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Population trends and issues, statement made at the Meeting of the Netherlands Association of Demographers, The Hague, Netherlands, 14 September, 1983.
New York, N.Y., UNFPA, . 7 p. (Speech Series No. 97)If world population is to stabilize by the end of the next century, it will be necessary to strengthen and sustain the downward trend in fertility already begun in most developing countries. Whatever reductions have been achieved in the rate of population growth are the result of fertility declines accompanied by moderate reduction in mortality. Added to the challenge of high birth, mortality and growth rates in some parts of the developing world, a number of issues of equal importance have emerged since the United Nations World Population Conference held in Bucharest in 1974. There are, for example, issues relating to aging, international and local migration, including urbanization, and the interrelationships between population, resources, the environment and development. Most of these problems have national as well as international dimensions. The Government of the Netherlands has taken important steps to alleviate some of these problems. For example, it considers that social and economic policy should constantly take in requirements resulting from changes in the age structure of the population. The Government has been a major donor to the United Nations Fund for Population Activities (UNFPA) since its inception and has contributed nearly US$105 million in 14 years.
REVIEWS OF INFECTIOUS DISEASES. 1983 May-Jun; 5(3):452-9.This summary of the worldwide impact of measles discusses epidemiology, reported incidence, clinical severity, community attitudes toward measles, and the impact of immunization programs on measles. Measles, 1 of the most ubiquitous and persistent of human viruses, occurs regularly everywhere in the world except in very remote and isolated areas. Strains of measles virus from different counties are indistinguishable, and serum antibodies from diverse population have identical specificity. Yet, the epidemic pattern, average age at infection, and mortality vary considerably from 1 area to another and provide a contrasting picture between the developing and the developed countries. In the populous areas of the world, measles causes epidemics every 2-5 years, but in the rapidly expanding urban conglomerations in the developing world, the continuous immigration from the rural population provides a constant influx of susceptible individuals and, in turn, a sustained occurrence of measles and unclear epidemic curves. In the economically advanced nations, measles epidemics are closely tied to the school year, building up to a peak in the late spring and ceasing abruptly after the summer recess begins. Maternal antibody usually confers protection against measles to infants during the 1st few months of life. The total number of cases of measles reported to WHO for 1980 is 2.9 million. Considering that in the developing world alone almost 100 million infants are born yearly, that less than 20% of them are immunized against measles, and that various studies indicate that almost all nonimmunized children get measles, less than 3 million cases of measles in 1980 is a gross underestimate. There was adecrease in the global number of reported cases of measles during the 1979-80 period due primarily to the reduction in the number of cases in the African continent and, to a lesser extent, in Europe. It is premature to conclude that such a reported decline is real and that it reflects the beginning of a longterm trend. The contrast between the developed and the developing worlds is most marked in relation to the severity and outcome of measles. Case fatality rates of more than 20% have been reported from West Africa. It has been estimated that 900,000 deaths occur yearly in the developing world because of measles, but data available to WHO indicate that the global case fatality rate in the developing world approaches 2% (in contrast to 2/10,000 cases in the US), and the actal mortality may be greater than 1.5 million deaths per year. The advent of WHO's Expanded Program on Immunization has brought about an awareness of the measles problem. Whenever and wherever measles vaccine has been used effectively on a large scale, a marked reduction in the number of cases has been recorded.