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Report of the European Region on Immunization Activities. (Global Advisory Group EPI, Alexandria, October 1984). WHO/Expanded Immunization Programme and the European Immunization Targets in the Framework of HFA 2000.
[Unpublished] 1984. Presented at the EPI Global Advisory Group Meeting, Alexandria, Egypt, 21-25 October 1984. 3 p. (EPI/GAG/84/WP.4)Current reported levels of morbidity and mortality from measles, poliomyelitis, diphtheria, tetanus, and tuberculosis in most countries in the European Region are at or near record low levels. However, several factors threaten successful achievement of the Expanded Program on Immunization (EPI) goal of making immunization services available to all the world's children by the year 2000, including changes in public attitudes as diseases pose less of a visible threat, declining acceptance rates for certain immunizations, variations in vaccines included in the EPI, and incomplete information on the incidence of diseases preventable by immunization and on vaccination coverage rates. To launch a more coordinated approach to the EPI goals, a 2nd Conference on Immunization Policies in Europe is scheduled to be held in Czechoslovakia. Its objectives are: 1) to review and analyze the current situation, including achievements and gaps, in immunization programs in individual countries and the European Region as a whole; 2) to determine the necessary actions to eliminate indigenous measles, poliomyelitis, neonatal tetanus, congenital rubella, and diphtheria; 3) to consider appropriate policies regarding the control by immunization of other diseases of public health importance; 4) to strengthen existing or establish additional systems for effective monitoring and surveillance; 5) to formulate actions necessary to improve national vaccine programs in order to achieve national and regional targets; 6) to reinforce the commitment of Member Countries to the goals and activities of the EPI; and 7) to define appropriate activities for the Regional Office for Europe of the World Health Organization to achieve coordinated action.
Who Chronicle. 1984; 38(5):212-6.This article highlights the conclusions and recommendations of the 5th meeting of the Technical Advisory Group of the World Health Organization (WHO) Diarrheal Diseases Control (CDD) Program held in March 1984. On the basis of clinical trials supported by the CDD Program, WHO has endorsed use of oral rehydration salts (ORS) containing trisodium citrate dihydrate in place of sodium bicarbonate. Although the bicarbonate formulation remains highly effective and may continue to be used, the citrate formula results in less stool output and is more stable under tropical climatic conditions. At its meeting, the Technical Advisory Group expressed satisfaction with progress in the health services and research components of the program's activities. By 1983, 72 countries or areas had formulated plans of operation for national CDD programs and 52 had actually implemented programs. Training courses directed at program managers, first-line supervisors, and middle-level health workers are held on a regular basis. 38 developing countries are now producing ORS. Another area of activity has involved development of a management information system to monitor progress toward the target of increased access to and use of oral rehydration therapy for diarrhea in children under 1 year of age. Data from 40 countries indicate that access to ORS was 6-10% in 1982 and usage was 1-4%. There have been reviews of 10 national CDD programs, 7 of which utilized a joint national-external team to collect and analyze information on the management and impact of the CDD program. During 1983, 71 new research projects were funded by the CDD program, bringing the total number of projects supported to 231 (59% in developing countries). Biomedical research has focused on development of more stable and effective ORS; the etiology and epidemiology of acute diarrhea: and development and evaluation of new diagnostic tests, vaccines, and antidiarrheal drugs. In 1982-83, the CDD program received US$1.4 million from WHO and about US$11 million from voluntary contributors. The 1984-85 budget has been set at US$19.7 million.
[Unpublished] 1984. 51 p.This listing of research projects funded since 1980 by WHO's Diarrhoeal Diseases Control Programme, is arranged by project title, investigator and annual budget allocations. Project titles are listed by Scientific Working Grouping (SWG) and include research on bacterial enteric infections; parasitic diarrheas; viral diarrheas; drug development and management of acute diarrheas; global and regional groups and research strengthening activities. SWG projects are furthermore divided by geographical region: African, American, Eastern Medierranean, European, Southeast Asian and Western Pacific. The priority area for research within each SWG is specified.
