How to influence health providers.

In spite of the recognition that Helicobacter pylori is responsible for most duodenal ulcer and peptic ulcer and that it is the underlying cause of most gastric cancer, little or no attention has been paid to its effect upon public health and in particular no measures have been put in place to address them. For over 20 years relatively inexpensive and noninvasive testing and treatment have been available, but no country has introduced a "screen-and-treat" policy, and relatively little research has been devoted to the identification of a vaccine for the disease. Health-care providers and doctors themselves are amenable to persuasion but in order to achieve appropriate investment in this area media pressure is required to publicize the arguments of health economics and equality of health that support the introduction of appropriate measures. There is a strong movement to eradicate inequalities of health. Population studies have shown that eradication of the infection can be provided at reasonable cost. Such a policy can easily be audited. Helicobacter pylori infection is the commonest environmental cause of cancer death after smoking, the diseases it causes represent a serious cost to health providers, and it affects the poorest members of our society. In the words of Kofi Annan, "Health should not be regarded as a blessing to be wished for, but a human right to be fought for."