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    Preparatory Meeting on Diphtheria Control Strategy, Berlin, December 15, 1994.

    Steinglass R

    Arlington, Virginia, Partnership for Child Health Care, 1994. [3], 7, [75] p. (BASICS Trip Report; BASICS Technical Directive: 000 NS 01 001; USAID Contract No. HRN-6006-C-00-3031-00)

    In December 1994 in Berlin, Germany, WHO and UNICEF sponsored a meeting on diphtheria control strategy for the Newly Independent States (NIS). The participants prepared a proposed strategy to be elaborated on and endorsed by ministries of health (MOHs) of the NIS and donor agencies at 2 follow-up meetings scheduled for January 1995. The NIS is experiencing a diphtheria epidemic. The epidemic is starting to stabilize only in the Ukraine. Children comprise 40% of cases. Diphtheria has become firmly established in all age groups and throughout entire countries, so past immunization strategies (i.e., 3 doses of diphtheria toxoid-containing vaccine [Td] for just high risk groups) cannot curb the epidemic. Now as many people as possible must receive 1 dose of such a vaccine. Some high risk age groups should receive additional doses. A group at very high risk of diphtheria is school-aged children. Last year it was estimated that the Ukraine needed 22 million doses of Td for mass immunization, but it now needs 81 million doses of Td. UNICEF will provide 4 doses of DPT (diphtheria, pertussis, tetanus toxoid) vaccine as part of the standard primary series and 1 booster dose of diphtheria-tetanus vaccine (pediatric formulation) at school entry. Manufacturers are not responding to requests for production of additional quantities of antitoxin by the spring, thereby prolonging the chronic global shortage of antitoxin. The meeting was productive in developing a technically sound strategy, but more attention is needed to produce political interest/will and to mobilize resources. In addition to WHO talking to MOHs, more media coverage and social mobilization are needed within each NIS. During the next few months, WHO and UNICEF will determine whether a pledging session of potential donors is needed. The International Federation of Red Cross is donating $2 million for diphtheria control in the Ukraine.
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