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Lecture notes, cheat sheets
History of medicine. Development of medicine at the end of the 20th century. International cooperation in the field of health (lecture notes)
Directory / Lecture notes, cheat sheets Table of contents (expand) LECTURE No. 10. The development of medicine at the end of the XNUMXth century. International cooperation in the field of health 1. The development of healthcare in the late XX - early XXI centuries Either due to the political situation in the country, or due to some other reasons, the healthcare system during the years of the country's transition from the socialist to the democratic-capitalist system underwent strong transformations, which initially did not have the best effect on the health of the population. The departure of the dictatorship into oblivion was accompanied by an unnecessarily abrupt transition from excessive centralization to liberalism in all respects and directions, including medicine. In the light of deep social and economic reforms, there was not enough work, housing conditions became limited, and health care ceased to fulfill its functions as it was expressed in the dawn of the Soviet period. Funding has been drastically reduced, making health care unavailable to all segments of the population, reducing the influence of government agencies and guarantees in this regard, and, as a result, the standard of living and the main vital indicators of health of large groups of the population have declined. The reason for the insufficient receipt of money in the "health treasury" was funding "on a residual basis", which was surprising: medicine receded into the background, ceased to be one of the most important development courses. The technical equipment of the health care base has deteriorated, the quality of medical care has inexorably declined, and the level of preventive work among the population has greatly decreased. Scientific and medical research, which had no support from the state, was carried out in a much smaller volume. All this led to the fact that in an incredibly short period of time the demographic state of the country was disturbed: against the background of a more than 2-fold decrease in the birth rate, the death rate increased 1,5 times. Although the reasons for this lay not only in the insufficiency of the healthcare system: the forensic situation worsened, which law enforcement agencies could not cope with. A situation was created in the country that had not been remembered since the post-war years - sociologists and demographers registered a clear picture of depopulation. Thus, at the beginning of 1990, the resources allocated to medicine were used extremely inefficiently and incompletely, since there was no clear structure for the provision of medical care. In addition, there was a clear bias towards the development of expensive types of medicine, and the system for the development of public, high-quality and financially easy preventive care did not find a way out. The resulting imbalance between what the population needed and what was actually provided to them led to people's distrust in the health care system, it was considered secondary. The situation demanded an immediate resolution through a clear, directed and effective reform. The reform of the health care system began in 1991. It put forward completely new principles for the elimination of centralization and monopolization of the public health sector. Laws on compulsory health insurance, the introduction of market mechanisms and the development of a network of channels for financing medical and preventive and research institutions were also promoted. In 1991, the Law on Compulsory and Voluntary Health Insurance was adopted, the main expected results of which were the partial elimination of the problems of financing the medical industry and relief for patients representing the largest groups of the population. The hopes placed on reform did not materialize. The health insurance system is still unfinished, however, with its precise development, many problems in the financial system of providing the medical industry can be solved. Until 1996, health care reforms were supported by only a small circle of enthusiasts, not finding support from the state government. The incomplete and underdeveloped nature of the reforms led to a sharp decline in the volume and quality of medical care, and public and free medical care was not guaranteed. In addition, the excessive development of commercial medicine has led to the emergence of corruption in this area. Health care in its relation underwent state regulation, and not central planning, as before. After a long stagnation, in 1996-1997, the situation began to improve somewhat. This improvement began with the adoption of the concept of the development of health care and medical science. When adopting this concept, the Government of the Russian Federation approved and fixed the course for a new strategy for reforms in the healthcare system. Since then, the main task in the field of medicine has been to unite all existing health systems by establishing close contacts between individual sectors, as well as establishing a balance in the processes of centralization and decentralization, public administration and self-government. Also, the boundaries between state institutions and private estates were established, and consequently, a system of private supplies to the medical services market developed. A line was established between the financing of public health structures and the financing of medical needs and requirements. The fact that "health is not when you are treated and recover, but when you do not get sick" still remained relevant. In this regard, the most