It has to be emphasized that 90% of all
deaths related to recent wars were among civilians [3].
Further, war has also indirect consequences including
damage to the social fabric and infrastructure of the soci-
ety, displacement of people, damage to the environment
and fostering of a culture of violence [3]. In complex
emergencies, public health activities have been shown to
promote peace, prevent violence and reconcile enemies
[4].
We propose the establishment of institutionalized part-
nerships between non-government organizations, such as
those mentioned above, and individual medical societies
in order to facilitate the exchange of knowledge and to rec-
ognize societies at risk for instability and violence. Every
national physicians' organization should establish a posi-
tion responsible for human rights – protected by political
immunity, and should issue regular reports to representa-
tive international bodies. We agree most warmly with Mac
Queen [5] on the unique contributions health workers
can contribute to peace-making.
Finally, we should expect that the training of physicians
include a serious study of ethics and human rights, as well
as acquisition of the skills to deal with conflict and the
therapeutic implications of trauma, both physical and
mental.
References
1. Alternative projections of mortality and disability by cause 1990–
2020: Global Burden of Disease Study Lancet 1997, 349:1498-
504.
2. Pedersen D: Political violence, ethnic conflict, and contempo-
rary wars: broad implications for health and social well-being
Soc Sci Med 2002, 55:175-190.
3. Levy BS: Health and peace Croat Med J 2002, 43:114-116.
4. Grademann J: Primary health care in complex humanitarian
emergencies: Rwanda and Kosovo experiences and their
implications for public health training Croat Med J 2002, 43:148-
155.
5. MacQueen G, Santa-Barbara J, Neufeld V, Yusuf S and Horton R:
Health and peace: time for a new discipline Lancet 2001,
357:1460-1.
Published: 23 July 2003
International Journal for Equity in Health 2003, 2:6
Received: 16 July 2003
Accepted: 23 July 2003
This article is available from: http://www.equityhealthj.com/content/2/1/6
© 2003 Mirzaei and Knoll; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in 
all media for any purpose, provided this notice is preserved along with the article's original URL.


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