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BULLETIN OF THE INTERNATIONAL UNION AGAINST TUBERCULOSIS AND LUNG DISEASE. 1990 Dec; 65(4):75.WHO estimates of pediatric AIDS cases are 400,000 by September 1990, not including 300,000 who have already died. WHO projects that 10 million or more infants and children will have HIV infections by 2000, in addition to 25-30 million adults. The primary mode of transmission in most countries is heterosexual contact, resulting in a rapidly increasing prevalence in women of childbearing age. WHO predicts that pediatric AIDS will be a major, and in some countries the predominant, cause of death in children in the 1990s. Even though child survival programs have made progress recently, by immunization and diarrhea control, the fruits of these efforts are expected to be reversed. The world's cumulative total of HIV infected women is about 3 million. In the U.S., 20,000 infants have been born to infected mothers. In contrast, in Eastern Europe, about 1000 children are infected, mostly from unscreened blood transfusions and unsterilized needles and syringes. The impact of childhood AIDS is expected to be an increase in child mortality by 50% in many developing countries. Serious social repercussions for children also stem from projected 10 million uninfected children orphaned by AIDS, mostly in sub-Saharan Africa. The only way to lessen this tragedy is for people to protect themselves by practicing safe sex and having sexually transmitted diseases treated.
In: Issues in contemporary international health, edited by Thomas A. Lambo and Stacey B. Day. New York, New York, Plenum Medical Book Company, 1990. 113-33.The causes of mortality and disability in the world are reviewed, and the 4 most important mechanisms for promoting maternal and child health are proposed: female literacy, family planning, community-based efforts and global strategies for international cooperation. The health needs of women, children and adolescents, who make up the majority and the most vulnerable segment of the population, must be met. Malnutrition is the single most important cause of health problems through adult life, and affects 20 million children in Africa alone. Statistics are cited for infant mortality, vaccine-preventable diseases, diarrheal diseases and respiratory infections, infant mortality and maternal mortality. The key determinant of infant survival is female literacy. Existing scientific cooperation is the closet thing we have to a global international community. An example of applied scientific solutions to health care is the risk approach in maternal health care. 2 strategies of scientific cooperation have emerged: the international center model in a country or region to address a specific problem, and the task force model, as used effectively by WHO, UNICEF, and the Task Force for Child Survival. Research topics on health in developing countries are listed that could be tackled by universities and scientific networks, e.g. scientific research is lacking on how to make household hygiene effective in poor countries. A concerted global research effort and surveillance effort is needed for AIDS.