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The role of food safety in health and development. Report of a Joint FAO-WHO Expert Committee on Food Safety.
World Health Organization Technical Report Series. 1984; (705):1-79.This document presents the recommendations of a Joint Food and Agriculture Organization (FAO)-World Health Organization (WHO) Expert Committe on Food Safety. Illness due to contaminated food is perhaps the most widespread health problem in the world and a major cause of reduced economic productivity. The safety of food is affected by food systems, sociocultural factors, food chain technology, ecologic factors, nturitional aspects, and epidemiology. It was the assumption of the Committee that, if food safety is given sufficient priority within national planning, countries can prevent and control foodborne disease, especially pathogen-induced diarrheal syndromes, and interrupt the vicious cycle of diarrhea-malnutrition-disease. Attainment of this objective requires a national commitment and the collaboration of all ministries and agencies concerned with health, agriculture, finance, planning, and commerce as well as the food industry, the biamedical and agricultural scientific community, and the consuming public. Prevention and control interventions should aim to avoid or minimize contamination, to destroy or denature the contaminant, and to prevent the further spread or multiplication of the contaminant. The Committee outlined a series of recommendations for achieving a worldwide reduction in the morbidity and mortality caused by foodborne hazards. Food safety should be considered an integral part of the primary health care delivery system. Food safety should also be regarded as an integral part of the total food system. National food control infrastructures should be strengthened, and regional, national, multinational, and international surveillance of foodborne diseases should be carried out. Each country should aim to develop at least 1 laboratory capable of identifying the etiologic agents of diarrhea and other foodborne diseases. Health workers should be trained to play a role in identifying and monitoring critical control points in food production and preparation. Health education, within the context of the cultural and social values of the community, should inform the public about food safety hazards and preventive measures. Finally, the hazard analysis critical control point approach to prevention is recommended.
World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1984; 37(2):130-61.This paper sets forth the number of malaria cases reported in 1973-82 to the World Health Organization (WHO) by region. Excluding Africa, the total number of cases rose from 3.9 million in 1973 to a high of 10.7 million in 1977 and declined to 6.5 million in 1982. It is noted, however, that reporting during this period was often deficient and uneven. The prevalence of malaria has remained relatively unchanged in Africa south of the Sahara, with the exception of urban centers where transmission has been considerably reduced. In the Americas, the number of cases reported has risen steadily since 1973. South East Asia experienced a dramatic increase in malaria cases in 1976, but intensive efforts haveresulted in a decline almost back to the 1973 level. About 28% of the world's population lives in areas where malaria never existed or disappered without specific antimalaria efforts. Another 18% lines in areas where the disease has been eliminated by improvements in health facilities, environmental changes, and specific antimalaria measures. 46%, or 2117 million people, live areas where the incidence of malaria has been reduced to varying degrees, ranging from a slight reduction of the original endemicity to the near elimination of the disease. A final 8%, or 365 million people, live in areas where no specific antimalaria measures are undertaken and the original levels of endemicity remain largely unchanged outside of certain urban centers. In addition to presenting data on malaria cases by world region, tables accompanying this article summarize malaria eradication registration, the importation of malaria cases into malaria-free countries, and the development of resistance to chloroquine.
[Record of the second meeting of the WHO Collaborating Centers on AIDS] Deuxieme reunion des centres collaborateurs de l'OMS pour le SIDA: memorandum d'une reunion de l'OMS.
