WHO and its role in the prevention of deafness and hearing impairment.

The World Health Organization (WHO) is a specialized agency of the United Nations which was set up in Geneva in 1948. The constitution of WHO establishes it as 'the directing and coordinating authority on international health work'. It is responsible for helping all peoples to attain 'the highest possible levels of health'. The central structure of WHO includes a policy-making body termed the World Health Assembly (WHA). The WHA consists of delegates of all member states (meeting yearly), an executive board of 32 individuals elected by the assembly, and a secretariat, consisting of a director-general assisted by technical and administrative staff. The World Health Organization has produced, or been associated with the production of, a number of documents. Perhaps the three that are best known to the medical profession in general are the International Classification of Impairments, Disabilities, and Handicaps (ICIDH): A manual of classification relating to the consequences of disease (World Health Organization, 1980), the International Statistical Classification of Diseases and Related Health Problems (World Health Organization, 1992), and the State of the World's Vaccines and Immunization (World Health Organization and United Nations Childrens' Fund, 1996). Although it is now being revised, the first document has been used extensively in areas such as anthropology, demography, economics, education, legislation, policy, rehabilitation, sociology and statistics. In relation to hearing, there is a need to distinguish between the terms 'impairment', 'disability' and 'handicap' as they are used by WHO (and in the UK) and as they have been used in the USA. In respect of hearing, the WHO considers 'impairment' to be a measure of defective auditory function; 'disability' is the auditory problem experienced and complained of by the individual; 'handicap' encompasses the non-auditory consequences (e.g. occupational, sociological, psychological, economic) of hearing impairment and hearing disability (Stephens and Hetu, 1991). Current terminology recognizes the necessity for addressing both individual needs (for example, in respect of rehabilitation and technical aids) and the shortcomings of society (various obstacles to participation). Stemming from the International Year of Disabled Persons, 1981 and the World Programme