Report of the third meeting of the scientific working group on viral diarrhoeas: microbiology, epidemiology, immunology and vaccine development, [held in] Geneva, 1-3, February 1984.
Geneva, Switzerland, WHO, . 19p.The current status of the Scientific Working Group Program is reviewed, showing an expansion of activities in both its health services component (planning, implementation and evaluation of national diarrheal diseases control programs) and its research component (biomedical and operational). Submission of research proposals is encouraged by the Steering Committee (SC), namely those investigating the etiological role of viral agents in diarrheal disease and the epidemiology of these agents. Recently, the SC has made a particular effort to stimulate research in the area of immunology of viral enteric infections, which has been a generally neglected area. Other important areas of Program activity include site visits to review progress made by its projects, to participate in the initial design or the analysis of studies, or to stimulate general interest among research workers in the activities of the SWG. Workshops have also been initiated and conducted in WHO regions. The SWG notes with satisfaction the progress of the Program and commends the SC's efforts to stimulate and support research activities. SWG recommendations bear on the need for more data on the etiology and epidemiology of diarrhea in the community and the encouragement of further community-based studies. Particular attention should also be given to the preparation of reagents for the serotyping and subgrouping of rotaviruses. Moreover, the Group recommends that research strengthening workshops be continously held. In addition to the review of the meeting and recommendations, this paper includes a report on active and passive immunity to viral diarrheas. Special attention is given to rotavirus diarrhea as it tends to be common and quite severe. Its epidemiology is briefly presented, showing its incidence, seasonality (winter) in temperate climates, age-specific occurrence (most severe in infants and young children) and transmission (fecal-oral, person-to-person). Neonatal ans sequential postneonatal rotavirus infection are addressed ans issues for further investigation clarified; e.g., the relationship between low birth weight and the occurrence and severity of infection. Much remains to be elucidated regarding the serotyping-specific epidemiology of rotaviruses. The Group notes that further immunological studies of rotaviruses are essential to elucidate the role of passive protection. The other area of study in which research activities need to concentrate is vaccine development.
[Unpublished] 1984. 27 p.The current status of the Control of Diarrhoeal Diseases (CDD) Program was reviewed, and activities related to the evaluation of country control programs, the assessment of potential diarrheal disease control interventions, and the program's operational research activities were examined. In the health services component, ciontinued efforts to promote the preparation of plans of operation for national CDD programs is recommended, as is continued use of the national CDD program managers training course. Concern was expressed that the level of use of oral rehydration therapy (ORT) appeared to be modest. Case management was endorsed as the major program strategy. The series of studies on interventions for reducing diarrhea's mortality and morbidity were welcomed. For evaluation purposes, it is recommended that the program develop additional criteria for monitoring increased access to and usage of oral rehydration salts (ORS) and the reduction of diarrheal mortality. Continued accumulaton and publication of information yielded by the program's survey of the impact of ORT in hospitals was recommended. In the research component, the growth of research activities is satisfying. While biomedical aspects have developed well, it might be necessary to relate them gradually to specific control interventions in the future. Further studies of improved ORS formulatons were recommended. High priority should also be given to the promotion of breast feeding, immunization, and water supply and sanitation. The underlying mechanisms that cause the intervention to reduce diarrheal morbidity or mortality should be clarified. Research is recommended on the promotion of personal and domestic hygiene, food hygiene, and improved weaning practices. Emphasis on the development and evaluation of vaccines against the causes of diarrhea is supported. Some changes in the balance of research activities should be made. Epidemiological weak.
