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Will the circle be unbroken? - includes related article on population assistance to developing countries - child survival programs and fertility decline.
UN Chronicle. 1998 Winter; 35(4): p..The demographic transition which has been under way in the developing countries since the middle of the twentieth century has shown much difference, both in its course and in the factors behind it, from the transition which started two centuries ago in countries that are now developed. In the developed countries, the gradual improvement in living conditions accompanying industrialization and urbanization, coupled with broadening education and sanitation and a growing understanding of the principle of hygiene and nutrition, resulted in progressive gains in child survival and declines in mortality at all ages. These same forces of development were progressively changing attitudes towards reproduction, reducing the demand for children and lowering marital fertility. In the developing countries, there have been unprecedented declines in mortality over a few decades since midcentury. Only sub-Saharan Africa as a whole Ires not yet entered into this phase of demographic transition to a significant extent. A distinguishing feature of this transition has been that declines in mortality and fertility were not accompanying major gains in economic development. (excerpt)
BMJ. British Medical Journal. 1999 Oct 23; 319(7217):1090.This article reports the success of WHO in eliminating onchocerciasis or river blindness in most of West Africa. The onchocerciasis control program was able to save 100,000 people at immediate risk of contracting the disease and prevented the infection of about 12 million children. About 1.25 million onchocercal infections have been resolved by the program. Moreover, removal of the threat of the disease has allowed people to farm 25 million hectares of fertile land capable of feeding 17 million people annually. The land was previously abandoned due to black fly infestations, the transmission vector of the disease. The control program, which was started 25 years ago, had successfully eliminated the disease after a partnership between the UN agency and Merck, the company that developed ivermectin. Ivermectin is the first drug against river blindness that could be dispensed widely without fear of serious side effects.
Lancet. 1998 Mar 28; 351(9107):966.On March 19, 1998, Arata Kochi, director of the Global Tuberculosis Programme of the World Health Organization (WHO), announced that the WHO goal of curing 85% of new infectious tuberculosis (TB) cases by the year 2000 would not be achieved. An estimated 70 million more people will die from TB by the year 2020, if control is not improved. While speaking in London at the launch of the 1998 WHO global TB control report, Kochi stated that 22 countries account for 80% of all TB cases. Viet Nam, Tanzania, and Peru were making good progress toward control goals. The Democratic Republic of the Congo and Bangladesh had increased cure rates two-fold by using the directly-observed treatment, short-course (DOTS) approach; parts of China had achieved a 94% cure rate through its use. According to Kochi, progress had stalled in 16 countries because the global threat of TB had not been taken seriously. In spite of the slow rate of progress, WHO continues to believe in DOTS; Richard Bumgarner, senior program management officer of the WHO Global Tuberculosis Programme, considers DOTS to be cost-effective and the best possible use of funds. When asked if claims for DOTS were unrealistic and if more effort should be put into drug development, Bumgarner said that such research was important, but that it did not weaken DOTS. He said that better diagnostics, drugs, and vaccines might be 10-20 years down the line. Such research includes Action TB, a research initiative between GlaxoWellcome and academics, that received extra funding (10 million pounds) on March 24. On March 19, the British Lung Foundation stated that a new test for multidrug-resistant TB, which had been developed by Rory Shaw (Imperial College, London), decreased the time for diagnosis of rifampicin resistance from 8-10 weeks to 3-4 days.