important task, after providing the necessary medical care, was to provide a full range of preventive methods in order to maintain the health of the healthy. This was especially important in connection with the ever-increasing technogenic situation, the discovery and study of new viruses and bacteria, as well as factors that cause non-infectious diseases. A special role here was played by the accident at the Chernobyl nuclear power plant, which has not yet been forgotten, and its consequences were still too pronounced. In this regard, preventive control over the population was strengthened, annual medical and preventive examinations at enterprises and institutions were strictly regulated, the criteria for which depended on the type of activity. A system for identifying various occupational pathologies was developed, the state vaccination calendar was improved, which was amended in 1996 - a mandatory vaccination against hepatitis B was introduced due to the widespread spread of this infection, both concomitant with HIV infection and separately. In the new economic and social structure of post-Soviet Russia, the priority of human values and the value of human life itself, the impossibility of donating it in the name of fulfilling any state tasks, was affirmed. These changes prompted the idea of revising the text of "The Oath of the Doctor of the Soviet Union" (1971) and "The Oath of the Doctor of Russia" (beginning of 1990). The issue was considered both from ethical and state-legislative points of view, as a result of which, in 1991, the State Duma of the Russian Federation adopted a law on amendments to Article 60 of the Fundamentals of the Legislation of the Russian Federation on the Protection of Citizens' Health. In accordance with this law, persons who received a diploma of higher medical education in connection with the graduation from a medical higher educational institution on the territory of the Russian Federation took the Doctor's Oath, for violation of which they were criminally and civilly liable under the legislation of the Russian Federation (Fundamentals of the legislation of the Russian Federation on health protection citizens." The modern "Doctor's Oath", which is given by a graduate of any higher medical educational institution in Russia, is a combination of the fundamental principles of the "Hippocratic Oath" and the best traditions of Russian higher education, which are presented in the "Faculty Pledge". This is the content of the modern "Doctor's Oath" (approved by the State Duma of the Russian Federation in 1999). "Having received the high title of a doctor and embarking on a professional career, I solemnly swear: 1) honestly fulfill their medical duty, devote their knowledge and skills to the prevention and treatment of diseases, the preservation and strengthening of human health; 2) to be always ready to provide medical care, keep medical secrets, treat the patient attentively and carefully, act solely in his interests, regardless of gender, race, nationality, language, origin, property and official status, place of residence, attitude to religion, beliefs , belonging to public associations, as well as other circumstances; 3) show the highest respect for human life, never resort to euthanasia; 4) keep gratitude and respect for their teachers, be demanding and fair to their students, promote their professional growth; 5) treat colleagues kindly, turn to them for help and advice, if the interests of the patient require it, and never refuse colleagues help and advice; 6) constantly improve their professional skills, preserve and develop the noble traditions of medicine." Today, the development of practical and scientific medicine has reached its peak. However, all new discoveries and research are now more than ever associated with almost all branches of the national economy, the technical sector. The connection with the natural sciences, of course, prevails. Achievements of science and technology not only help the development of medicine. Now all technical innovations are tested for safety for human health and the environment. These measures began to be taken at a time when it was impossible not to notice the impact of technical production on nature and man, because humanity has repeatedly faced the threat of a global man-made disaster, and its local manifestations are undoubtedly known to almost everyone. Today, humanity has begun to seriously think about the creation of environmentally friendly fuels, the construction of factories for the safe disposal of man-made waste. Food containing chemical additives, carcinogens, transgenes and artificial colors and flavors is less and less welcome. The concepts of modern natural science are comprehensively considered in the course of study at various departments of medical universities. Compared with medical education of the Soviet period, modern medical education has gone ahead not only in connection with the study of discoveries and achievements in a purely clinical mainstream of medicine, but also because great importance has been attached to the study of issues and theories that were previously considered pure casuistry. Synthesized and harmonized the knowledge given to us by naturalists and scientists of past centuries, and the achievement of perfect technical and computer analysis. This gave modernity new ideas about the theory of evolution: Darwin's theory received modern additions and took on the form of a modern synthetic theory of evolution, which includes additions from the chromosome theory of heredity, etc. at the level of formation of immune complexes, but also on their subcellular and submolecular structure and ability to form. Probably, such a science as pharmacology has now reached the highest