Geneva, Switzerland, WHO,  27 p.This is the 1st interim report issued by the Diarrhoeal Diseases Control (CDD) Programme, summarizing progress in its main areas of activity during the previous calendar year. Most of the information is presented in the form of tables, graphs and lists. Other important developments are mentioned briefly in each section. The information is presented according to major program areas; health services; research; and program management. Within the health services component, national program planning, training, the production of Oral Rehydration Salts (ORS), health education and promotion are areas of priority activity. Progress in the rate of development of national programs, participants in the various levelsof training programs, and the countries producing their own ORS packets and developing promotional and educational materials are presented. An evaluation of the health services component, based on a questionnaire survey to determine the impact of Oral Rehydration Therapy (ORT), indicates significant decreases in diarrheal admission rates and in overall diarrheal case-fatality rates. Data collected from a total of 45 morbidity and and mortality surveys are shown. Biomedical and operational research projects supported by the program are given. Thhe research areas in which there was the greatest % increase in the number of projects funded were parasite-related diarrheas, drug development and management of diarrheal disease. Research is also in progress on community attitudes and practices in relation to diarrheal disease and on the development of local educational materials. The program's organizational structure is briefly described and its financial status summarized. The report ends with a list of new publications and documents concerning health services, research and management of diarrheal diseases.
The role of food safety in health and development. Report of a Joint FAO-WHO Expert Committee on Food Safety.
World Health Organization Technical Report Series. 1984; (705):1-79.This document presents the recommendations of a Joint Food and Agriculture Organization (FAO)-World Health Organization (WHO) Expert Committe on Food Safety. Illness due to contaminated food is perhaps the most widespread health problem in the world and a major cause of reduced economic productivity. The safety of food is affected by food systems, sociocultural factors, food chain technology, ecologic factors, nturitional aspects, and epidemiology. It was the assumption of the Committee that, if food safety is given sufficient priority within national planning, countries can prevent and control foodborne disease, especially pathogen-induced diarrheal syndromes, and interrupt the vicious cycle of diarrhea-malnutrition-disease. Attainment of this objective requires a national commitment and the collaboration of all ministries and agencies concerned with health, agriculture, finance, planning, and commerce as well as the food industry, the biamedical and agricultural scientific community, and the consuming public. Prevention and control interventions should aim to avoid or minimize contamination, to destroy or denature the contaminant, and to prevent the further spread or multiplication of the contaminant. The Committee outlined a series of recommendations for achieving a worldwide reduction in the morbidity and mortality caused by foodborne hazards. Food safety should be considered an integral part of the primary health care delivery system. Food safety should also be regarded as an integral part of the total food system. National food control infrastructures should be strengthened, and regional, national, multinational, and international surveillance of foodborne diseases should be carried out. Each country should aim to develop at least 1 laboratory capable of identifying the etiologic agents of diarrhea and other foodborne diseases. Health workers should be trained to play a role in identifying and monitoring critical control points in food production and preparation. Health education, within the context of the cultural and social values of the community, should inform the public about food safety hazards and preventive measures. Finally, the hazard analysis critical control point approach to prevention is recommended.
World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1984; 37(2):130-61.This paper sets forth the number of malaria cases reported in 1973-82 to the World Health Organization (WHO) by region. Excluding Africa, the total number of cases rose from 3.9 million in 1973 to a high of 10.7 million in 1977 and declined to 6.5 million in 1982. It is noted, however, that reporting during this period was often deficient and uneven. The prevalence of malaria has remained relatively unchanged in Africa south of the Sahara, with the exception of urban centers where transmission has been considerably reduced. In the Americas, the number of cases reported has risen steadily since 1973. South East Asia experienced a dramatic increase in malaria cases in 1976, but intensive efforts haveresulted in a decline almost back to the 1973 level. About 28% of the world's population lives in areas where malaria never existed or disappered without specific antimalaria efforts. Another 18% lines in areas where the disease has been eliminated by improvements in health facilities, environmental changes, and specific antimalaria measures. 46%, or 2117 million people, live areas where the incidence of malaria has been reduced to varying degrees, ranging from a slight reduction of the original endemicity to the near elimination of the disease. A final 8%, or 365 million people, live in areas where no specific antimalaria measures are undertaken and the original levels of endemicity remain largely unchanged outside of certain urban centers. In addition to presenting data on malaria cases by world region, tables accompanying this article summarize malaria eradication registration, the importation of malaria cases into malaria-free countries, and the development of resistance to chloroquine.
