Overview

Long-term care of people with chronic illnesses and disabilities raises critical issues that cut across national borders. The universal problem of long-term care is intensifying, due to a combination of demographic and epidemiological forces. A WHO study estimates that in many developing countries, the need will increase by as much as 400 per cent in the years to come. The demand for long-term care arises from ageing populations, chronic health challenges, increasing dependency, the HIV/AIDS epidemic, dietary and lifestyle habits, increased road injuries and the rise in diabetes, cardiovascular disease and stroke. The need for increased attention to long-term care must be met by health system, state and institutional changes. To contribute to this dialogue about how best to achieve equitable, fair, rational, and transparent decisions, this report addresses the social and ethical basis of long-term care, identifying the key issues entangled in problems in caring for persons with chronic illnesses and disabilities. It provides a framework of analysis that specifies the issues and stakeholders instrinsic to redesigning long-term health care systems. The report includes three commissioned papers, by distinguished philosophers Martha Nussbaum, Norman Daniels, and Eva Kittay, which illuminate the need to expand theories of justice and social contract to encompass social responsibility for care. Collectively, they provide a theoretical lens for rethinking issues of fairness in allocating social resources for all kinds.

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World Health Organization is a Specialized Agency of the United Nations, charged to act as the world's directing and coordinating authority on questions of human health. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries, and monitoring and assessing health trends.

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