Besides the fact that roughly 100 million people a year fall below the poverty line because of personal health expenditure, the WHO said as many as 5.6 billion people have to pay for more than half of their health expenditures themselves.

Also, nearly 60 million women will give birth without any medical assistance this year, the report said.

Some 58 million of the 136 million women who will have babies this year will lack medical help during and after their births, it said.

The WHO said that the billions of aid dollars devoted to fight specific epidemics like AIDS had distracted attention from providing comprehensive care to mothers and children.

The difference in life expectancy between the richest and poorest countries still exceeds 40 years, the report said, of which launch coincided with a global financial crisis that could freeze aid flows and squeeze government budgets for healthcare.

Increasingly specialized and technical medicine in wealthy nations has also excluded and impoverished millions of patients, exposing failures of laissez-faire governance in health, according to Margaret Chan, the WHO's director-general and a former Hong Kong health director.

"We are, in effect, encouraging countries to go back to basics," Chan said in an introduction to the WHO report.

The report estimated that focusing more on disease prevention and health promotion - through vaccine and nutrition-boosting program - could cut the global burden of infirmity by 70 percent.

Despite huge foreign aid sums earmarked for program fighting AIDS, tuberculosis, malaria and other killer diseases in developing countries, quality care remains scarce outside these areas, it said.

"Disproportionate investment in a limited number of disease programs considered as global priorities in countries that are dependent on external support has diverted the limited energies of ministries of health away from their primary role," it said.

Governments have a responsibility to extend healthcare to all who need it, and to support good community health through education, food and safety standards, and clean water and sanitation services, Chan said.

Inequitable access and the high cost of healthcare could erode social stability in a number of vulnerable countries, she said.

"A world that is greatly out of balance in matters of health is neither stable nor secure," Chan said.

The publishing of the report also commemorated the 30th anniversary of the Alma-Ata International Conference on Primary Healthcare held in 1978.

That event was the first to put health equity on the international political agenda.

(China Daily via agencies October 16, 2008)