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The Bulgarian experience, statement made at the Special Convocation, Sofia State University, Sofia, Bugaria, 7 October, 1983.
New York, N.Y., UNFPA, . 5 p.Although world fertility has entered a perceptible period of decline heralding a deceleration in the rate of population growth, even with the current rate, which is about 1.7%/year, the world is still adding close to 78 million people to its population each year. This figure is estimated to rise to 89 million by the year 2000. A major concern confronting most developing countries at present is the integration of population factors into the development process. In this context, Bulgaria's progress in the twin fields of population and development provides an outstanding example of what can be achieved. Demographic development in the country since 1950 has been impressive. Although the bulk of transition in fertility and growth rate of population had occurred by 1950, the consistent improvement in health services has achieved at an early date what was sought by the World Population Plan of Action in its 2 quantified targets: lower infant mortality rates and longer life expectancy. A major reason for this success is the official policy in regard to the full integration of women into the development process. Internally, Bulgaria pursues a pronatalist policy. Within the context of Bulgaria's national goals of development objectives and human resource potential, this policy is understandable. Bulgaria's population program includes activities to reduce infant and child mortality, improve maternal health, augment reproductive health and increase marital fertility. The United Nations Fund for Population Activities, because of its respect for the sovereign rights of countries to determine their own population policies, has provided assistance for the implementation of this national program.
In: Proceedings of the International Conference on Oral Rehydration Therapy, June 7-10, 1983, Washington, D.C., edited by Richard Cash. Washington, D.C., Agency for International Development [AID], Bureau for Science and Technology, 1983. 4-5. (International Conference on Oral Rehydration Therapy, 1983, proceedings)The Honorable Margaret Heckler, secretary of Health and Human Services, presents the goal of the conference--discussion of the remarkable potential of oral rehydration therapy and its importance to the health of infants and children throughout the world. The conference celebrates the scientific advances of recent years that give new hope for millions of children every year. Over 500 million episodes of diarrhea afflict infants in developing countries each year; each year, some 5 million children lose their lives to these diseases. In Europe, and in North America as well, diarrhea is the 6th most common cause of death among small children. At the turn of the century, mortality due to cholera was 60%. A scientist in Calcutta and 1 in Manila developed methods of intravenous therapy that reduced mortality dramatically to 20%. Treatment of the disease remained relatively unchanged until the middle of the century when work in Egypt and Asia resulted in a therapy method that reduced mortality for cholera to less than 1%. The crucial discovery of an effective cholera agent occurred in India in 1959. In 1962, scientists in Manila established the vital role of oral glucose in the absorption of sodium and water. The large-scale use of oral rehydration therapy was demonstrated in Dhaka and Calcutta in the 1960s, when 100s of cholera cases were managed under field conditions during a rural epidemic. A massive epidemic during a refugee crisis in 1971 was well-coped with by the Johns Hopkins group in Calcutta by treating 3700 patients over an 8-week period. This was one of the 1st large-scale uses of prepackaged materials for oral hydration, costing only US$750. In Dhaka and Calcutta in the early 1970s the critical discovery that noncholera diarrheal diseases could be treated with the oral rehydration therapy developed for cholera was made. The discovery of the role of glucose in accelerating the absorption of salt and water was underscored in the British journal "Lancet" as being potentially the most important medical advance of this century. A strong coalition of interest exists between governments and scientists of many nations as well as the international organizations to promote oral rehydration therapy. WHO, UNICEF, USAID and other agencies are playing an extremely important part in discovering how oral rehydration therapy can best be incorporated into broader health services, and how to prevent diarrheal diseases from occurring.