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Geneva, Switzerland, WHO, 1986. 130 p. (WHO/CDD/86.16)This 5th report of the Diarrheal Diseases Control Program (CDD) describes the activities undertaken by the program during 1984-1985. Primary objectives of the program are to reduce diarrhea associated mortality, malnutrition, and treatment costs. In so doing the program advocates the use of oral rehydration therapy (ORT) solutions in the treatment of diarrhea and dehydration, and promotes proper feeding during and after diarrheal illness. 3 major strategy areas are: improved nutrition (such as breastfeeding for the 1st 2 years of life), use of safe water, and good personal and domestic hygiene. Program activities involve planning, training (supervisory, management and technical), increasing the availability of ORT (including household solutions, and production and supply of ORS), promoting health education and communication, and the control of cholera in Africa. Summaries of program activities in different regions are included, and collaborations with other WHO programs and other agencies are described. The program supports biomedical research through its global and regional scientific working groups, which includes 62 new projects for 1984 and 67 new projects for 1985. Scientific Working Groups focus on bacterial enteric infections, viral diarrheas, drug development, and clinical management ofdiarrhea.
Geneva, Switzerland, WHO, 1985. 101 p. (WHO/CDD/85.13)The Diarrheal Diseases Control (CDD) Program, initiated in 1978, is a priority program of WHO for attainment of the goal of Health for All by the Year 2000. Its primary objectives are to reduce diarrheal disease mortality and morbidity, particularly in infants and young children. This report describes the activities undertaken by the Program in the 1983-1984 biennium. During this period, the Program collaborated with more than 100 countries in the implementation of national diarrheal disease control and research activities. The biennium has witnessed a growing interest of other international, bilateral, and nongovernmental agencies in diarrheal disease control; their financial support and commitment have contributed in a large measure to furthering the development of CDD programs and related research in many countries. During the biennium, the services component continued to expand both the quantity and scope of its activities at global, regional, and national levels. This is readily seen from the increase in global acess to Oral Rehydration Salts (ORS) packets from less than 5% in 1981 to 21% in 1983. Other significant developments were a substantial increase in the number of countries planning and implementing programs and the initiation of a new management course in supervisory skills. Successful implementation of national primary health care systems was recognized as necessary for the achievement of the Program's objectives. Efforts of both developing and industrialized countries must continue in a joint endeavor to reduce the problem of diarrheal diseases, especially cholera, the most severe diarrheal disease. The following areas are discussed: the health services component; the research component; information services; program review bodies; program resources and obligations; and program publications and documents for 1983-1984.
Proceedings of the International Conference on Oral Rehydration Therapy, June 7-10, 1983, Washington, D.C.
Washington, D.C., Agency for International Development [AID], Bureau for Science and Technology, 1983. 210 p. (International Conference on Oral Rehydration Therapy, 1983, proceedings)With over 600 participants from more than 80 countries, the International Conference on Oral Rehydration Therapy (ICORT) was a testimony to the international health community's recognition of the seriousness of diarrheal disease, the value of oral rehydration therapy, and the commitment to primary health care. The conference, initiated by the Agency for International Development, was cosponsored by the International Center for Diarrheal Disease Research, Bangladesh, the United Nations Children's Fund, and the WHO. The conference focused on oral rehydration therapy, an important treatment of diarrhea. 1 out of 10 children born in developing countries dies from the effects of diarrhea before the age of 5. A 70% reduction in the mortality rate can result from ORT--a major breakthrough for primary health care. Excellent laboratory investigation, well-conducted clinical studies, and careful field observation have led to this effective therapy. Many papers presented at the conference demonstrated the effectiveness of ORT. Participants agreed on the best formula for ORT in terms of electrolyte content and on the need for an international commitment to expand implementation of ORT. Problems in implementing oral therapy programs are discussed. Possible areas of investigation include: 1) improving the solution through the addition of glycine, other amino acids, or cereal-based substrates; 2) developing methods for teaching ORT; and 3) investigating better methods of program evaluation. Innovative approaches to informing the public about the use and benefits of oral therapy were also discussed. Participants, recognizing that problems are shared among many different programs and nations, exchanged ideas and addresses, pledging to keep each other abreast of their ORT research and implementation efforts. The conference closed with a strong call for action to attain near universal availability of ORT in the next 10 years.
An assessment of the scientific achievements of the International Centre for Diarrhoeal Disease Research, Bangladesh and their relevance to AID health sector priorities.
[Unpublished] 1983. ii, 32 p.This docunment reports the findings of a United States Agency for International Development (USAID) assessment of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) which examined the scientific work of the Center in realtion to USAID's health sector priorities. USAID's Bureau of Science and Technoloby/Health has been providing core support to ICDDR,B but this grant terminated during fiscal year 1983. The multi-disciplinary assessment team was charged with making recommendations about the continuation of these funds and about any ways in which the ICDDR,B program might be modified to more closely respond to USAID's concerns. ICDDR,B's scientific reseachis of excellent quality and of great significance to the acquisition and spread of new knowledge about diarrheal diseases. There is every reason to believe that the work of scientists at ICDDR,B, which has in the past revolutionized thinking about these diseases, will continue to contribute to the search for ways to address this critical public health probelm. USAID should, therefore, continue to provide generous core support to ICDDR,B. The nature and diversity of the global diarrheal disease problem, and the ecologically determined differences in the requirements of implementation of control programs, make it impossible for ICDDR,B to carry the burden of scientific investigation alone. While the Center should continue to play a focal role, USAID is encouraged to identify and support institutions in other developing countries which could undertake scientific and operational research of diarrheal diseases. ICDDR,B could assist this globall effort by providing guidance and specialized technical consultation and training as new research programs are being developed elsewhere. The program of ICDDR,B is generally balanced and appropriate. However, the assessment team was concerned about the lack of expertise in epidemiology and immunology. (author's modified)
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.