BULLETIN OF THE WORLD HEALTH ORGANIZATION. 1986; 64(2):221-31.Participants at the 2nd meeting of World Health Organization (WHO) collaborating centers on AIDS (acquired immune deficiency syndrome) held in Geneva in December 1985 reported on progress since the 1st meeting in September 1985 and made a number of recommendations for future action in the areas of information, education, and prevention; reference reactants and tests of anti-HTLV-III antibodies; epidemiologic evaluation; and research on vaccines and antiviral agents. It was recommended that ministries of health, education, and social services provide the public with timely and accurate information on AIDS, that physicians, nurses, and similar personnel inform the ill and the public about AIDS and its prevention, and that school age children and young people be informed about AIDS and how to avoid infection. Systems of registration of AIDS cases should be implemented in order to provide the WHO and member states with data on the international level. Standardization and availability of serologic tests is also required. Instructions for avoiding infection should be provided for health personnel and others caring for AIDS patients, for individuals providing personal services to the public, and to ensure adequate methods of disinfection. Instructions for preventing AIDS should discuss sexual and parenteral transmission as well as perinatal transmission. Specific recommendations for education and family placement for children with AIDS have already been published. Instructions should be provided for prisons and similar estabilshments. Requiring international travellers to provide certificates attesting to their AIDS-free status is not justified as a preventive measure. The significant existing demand for reference reactants including human serums with anit-HTLV-III antibodies and controls is being addressed by several institutes in different countries, but it would be premature to furnish reference reactants other than serums. The WHO collaborating centers should furnish materials for purposes of training in diagnostic techniques. Existing tests for diagnosis and confirmation should be imporved and new tests should be developed, with particular attention to simple methods appropriate for use in developing countries. It will be necessary to establish international biological standards for the HTLV-III virus, but the required specifications are not yet known. Technical cooperation and epidemiological evaluation must be planned separately, based on the different prevalence of infections and technical expertise of different countries. A clinical definition of AIDS is needed for countries lacking resources needed to apply the Centers for Disease Control/WHO definition. Surveillance methods and laboratories can be installed with WHO assistance, to help evaluate the extent of AIDS infection in different countries. Later technical cooperation in the areas of continued surveillance and laboratory capacities will depend on results of the initial evaluation in each country. Research is currently underway in several countries of possible vaccines and drugs. Careful preclinical studies should be done to evaluate the toxicity of an agent before clinical studies are conducted. Convenient animal models should be sought for future research. 3 annexes to this report specify methods of disinfection; general principles of preventing transmission of the AIDS virus through parenteral exposure or following donation of organs, sperm, or other tissue; and a proposed definition of clinical cases of AIDS.
Journal of the National Medical Association. 1985 Dec; 77(12):963-5.The goal of "Health for All by the Year 2000," adopted by the World Health Organization, will be pure rhetoric if all sectors involved are not sensitized to the problem of famine in many countries in Africa and other 3rd world nations. The medical profession should be made aware of this goal, both on national and international fronts. The case of Ethiopia is discussed as a valid example of a "diseased third world," focusing on the famine, other medical problems, and the health system. The last emperor of Ethiopia, Haile Selassie, was swept away by the 1974 revolution. The major cause of his downfall was the 1973 famine, which the emperor wanted to conceal from the outside world. A military government took over, espousing Marxist ideology and aligning itself with the Soviet Union. Famine has been endemic for decades; the last famine in 1973 claimed over 300,000 lives. The country never totally recovered from the effects of that drought, and as early as 1981-82, major relife organizations were warned of another looming crisis. Some of the causes of the current crisis include the absence of rain for 3 consecutive years that paralyzed agriculture, poor and primitive farming practices, and deforestation. It is estimated that the land area covered by forest has dropped from 16 to 3.1% over the last 20 years. This has adversely affected the moisture-retentive capacity of the soil. Other man-made contributory factors are the civil war, the resulting dislocation of the population, and administrative mismanagement. 10 million people now face starvation; 300,000 have already died, and 1000 per day continue to die. The attention of the international community is justifiably focused on the immediate task of providing food. Yet, the full medical aspect of the famine and its consequences have not been adequately handled. Assuming that international aid will effectively prevent further loss of life, the survivors will face a host of health problems, epidemics in particular. Most of the feeding camps and various refugee centers are overcrowded; elementary sanitary facilities are lacking. There is a critical shortage of vaccines and other medical supplies. The vast majority of the Ethiopian population suffers from various preventable communicable diseases. The leading 10 causes of morbidity diagnosed in 1976 were venereal diseases, helminthiasis, bacillary and amebic dysentery, gastroenteritis, leprosy, malaria, tuberculosis, schistosomiasis, trachoma, and influenza. WHO reports that health expenditures represent only 5.7% of the total budget and that only 20% of the population are vaccinated against smallpox, yellow fever, DPT (diptheria, pertussis, tetanus), measles, tuberculosis, and polio.