development in its direction, thanks to which medicine has been enriched with new highly effective drugs and prophylactic agents, immunomodulators, biologically active additives, vitamins and their complexes, designed for use by different age and gender groups to achieve the best results. All this became possible due to the discovery of previously unknown mechanisms of interaction of drugs with the body through endogenous ligands, neuromodulators, individual receptors, ion channels, presynaptic receptors, secondary transmitters. Genetic engineering methods are widely used in the creation of new generation drugs that are distinguished by a protective and stimulating effect on the body, in particular on the immune system and its links, high bioavailability and minimization of side effects. In fact, it has become possible to create drugs whose components are not alien to the body, and, integrating into the genetic apparatus of the body's cells, they improve the body's defense systems. Students of modern medical universities are widely taught such branches of science as psychoanalysis, which is studied in the course of general and medical psychology, psychiatry, and in the departments of nervous diseases. Great importance is given to the study of such phenomena as stress, the general adaptation syndrome, because the participation of these processes in the occurrence of many diseases of endogenous origin has been proven. For the first time, these conditions were mentioned in 1936 by the Canadian physician and scientist Hans Selye. He spoke about such factors as stress factors, about their nervous influence on the sympathoadrenal and hypothalamic-pituitary-adrenal systems, identified three stages of stress, which can result in serious mental and psychosomatic diseases. Many of his works have been translated into Russian. Among them are such works as "Essays on the Adaptation Syndrome" (1960), "At the Level of the Whole Organism" (1972), "Stress without Distress" (1979), "From Dream to Discovery" (1987). .). The problems of genetic engineering, as a rule, are discussed from the socio-ethical side. Modern students, as a rule, get an idea about them at the departments of general biology, genetics, medical law and medical ethics. To this day, there are disputes about how such achievements of genetic engineering as cloning are linked to the ethical standards of life. The subsequent cloning of an animal (Dolly the Sheep) opened up new horizons in the study of not only the organism, its functioning, but also the issues of life and death, because for the first time mankind had the opportunity to make a person's life infinite due to the periodic reproduction of its copies. However, the fact that such experiments still contradict what nature has given us (namely, a certain life cycle, limited by time frames from birth to death, varying for each person individually) - does not allow this scientific achievement to be made commonplace. At the end of XX - beginning of XXI centuries. more and more the doctrine of a healthy lifestyle began to gain momentum. This subject has the scientific name "valeology" ("sanology") and is taught in universities and institutes along with public health sciences and medical statistics in the departments of public health and health. The extraordinary popularity of the study of a healthy lifestyle is given by the fact that being healthy and leading a healthy lifestyle has become very fashionable. In this regard, sports activities at an amateur level have become very common, and a system of fitness centers has developed. This also includes private clinics that develop new principles of dietetics based on computer diagnostics of the state of the whole organism, blood group. Associating the causes of overweight or underweight with these criteria, clinic specialists select the most suitable diets that have a minimum of undesirable effects and give the best possible result for a given organism. The latest achievements in medicine have led to the development of another of its branches - medical cosmetology and plastic surgery. The first of them is becoming increasingly relevant today, because using the latest methods, people have received another, albeit rather conditional, way to stop time or create an ideal body for themselves. Initially, such changes were carried out by rather crude surgical interventions, which subsequently had a lot of undesirable effects. Later, non-surgical, so-called injection and skin methods of chemical, biological, physical, thermal effects on the body began to be widely used, which, in combination with the correct principles of diet and physical activity, give a result that is not much different from the results of surgical intervention. However, the development of surgery must be said separately: in addition to plastic methods used to eliminate physical “imperfections”, which are actually a physiological norm, people just don’t like their appearance, nowadays methods are widely used that save people from real physical deformities, returning them an attractive appearance and thereby relieving them of social and psychological problems with others and themselves. New technologies of functional diagnostics, such as ultrasound, computed tomography, magnetic resonance imaging, radio-pharmacological methods, angiocardiography, began to be actively introduced into practical medicine. These methods make it possible to diagnose diseases of various organs and systems at the very beginning of their occurrence and thereby prevent their further progressive development and choose the most correct, short and effective course of treatment. In addition, thanks to these methods, it became possible to carry out pre-diagnosis of diseases, i.e., the determination