CHRISTINA L. DE VRIES [*]
Health issues are now, more than ever, issues of social justice and peace, of values in respect of human life and dignity, and of the striving for "wholeness". The need for the empowerment of women and for the care of the marginalized increases. This becomes painstakingly clear from the societal devastation following the AIDS epidemic. Health issues invade all segments of society and of individuals' lives. Thus churches cannot ignore health issues as "non-theological" aspects of the churches' mission.
The shift of attention for health concerns from the religious domain towards the medical profession was accentuated during the 20th century, when, due to revolutionary new technology, health issues became more medical-technological issues, to be addressed by health professionals. In the second half of the century, health issues were not just defined as an issue between a patient and his/her doctor, but became an object of nationally and internationally managed intervention programmes. The realization arose that health seemed no longer just the opposite of disease, but that the health of populations and individuals was constantly under threat from poverty, violence and wars. Globalization, the power of multinational companies and the passive attitude of many governments towards health needs made the scenario even more gloomy: would health now become just another free market issue, and drugs merely an economic commodity? Would health be attained only by those who were willing and able to pay for it? Would healt h cease to be a basic human right for all? Where are the mechanisms left for societies to exercise solidarity for the weak and the poor? Do global economic principles overrule local societal values at national and sub-national level?
What could and should be the role of churches?
An excellent overview article by Sigrun Mogedal and Mirjam Bergh that addressed the global health situation and the churches' response was published in this journal in 1994.  It is still valid today, yet the scenario has become even more urgent. This present article will further highlight some of the challenges in health and health care, which urgently need to be addressed by the churches.
Achievements of the 20th century
The 20th century has become part of our shared history, now we can look at it and marvel at what it has brought to humankind:
* Standards of living improved for large segments of populations, especially in Europe and the Americas. There is now better housing, greater access to clean water, sewage systems and latrines, which have all contributed greatly towards reducing the occurrence of tuberculosis, cholera and child mortality through diarrhoea.
* There was an improvement in knowledge about healthy diets coupled with an increased availability of foods, and the development of vitamin and iron supplements for children and pregnant women. All of these increased people's life expectancy.
* The discovery of antibiotics contributed towards reducing deaths from communicable diseases.
* The development of vaccines in conjunction with the establishment of the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) resulted in global programmes for the prevention of diseases. The results were impressive: the eradication of smallpox and the Extended Programme for Immunizations (EPI) against major childhood diseases are truly the highlights.
* Revolutionary new technologies changed hospital care: more diagnostic and imaging facilities changed the role of doctors and hospitals, in the sense that technology became more prominent at the expense of care and comfort.
* The development and adoption of family planning methods on a large scale (whether compulsory or voluntary) resulted in a demographic transition in many countries resulting in populations containing relatively less youth and more elderly people. …