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[Unpublished] 1987. 9 p. (WHO/SPA/GLO/87.3)A consultation in August 1987, co-sponsored by the World Health Organization (WHO) Special Program on Acquired Immunodeficiency Syndrome (AIDS) and the Expanded Program on Immunization (EPI), was called to review available information on human immunodeficiency virus (HIV) infection and immunization guidelines. Of particular concern was the safety and efficacy of the 6 EPI vaccines in children with HIV infection. Concerns have been raised that children infected with HIV who receive routine childhood immunizations may have decreased immune responses and be at greater risk of adverse effects or acceleration of HIV-induced immunosuppression. Available data, although limited, suggest that there is no risk of accelerating HIV infection by the simultaneous administration of multiple antigens, except perhaps in the case of Bacille Calmette-Guerin (BCG) immunization. In areas where exposure to measles and poliomyelitis is high, the benefits of immunization far outweigh the risks of adverse effects from immunization, even in the presence of symptomatic HIV infection. Overall, consultation participants affirmed the validity of the following EPI guidelines developed in 1986: 1) in countries where HIV infection is problematic, children should be immunized with EPI antigens according to the standard schedule, including children with asymptomatic HIV infection; and 2) unimmunized individuals with clinical AIDS in countries where the EPI target diseases remain serious risks should not receive BCG, but should be given the remaining 5 vaccines. Since vaccine-related adverse effects are minimized and vaccine responses optimized by beginning immunization before the progression of HIV-induced immunosuppression, children should be immunized as early in life as possible.
Oxford, England, Oxford University Press, 1988. , 86 p.The 1988 UNICEF report on the world's children contains chapters describing the multi-sectorial alliance to support child health, the current emphasis on ORT and immunization, the effect of recession on vulnerable children, family rights to knowledge of basic health facts, and support for women in the developing world. Each chapter is illustrated by graphs. There are side panels on programs in specific countries, including Senegal, Syria, Colombia, Bangladesh, Turkey, India, Honduras, Japan and Southern Africa, and highlighted programs including immunization, AIDS, ORT, breast-feeding and tobacco as a test of health. The SAARC is a new regional organization of southern Asian countries committed to immunization and other health goals. Tables of health statistics of the world's nations, divided into 4 groups by "Under 5 Mortality Rate" present basic indicators, nutrition/malnutrition data, health information, education, literacy and media data, demographic indicators, economic indicators and data pertaining to women. The absolute numbers of child deaths had fallen to 16 million in 1980, from 25 million in 1950. Saving children's lives will not exacerbate the population problem because, realizing that their children will survive, families will have fewer children. Furthermore, the methods used to reduce mortality, such as breast feeding and empowerment of families to control their lives, are known to reduce fertility.
Accelerated immunization programmes and CSDR: their meaning and broader implications for development [editorial]
ASSIGNMENT CHILDREN. 1985; 69-72:vii-xxvi.This editorial introduces a special issue of "Assignment Children" devoted to the theme of universal child immunization by 1990. Not only will this campaign significantly reduce morbidity and mortality from 6 childhood diseases, but it will also, through the experience of massive public participation, create conditions favorable for achieving development goals in areas other than health care. Immunization is a means for enabling those who have grasped the concept of protection of one's children to carry this effort into other areas for other goals. If families are to be empowered in this way, the knowledge and know-how held by the experts at the top must be melded with traditional knowledge and the wish of parents to protect their children from disease and death. The usual concept of development conveys ethnocentric and central power biases as well as a fragemented and sectoral approach. In contrast, accelerated immunization programs represent an example of action within a new development paradigm. This approach addresses not just symptoms, but fundamental causes of underdevelopment in the areas of health and survival. Although the underlying causes of poverty are only marginally affected by such campaigns, the validation of important goals of the majority of the population can release social energy and increase individuals' control over other aspects of their life.