of pathological and pre-pathological changes in tissues and organs, due to which active prevention of certain diseases became possible, based not on empirical, but on objective data. Due to the tense demographic situation in the country, much attention has been paid to the creation of institutions such as family planning centers. In these centers, based on a general examination of the physical and biochemical parameters of the organisms of potential mothers and fathers, pathologies are identified that cause problems in conceiving children, the most effective methods of treating infertility are selected, and recently such actions as determining the optimal timing and dates have become possible. for conception for each couple individually and even "selection" of the sex of the unborn child. These programs are actively supported by government laws on additional funding for large families. All this is being done to eliminate the problem of depopulation, or simply the extinction of the nation. In order to effectively and comprehensively introduce modern achievements of science and technology into medical practice, in 1998 the Government of the Russian Federation approved the target federal program "High-Tech Medicine", which provided for the development of surgery of the cardiovascular system, neurosurgery, transplantology, obstetrics and gynecology, traumatology and orthopedics, disease prevention. The program was designed for a period from 1999 to 2006. At the end of the meeting, its results were taken into account, and feedback was made on the effective implementation of activities on the main points of the program. In addition to all the measures taken, the necessary attention should be paid to the state of the environment, since active human activity has a detrimental effect on the quality of air, water, and soil. These environments are an integral part of human life, and therefore their excessive pollution leads to diseases that can be caused by natural sources of infections, poisoning of drinking water and inhaled air, which is inextricably linked with the occurrence of various allergic reactions and atypical phenomena, poisoning, the appearance of an increasing the number of cancers. According to the WHO, 20% of diseases that are non-infectious in nature and of unclear etiology are the result of living in non-ecological habitats, another 20% are caused by a hereditary factor, and they, in turn, are the result of environmental pollution with mutagens, carcinogens, radioactive substances and the spread of harmful substances. habits. Among the latter, the most common in Russia are smoking, youth beer drinking, and drug use. Bad habits can also be attributed to an unhealthy lifestyle, which causes 50% of diseases. A very serious problem associated with drug use and promiscuity has become the increase in the number of HIV-infected people and people suffering from viral hepatitis B, C, D and E. Thus, only 10% of all diseases are associated with the quality of medical and social care. Although on a national scale this is also a lot. We must not forget about oncological diseases, which in some cases are also the result of the action of pathogenic environmental factors. In terms of prevalence, cancer is in second place after diseases of the cardiovascular system. About 2 million people die from tumors every year, and another 2 million are registered. It must be said that the spread of oncological diseases across continents and climatic zones is not the same, i.e., in a certain climatic zone, a certain type of tumor is more common (for example, in Japan - stomach cancer, in Africa - lung cancer, in the equatorial zone - melanoma etc.). According to the World Health Organization, men are more likely to develop cancer of the lungs, stomach, and rectum, while women are more likely to develop cancer of the breast, uterus, and rectum. Therefore, today more and more oncological centers are being opened in the world, and quite a lot of emphasis is being placed on the development of such a branch of medicine as oncology. Cancer is a widespread disease that kills thousands of people. Today, there is an active development of drugs that can cure cancer, and numerous methods are offered to get rid of this disease, but none of them guarantees a 100% cure. In the modern world, in which a person lives and is aware of its quality, there is a gradual reassessment of values, as a result of which humanity has finally understood the importance of health. In order not to lose this value, it is necessary to protect health by all known methods, both at the individual and at the social levels. 2. International cooperation in the field of healthcare. History, modern development No matter how countries differ in terms of the level of cultural development, socio-economic development, nevertheless, in the field of health care, the tasks for all are more or less common, and the actions aimed at fulfilling these tasks ultimately lead to one goal - to preserve the health of all nations. the globe. Due to the commonality of all these processes, physicians of various directions gradually, at different times, came to a common idea about uniting into international medical organizations and movements. There were many such societies and they were created at different times. However, the leading ones in our time are the following: the International Committee of the Red Cross, the League of Red Cross and Red Crescent Societies, the Public Movement "Physicians of the World for the Prevention of Nuclear War" and, of course, the World Health Organization. International Committee of the Red Cross The history of the emergence of this organization has its roots in the distant 1862, during the Franco-Italian-Austrian