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[Expanded Programme on Immunization: Global Advisory Group] Programme Elargi de Vaccination: Groupe consultatif mondial.
Weekly Epidemiological Record / Releve Epidemiologique Hebdomadaire. 1984 Mar 23; 59(12):85-9.In addition to the conclusions and recommendations reached at the 6th meeting of the Expanded Program on Immunization (EPI) Global Advisory Group and summarized in this report, the Group reviewed at length the status of the program in the Western Pacific Region and made a series of recommendations specifically directed to activities in the Region. Of particular significance for the operational progress of the global program are the recommendations concerning "Administration of EPI Vaccines," which were subsequently endorsed by the Precongress workshop on Immunization held before the XVIIth International Congress of Pediatrics in Manila in November 1983. These recommendations are not listed here. In his report to the World Health Assembly in 1982, the Director-General summarized the major problems which threaten the success of efforts to achieve the World Health Organization (WHO) goal of reducing morbidity and mortality by providing immunization for all children of the world by 1990. The 5-Point Action Program adopted at that time remains a relevant guide for countries and for WHO as they work to resolve those problems. The EPI is concerned about the prevention of the target diseases, not merely with the administration of vaccine. In addition to working toward increases in immunization coverage, the EPI must assure the strenghtening of surveillance systems so that the magnitude of the health problem represented by the target diseases is known at the community, district, regional, and national levels; immunization strategies are continuously adapted in order to reach groups at highest risk; and the target diseases are reduced to a minimum. The development of surveillance systems is one of the priorities in the development of effective primary health care services. Disease surveillance in its various forms should be used at all management levels for monitoring immunization programs performance and for measuring program impact. Specific recommendations regarding disease surveillance to be undertaken at global and regional levels and at the national level are listed. The results of more than 100 lameness surveys conducted in 25 developing countries confirm that paralytic poliomyelitis constitutes an important public health problem in any area in which the disease is endemic. In most programs, initial emphasis should be placed on the develpment of sentinel surveillance sites to monitor disease incidence trends. Some progress has been made in acting on the recommendations made at the meeting on the prevention of neonatal tetanus held in Lahore in 1982, but intensification of activities is required. In many developing countries, the surveillance and control of diphtheria must be improved. All aspects of progress and problems in the global program are reflected at least somewhere in the Western Pacific Region, and most of the findings and recommendations generally are valid beyond the regional boundaries.
[Unpublished] 1984. Presented at the Second Conference on Immunization Policies in Europe, Karlovy Vary, 10-12 December 1984. Issued by the World Health Organization [WHO]. Expanded Programme on Immunization [EPI]. 8 p. (EPI/GEN/84/9)This discussion of the Expanded Program on Immunization (EPI) presents some background history and discusses current program status, some linkages between the global EPI and immunization programs in Europe, and the use of vaccines. In the early 1970s, as confidence grew that the global smallpox eradication program would achieve its goals, policy advisers within and outside of the World Health Organization (WHO) looked for an initiative which could become its successor. Representatives from industrialized nations and particularly from European countries were influential in selecting childhood immunization, as such programs had been such an early and successful element of their own health systems. Thus, the EPI was born. The resolution creating the EPI was passed by the World Health Assembly in 1974. Program policies were formalized by the World Health Assembly in 1977. It was at that time that the goal of providing immunization services for all children of the world by 1990 was set and that WHO's priority attention to developing countries was specified. The European Region takes pride of place in establishing the EPI and in supporting its work in developing countries and is itself a full-fledged member of the program with respect to immunization challenges which remain within its own countries. When the EPI began, no global immunization information system existed, and it is likely that coverage in developing countries was less than 5%. It now is on the order of 30% for a 3rd dose of DPT. Given the high dropout rates persisting in many developing countries, coverage for a 1st dose of DPT may be on the order of 50%, reflecting the delivery capacity of present immunization programs. Coverage for measles and poliomyelitis in infants and for tetanus toxoid among women of childbearing age is considerably less than 30%, reflecting the perception until the last 3-4 years that measles was a problem only in Africa, that poliomyelitis was not a problem in countries with poor levels of sanitation, and that neonatal tetanus was simply not a problem. While the EPI is working at the global level to help strengthen routine disease reporting systems, particularly in developing countries, it also has had to take refuge in estimates to obtain a picture of actual morbidity and mortality. A table presents a summary of such estimates. Not all countries of the Region are yet making optimal use of existing vaccines. Countries of the Region might want to recommit themselves to the EPI goal of reducing morbidity and mortality by providing immunization services for all children by 1990.
