Access to health poses a major challenge globally as 90% of health resources are invested in a mere 11% of the world’s population, the US Surgeon General Dr David Satcher told the 16th World Congress of Family Doctors in Durban yesterday (Monday).

“The struggle for access has already started playing itself out here in South Africa over access to drugs,” said Satcher. “There needs to be a humanising of the health system between nations and within nations.”  

Scientific advancement had often meant that “the whole patient has got lost in organ systems, diseases and, increasingly, genotypes,” added Satcher. “But the patient has a range of physical, mental and social problems interacting together, and only the family physician can put the whole patient back together again.”

Depression was increasingly becoming a serious problem worldwide, and some experts predicted that depressive disorders would be “the leading cause of disability in the world within the next 50 years”, said Satcher. “But 70% of people over 65 in the US who had committed suicide had seen a doctor within 30 days of their death. We forget to ask about depression.”

He urged doctors to speak to their patients about the importance of healthy lifestyles, and to write “prescriptions” for regular physical activity.  

While HIV/AIDS was “the biggest challenge ever facing family medicine”, Satcher said that, “at the other end of the spectrum” the developed world was battling to deal with problems relating to an aging population. In addition, environmental toxins, war and violence were major challenges facing family doctors.  

The congress, which ends on Thursday, has attracted over 2 000 delegates from 66 countries.