Global distribution of schistosomiasis: CEGET/WHO Atlas. Distribution Mondiale de la schistosomiase: Atlas CEGET/OMS.
World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1984; 37(2):186-99.Schistosomiasis, the most prevalent of the water-borne diseases, is endemic in 74 tropical developing countries and infects over 200 million persons in rural and agricultural areas. However, recent advances in diagnostic techniques, new antischistosomal drugs, and accumulated understanding of the epidemiology of the infection offer improved prospects for schistosomiasis control. Morever, adaptation of quantotative parasitologic techniques for the diagnosis of schistosomiasis will make more data available for use in national control programs. The World Health Organization (WHO) has been instrumental in providing reliable reference material on the geographic distribution of schistosomiasis and, on the basis of a survey of Member States, collaborated with Centre d'etudes de geographic tropicale (CEGET), in the development of an Atlas. This volume consists of topographic relief maps that identify the presence of absence of schistosomiasis by village or locality. There are wide variations in the prevalence, intensity of infection, ans species of parasite according to ecologic differences, snail intermediate hosts, and occupational and cultural norms. The Atlas also highlights the relationship of water resource development projects to schistosomiasis endemicity. Attention to such data may lead to the selection of project areas known not to be endemic. More sophisticated geographic analyses based on land form, soil and geologic characteristics, ground water level, and agricultural land use have been used predictively in Japan. The Atlas is expected to serve as a reference point to evaluate the global progress in schistosomiasis control.
In: The Tenth Asian Parasite Control/Family Planning Conference. Proceedings. Under the joint auspices of the Asian Parasite Control Organization, the Japanese Organization for International Cooperation in Family Planning, the Japan Association of Parasite Control and the International Planned Parenthood Federation. Tokyo, Asian Parasite Control Organization, . 63-70.Economic depression affects children in 3 major ways: disposable family incomes drop sharply, with the most severe consequences for poor people and their children; government budgets for social services, particularly those affecting young children and including nutrition, health, and education, are the first to be cut back; and national and international levels of development assistance stagnate as a consequence of the restrictive budgetary policies adopted by industrialized countries. Despite the first welcome signs of an economic recovery in some industrialized nations, most indications are that the worldwide recovery may be relatively shallow in the mid-1980s and that significant beneficial impacts on many low income countries and families will be long delayed. Thus, in the absence of special measures to accelerate health progress, millions more children and mothers are likely to die in the in low income areas than was thought likely at the beginning of the decade. Possibly the only hopeful sign is that the restrictions imposed by the world recession have stimulated the search for innovative and cost effective ways to protect and improve the health of children and mothers. Within a decade, low cost advances could be saving the lives of 20,000 children daily and preventing the crippling of another 20,000. What is in question is the priority of this kind of progress -- among governments, among international assistance sources and networks, and in developing countries. The strategy adopted by JOICFP in its Integrated Family Planning, Nutrition, and Parasite Control Projects offers one such way. The projects are based on the concept that family planning programs will be more acceptable if combined with related services, which the community readily perceives as beneficial and useful. What most contributes to making parasite control a good entry point is that the process of examination and the effects of treatment are immediately visible. Possibly more important that the biological and medical effects of parasite control is its effectiveness as a tool for community health and education motivation. The UN International Children's Emergency Fund (UNICEF) and the World Health Organization (WHO) and multilateral and bilateral agencies are promoting 4 simple and relatively inexpensive measures to reduce malnutrition, illness, and death among the world's children: the use of growth charts; oral rehydration therapy; breastfeeding and proper weaning practices; and immunization against major childhood diseases. Ways to achieve accelerated progress for the protection and survival of children are identified.