war. It was then that a young Swiss journalist, Henri Dunant, who wanted to be interviewed by Napoleon III, Emperor of France, came to him. Napoleon III was constantly in the center of hostilities. Then it was located in Lombardy, in the town of Solferino. It was June 24, 1859, when Henry Dunant first saw the consequences of hostilities with his own eyes: as a result of a bloody battle, thousands of the wounded and killed lay right on the ground, burned by the sun. The journalist was struck by the fact that no one helped them. What Henri Dunant saw shocked him. Having no medical education and no idea about the rules for providing medical care, Henri Dunant, together with four French doctors and several students, launched actions to help the wounded and injured. After some time, he was joined by women and tourists living nearby. For several weeks, the work to save human lives was in full swing. Returning from the theater of operations to Geneva, Henri Dunant told the world about the terrible consequences of military battles. He presented this information in his book, in which he called for the creation of social movements to help the wounded and injured in the wars. In 1862, the book was published and immediately received support from not only citizens, but also from the governments and monarchs of various countries. Henri Dunant also put forward the idea that it is necessary to provide assistance to the victims during the wars, regardless of their rank, nationality, because he saw how selflessly and indifferently the sisters of mercy treated the rest of what was happening during the Crimean War and in 1854 in Sevastopol. Thus, on the initiative of the Geneva Society for the Benefit of the People, in 1863 a Permanent International Committee for Relief for the Wounded was established. The committee included 5 citizens of Switzerland, including Henri Dunant. The committee promoted the creation of such societies throughout the world. And in October 1863, under his leadership, a congress was held, which included unofficial delegates from 16 countries of the world. The activities of the Committee were approved, at the same time the emblem of the movement was adopted - a red cross on a white background. Later, Islamic states such as Turkey adopted the Red Crescent as their emblem. The Committee received worldwide support, approved by the governments of various states, on August 22, 1864, when the Interstate Geneva Convention was signed, according to which the number of the wounded and sick in active armies was to be improved, regardless of whether they belonged to "their own" or "enemy" camp. In turn, the people who were supposed to provide medical care were supposed to be inviolable and not be considered as supporters or opponents of the army. The emblem of the Red Cross has become a sign of protection for medical personnel. Russia was one of the earliest and most active participants in the movement. She proposed not to use explosive bullets during the hostilities of 1868 (St. Petersburg, International Conference). Later, also at the initiative of Russia, at conferences in Brussels (1874) and Prague (1899), conventions on the rules of land warfare and the protection of the wounded in naval wars were pleasant. In 1874, it was proposed to withdraw from use weapons that cause especially dangerous injuries. In 1876, the "Committee of Five" was renamed the International Committee of the Red Cross and continued to put forward its proposals, promoting and putting them into practice during a series of conferences. The achievements associated with the actions of the International Committee of the Red Cross cannot be overestimated, however, he could not prove that waging wars (at least in relation to human life) is unlawful, he could only humanize wars, that is, reduce the suffering they bring people. Now the International Committee of the Red Cross is a society consisting only of representatives of Switzerland, performing the role of a neutral mediator in various kinds of armed conflicts. This body has inviolability in the provision of assistance during the war, both to wounded soldiers and civilians. League of Red Cross and Red Crescent Societies This movement appeared in 1919 with the unification of the national societies of the Red Cross and Red Crescent. The International Committee of the Red Cross and the League of Red Cross and Red Crescent Societies are united under the name "International Red Cross". The mission of the League of Red Cross and Red Crescent Societies is to supervise the activities of National Red Cross and Red Crescent Societies and to encourage the creation of new societies. The League of Red Cross and Red Crescent Societies today includes about 180 national societies. All of them develop humanitarian activities and alleviate human suffering in places of military operations. The motto of the League of Red Cross and Red Crescent Societies is "World Peace". The League of Red Cross and Red Crescent Societies and the International Committee of the Red Cross are headquartered in Geneva and unite under the leadership of the International Conference of the Red Cross. The conference is held once every 1 years. All Red Cross organizations that make up the conference are recognized as non-governmental and cannot be persecuted and repressed by the ruling political organizations. The International Red Cross condemns the use of nuclear weapons, atomic energy, and means of mass destruction for military purposes. He also opposes all manifestations of racism, fascism, nationalism, which has become widespread in our time, the skinhead movement (skin-head). All these factors are regarded as sources of international wars and international tension. The International Red Cross calls