About 100 million people fall into poverty each year paying for healthcare, the World Health Organization (WHO) said in the World Health Report 2008, published in Almaty, Kazakhstan on Tuesday.

The report, Primary healthcare - now more than ever, critically assesses the way healthcare is organized, financed and delivered in rich and poor countries around the world.

On this occasion, the WHO hopes to start a global conversation on the effectiveness of primary healthcare as a way of reorienting national health systems, because the source of the problem is that health systems and health development agendas have evolved into a patchwork of components.

"In short, health systems are unfair, disjointed, inefficient and less effective than they could be," the WHO said.

"Rather than improving their response capacity and anticipating new challenges, health systems seem to be drifting from one short-term priority to another, an increasingly fragmented and without a clear sense of direction," the report said.

This is evident in the excessive specialization in rich countries and donor-driven, single disease focused programs in poor ones, it said.

A vast proportion of resources are spent on curative services, neglecting prevention and health promotion that could cut 70 percent of global disease burden, it said.

Medical care in the rich world has also become dangerously fragmented, according to the report. It said front-line health workers ought to better assess patients' overall needs instead of referring them to costly specialists.

"This contributes to inefficiency, restricts access and deprives patients of opportunities for comprehensive care," the report said.

"In far too many cases, people who are well-off and generally healthier have the best access to the best care, while the poor are left to fend for themselves."

Profit-driven care has also increased the use of unnecessary tests and procedures, prompted more frequent and longer hospital stays, driven up overall costs and excluded those who cannot pay, the Geneva-based agency said.

Annual government spending on health worldwide varies from just $20 to more than $6,000 per person.