There are alarming trends in the incidence of a number of diseases. A host of environmental and social problems continue to add to the burden of disease and ill-health. Poverty remains a major cause of undernutrition and ill-health. It contributes to the spread of disease, undermines the effectiveness of health services and slows population control. The wide and increasing use of antibiotics in man and animals, and in agriculture has led to the development of microorganisms' resistance at an unprecedented rate.
Bacteria are extremely efficient at increasing resistance.
Physicians, under pressure from patients, prescribe antimicrobials even in the absence of appropriate indications. Patients often fail to comply with the prescriptions and forget their treatment or interrupt it prematurely, creating an ideal environment for microbes to adapt and survive. Numerous studies over the past 40 years, in different parts of the world, have clearly identified multiple risk factors in the development of major noncommunicable diseases and traced their origins in unhealthy lifestyles and polluted environments. Sanitation is universally accepted as a foundation for good health but nearly two-thirds of all people in developing countries do not have sanitary excreta disposal, and the number without adequate services is growing. Through good sanitation services, together with safe and ample water supply, hygienic behaviour and safe food, this risk can be reduced to nearly zero.