for general disarmament and the elimination of war from the life of all peoples. Russia and the Russian Red Cross Society fully support the activities of the International Red Cross to preserve the health of the planet's population and strengthen peace throughout the world. When military operations occur in other countries, Russia actively organizes humanitarian support, sends specialists there to provide qualified medical care, and teams to search for those missing as a result of earthquakes, floods, landslides, avalanches, and extensive fires. World Health Organization The World Health Organization is one of the most important agencies of the United Nations (UN). April 7, 1948 is considered the official day of the creation of the World Health Organization. On this day, the charter of the World Health Organization was approved by the members of the United Nations. The main idea of the Charter was "the achievement by all peoples of the highest possible level of health." The desire for such cooperation was caused by recurrent epidemics and pandemics. A semblance of international cooperation in the field of medicine and health care was created as early as the 1346th century. (1348-XNUMX), when a plague pandemic raged on the planet, claiming tens of millions of lives. This pandemic has gone down in history as the Black Death. Even then, measures were organized to limit the spread of the disease - quarantines, infirmaries, etc. At the national level, the effectiveness of such activities was low. Then international councils on health and sanitation began to be created. In 1851, the First International Sanitary Conference was held in Paris, by the decision of which the International Quarantine Charter and the International Sanitary Convention were adopted, which regulated the maximum quarantine periods for especially dangerous diseases: plague, smallpox, etc. In the same place, in 1907, the International Bureau of Public Hygiene was established, which was engaged in the dissemination of information relating to public health, especially dangerous infections and measures to combat them. Russia took part in the creation of the International Bureau of Public Hygiene until 1917, and in 1926 returned there in the person of the representative of the Soviet Union A. N. Sysin. In 1922, the International Bureau of Public Hygiene became a participant in the creation of the first international standard - diphtheria toxoid, and in 1930 a department at the State Serum Institute in Copenhagen became responsible for maintaining this standard. The International Bureau of Public Hygiene existed until 1950 and became the basis for the creation of the World Health Organization. In 1923, after the end of the First World War, the Health Organization of the League of Nations was created. Its creation was associated with the aggravation of the epidemiological situation in Europe: epidemics of cholera, typhoid, smallpox, and plague raged everywhere. The circle of questions covered by the Health Organization of the League of Nations was much wider than that covered by the International Bureau of Public Hygiene. The Health Organization of the League of Nations fought for "the adoption of all measures of an international scale for the prevention and control of the disease." The Health Organization of the League of Nations was engaged in the standardization of biological and medicinal products, the unification of the pharmacopoeia of various nations, the dissemination of information on the progress or regression of especially dangerous infections and the development of measures to combat them. The Health Organization of the League of Nations became the founder of a number of important expert commissions on sanitary statistics and the registration of cases of various diseases (malaria, cancer, leprosy, etc.). Also, this organization was engaged in the accounting of drugs, developed measures for the widespread introduction of normal nutrition. Scientists worked in the expert commissions - representatives of various nationalities, who went to different countries to help local doctors and scientists in creating quarantine regimes, ways to combat various diseases. The Health Organization of the League of Nations was the publisher of the Weekly Bulletin and the Weekly of Epidemic Diseases. These publications talked about the state of the epidemiological situation in various countries in terms of the incidence of various diseases, and also stated the demographic indicators of the birth and death rates, which helped to draw conclusions about the health of nations. In 1946, the Health Organization of the League of Nations ceased to exist, and was replaced in 1948 by the World Health Organization. The initiators of the creation of this organization were the countries - winners in the Second World War. The order establishing the World Health Organization was issued by the United Nations Special Agency for Health. The constitution of the World Health Organization proclaimed the principles necessary "for the happiness, harmony and security of all peoples". The main value was recognized as human health, which was given the definition adopted in all world health organizations - a state of complete physical, mental and social well-being, and not just the absence of disease or physical defects. The founding day of the World Health Organization is celebrated around the world as Health Day. The first congress of the World Health Assembly, which is the supreme body of the World Health Organization, took place on June 24, 1948. By its completion, the number of states that are members of the World Health Organization had increased from 26 to 55. The congress was held in Geneva. Dr. Brock Chitolne was elected as the first