Assignment Children. 1984; (65/68):43-8.The General Assembly Resolution 35/36 called for accelerated progress towards social, child-oriented goals as part of the International Development Strategy for the 3rd UN Development Decade. The reduction of mortality rates is seen as a major objective; life expectancy in all countries should reach 60 years as a minimum and infant mortality rates should reach 50/1000 live births, as a maximum, by the year 2000. The Resulution also called for full and effective participation by the entire population at all stages of the development process. Women, in particular, should play an active role in that process. All countries should respect and snsure the right of parents to determine the number and spacing of their children and make universally available advice on and means of achieving the desired family size. A comprehensive and adequate system of primary health care, as an integral part of a more general health system and as part of a general improvement in nutrition and living standards, is the strategy through which an acceptable level of health for all by the year 2000 can be achieved. The response of UNICEF should be an intensification of its concern with seeking more resources for children's services by promoting and protecting breastfeeding and improving maternal nutrition. In 1981 the Executive Board of UNICEF decided upon these objectives and stated that basic services strategy was the principal approach to be followed. The 1982 Executive Board meeting called for a new attack on child and maternal nutrition and for the inclusion of low-cost interventions in infant and child feeding, diarrheal disease control, and child immunization. The elements of UNICEF's Childrens Revolutioon are Oral Rehydration Therapy, universal child immunization, the promotion of breastfeeding, growth charts, birth spacing and food supplements. The 1683 Executive Board meeting supported the initiatives aimed at effecting a child health revolution. In 1984, the Executive Board meeting agreed that achieving the full potential f the child survival and development revolution would require strengthened program delivery and more effective program implementation at the national scale, aiming at universal coverage of target population groups.
Who Chronicle. 1984; 38(3):109-15.The theme of the 1984 World Health Day--children's health, tomorrow's wealth--provides an occasion to convey to a worldwide audience the message that children are a priceless resource, and that any nation which neglects them does so at its peril. World Health Day 1984 spotlights the basic truth that the healthy minds and bodies of the world's children must be safeguard, not only as a key factor in attaining health for all by 2000, but also as a major part of each nation's health in the 21st century. An investment in child health is a direct entry point to improved social development, productivity, and quality of life. Care of child health starts before conception, through postponement of the 1st pregnancy until the mother herself has reached full physical maturity, and through spacing of births. It continues from conception on, through suitable care during pregnancy, childbirth, and childhood. In the developing countries the child must be protected by all available means, particularly from the killer diseases. What happens in the immediate family and community around the mother and child, and even far away in the world, can have a direct impact on the health and security of both of them. The mother and child need to be placed in an environment that will ensure their health by protecting the overall setting in which they live. This means providing clean water, disposing of waste, and helping to improve shelter. Nothing can diminish the importance of good food, enough food, and proper nutrition for children and their mothers. Beyond the immediate physical needs are the equally important needs for love and understanding which stimulate the healthy development of the child. The emergence of new health problems of mothers and children in developing and developed countries should be kept in mind. Better health services must be made available to all who need them. The World Health Organization (WHO) provided resource material on World Health Day issues for dissemination throughout the world. Extracts from 4 articles on this year's theme are reproduced. The articles report on the success of the Rural Health Center in Ballabhgarh (India) in reducing maternal and infant mortality, the value of breastfeeding as 1 of the simplest and safest ways of ensuring adequate spacing of births, Tunisia's integration of a program of immunization into the routine activities of the health care system, and the needs of the healthy child.
New York, New York, UNICEF, . 42 p.In the last 12 months, world-wide support has been gathering behind the idea of a revolution which could save the lives of up to 7 million children each year, protect the health and growth of many millions more, and help to slow down world population growth. This document summarizes case studies which illustrate the techniques which make this revolution possible. These techniques are: oral rehydration therapy (ORT); growth monitoring; expanded immunization using newly improved vaccines to prevent the 6 main immunizable diseases which kill an esitmated 5 million children a year and disable 5 million more (measles, whooping cough, neonatal tetanus, polio, diphtheria and tuberculosis); and the promotion of scientific knowledge about the advantages of breastfeeding and about how and when an infant should be given supplementary foods. Results are summarized from Guatemala, Papua New Guinea, Brazil, Egypt, Indonesia, Barbados, the Philippines, Nicaragua and Honduras, Malawi, China, Nepal, Bangladesh, Colombia, and Ethiopia. The impact of economic recession and female education on childrens' health is discussed, and basic statistics for developed and underdeveloped countries are given.