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WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1980; (651):1-19.This document reports the discussions of a Scientific Group on Vaccination Against Tuberculosis, cosponsored by the Indian Council of Medical Research and the World Health Organization (WHO), that met in 1980. The objectives of the meeting were to review research on Bacillus Calmete-Guerin (BCG) vaccination, assess the present state of knowledge, and determine how to advance this knowledge. Particular emphasis is placed in this document on the trial of BCG vaccines in South India. In this trial, the tuberculin sensitivity induced by BCG vaccination was highly satisfactory at 2 1/2 months but had waned sharply by 2 1/2 years and the 7 1/2-year follow up revealed a high incidence of tuberculous infection in the study population. It is suggested that the protective effect of BCG may depend on epidemiologic, environmental, and immunologic factors affecting both the host and the infective agent. Studies to test certain hypotheses (e.g., the immune response of the study population was unusual, the vaccines were inadequate, the south Indian variant of M tuberculosis acted as an attenuating immunizing agent, and mycobacteria other than M tuberculosis may have partially immunized the study population) are recommended. A detailed analysis should be made when results from the 10-year follow up of the south Indian study population are available.
In: Quest for the killers, [by] June Goodfield. Boston, Massachusetts, Birkhauser, 1985. 191-244. (Pro Scientia Viva Title)This article relates the final phase of the campaign to eradicate smallpox from Bangladesh in the early 1970s under the leadership of Donald Henderson. The article is based on informal interviews with many of the participants in this campaign who shared their recollections of the drama and problems of these years. Bangladesh was the last country in the world to be free of smallpox. In retrospect, those involved in the campaign agreed that an unfortunate defect of the campaign was that the rapid importation of international advisors did not allow the slow build-up of national staffs. If was not a developmental effort, and organizers were forced to initiate activities that could not be sustained. On the other hand, the campaign's success achieved a number of very important ends over and above the eradication of a disease. It particularly boosted the authority of health ministries in Bangladesh and contributed to the society's understanding of disease control. The episodes in this campaign are a moving testimony to the power of international cooperation.