director-general of the World Health Organization. N. A. Vinogradov, B. D. Petrov, M. D. Kovrigina were appointed delegates from the Soviet Union to the First Assembly of the World Health Organization. At later dates, D. D. Venediktov, Yu. P. Lisitsyn, S. V. Kurashov, O. P. Shchepin, D. A. Orlov, and many others took part in subsequent assemblies. O. V. Barayan, N. I. Grashchenkov, I. D. Ladny, N. F. Izmerov, V. K. Lepakhin were appointed assistants to the Director General of the World Health Organization in different periods. At present, many outstanding scientists of our country are consultants to the World Health Organization. The World Health Organization has a regional structure that includes six regions: American - in Washington, European - in Copenhagen, headquarters of the Eastern Mediterranean - in Alexandria, African - in Brazzaville, headquarters of Southeast Asia - in New Delhi, headquarters of the Western Pacific - in Manila. To date, the World Health Organization has more than 190 states in its membership, with the combined efforts of which more than one and a half thousand projects are implemented every year, which are aimed at solving a wide variety of tasks: combating various diseases, training highly qualified personnel, improving the environmental situation, protecting mothers and child, international drug control, etc. The World Health Organization constantly organizes various symposiums and international conferences in Russia. Thus, in 1978 in Alma-Ata, at the initiative of the Soviet Union, an international conference on primary health care was held, in which representatives from more than 130 countries and 70 various international organizations were present. At the end of the conference, the "Magna Carta of Public Health of the 1991th Century" was written. In 1994 and XNUMX conferences and meetings were held to address health problems at the present stage. On the basis of Russian reference centers and laboratories, the World Health Organization is developing various international programs to combat epidemic situations. In general, Russia is one of the leaders in international cooperation in the field of healthcare. Movement "Physicians of the World for the Prevention of Nuclear War" The greatest and at the same time the most terrible discovery of mankind was the discovery of nuclear energy. The question of the use of nuclear weapons has always been very acute in the arena of world affairs, because from the moment this "world destroyer" was received, a real threat of extinction hung over humanity. Russia was the initiator of the elimination of weapons of mass destruction back in 1946, when the Soviet Union proposed signing a convention banning the use, production and storage of nuclear weapons. However, the danger of self-destruction hung over the world for a long time. Today, there are about 15 MT of nuclear weapons on the entire planet. In terms of equivalent explosive power, this is analogous to a million bombs dropped on Hiroshima and Nagasaki (August 1945). The power and scale of destruction can be compared with the result of 6 "Second World Wars". Doctors come to a common opinion that if a nuclear war breaks out today, half of the world's population will instantly die, the remaining half will experience all the "charms" of the consequences of a nuclear war - from radiation sickness and mass mutations to nuclear winter. And then it will be unknown who to envy - the living or the dead. Even before the receipt of nuclear energy, people who were directly involved in its discovery (V. I. Vernadsky, Niels Bohr - Nobel Prize winner) wrote that if humanity does not realize what power is given to them, then a nuclear catastrophe will occur and there will be a threat of omnicide - universal self- and mutual destruction. In 1980, the movement "Physicians of the World for the Prevention of Nuclear War" was founded, which included Professor Bernard Louis of Harvard University in the USA and Academician of the USSR Academy of Medical Sciences E. I. Chazov. In March 1981, the first congress of the new organization was held, where figures were given for possible human losses in the event of a nuclear war. In a short time, this movement gained immense popularity all over the world; in 1981, the Soviet Committee of the same name was organized. It has been proven that the mere existence of nuclear weapons on Earth already poses a threat: their presence can act like a detonator in an explosion. By the end of the 1980s. doctors around the world have sounded a serious alarm: according to their calculations, about 2,2 billion dollars are spent every day on weapons around the world, while, for example, to completely eliminate malaria in the world, only a fifth of this amount is required - 450 million. dollars. Other figures were also striking: there are 10 times more soldiers than doctors on earth. At all times, a reasonable solution to all the problems facing humanity was required. However, in the XX-XXI centuries. the range of these problems is so wide that it is not known whether mankind will cope with them. Today, no state develops in isolation, each is economically and politically connected with others. And only a general unification of forces and their direction to preserve the planet and its population will help to keep humanity from self-destruction. Author: Bachilo E.V. << Back: Healthcare and the development of medical science in the Soviet period (1917-1991) (General historical characteristics of the period under review. The formation of Soviet medicine. The principles of medicine in the USSR. Higher medical education. Medicine during the Great Patriotic War. The development of medicine in the post-war period)
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