INFECTION CONTROL. 1984 Nov; 5(11):538-41.In 1978 the Ministry of Health and Social Welfare (MHSW) of Liberia launched the Expanded Program on Immunization (EPI) with the 5-year objective of establishing an 80% reduction in child mortality and morbidity from measles, polio, diphtheria, neonatal tetanus, pertussis, and tuberculosis. The program at first adopted a strategy of using 15 mobile units in 11 operational zones to deliver vaccinations throughout the country. However, by 1980, despite support from the Baptist World Alliance, the UN International Children's Emergency Fund (UNICEF), and the World Health Organization (WHO), it became evident that the mobile strategy was neither economically feasible nor practical. Therefore, with support from the US Agency for International Development (USAID), the EPI shifted to a strategy of integrating immunization activities into the existing network of state health facilities. After 5 years, in 1982, the Program was evaluated by a team from the MHSW, WHO, USAID, and the Centers for Disease Control. The evaluating team felt that the EPI's strategy was good, but its goals were not being achieved due to deficiencies in funding, clinic supervision, and rural community outreach, as well as shortages of kerosene and spare parts needs to keep the essential refrigerators in operating condition. Measles remains endemic; in the capital, Monrovia, only 9% of the children have been vaccinated against it. Immunization coverage is particularly low in the capital the countries. Other reasons for low vaccination coverage in Liberia are lack of community awareness of existing facilities and the importance of vaccination and lack of coordination at the community level to use the existing facilities efficiently. International assistance is still needed, especially to develop heat-stable vaccines, so that maintenance of refrigerators will not be necessary.
In: Medical education in the field of primary maternal child health care [edited by] M.M. Fayad, M.I. Abdalla, Ibrahim I. Ibrahim, Mohamed A. Bayad. [Cairo, Egypt, Cairo University, Faculty of Medicine, Dept. of Obstetrics and Gynecology, 1984]. 421-34.This paper begins by stating that the mortality from neonatal tetanus has been peculiarly underestimated until recently, and discusses why this has been the case. The availability of a methodology for retrospective surveys and undertaking of such surveys in recent years has thrown much light on the subject. The results of these surveys from 15 countries are presented in tabular form. It is apparent that at present between 500,000 and 1 million newborn infants a year succumb to tetanus. The prospects for control, using the combined approach of improved maternity care and maternal immunization, are discussed, and an appropriate schedule of immunization suggested. The prospects for control are good wherever there is realization of the magnitude of the problem plus reasonable access to even quite basic primary health care. Some activities of WHO in this field are briefly described. (author's)
In: Mortality and health policy. Proceedings of the Expert Group on Mortality and Health Policy, Rome, 30 May to 3 June 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 289-303. (International Conference on Population, 1984; ST/ESA/SER.A/91)The United Nations Fund for Population Activities (UNFPA) assistance program encompasses basic data collection, population dynamics, formulation of population policies, implementation of general policies, family planning activities, communication and education programs, and special programs and multisector activities. This paper focuses on UNFPA assistance in the area of mortality. The Fund does not provide support for activities related to the reduction of mortality per se; rather, it contributes indirectly to the improvement of infant, child, and maternal health through assistance to family planning programs integrated with maternal-child health care. The types of activities UNFPA supports in this area include prenatal, delivery, and postnatal care of mothers and infants; infant and child care; health and nutrition education; promotion of breastfeeding; monitoring of infant malnutrition; and diagnostic studies and treatment of infertility and subfecundity. The Fund has cumulatively expended about US$87.3 million for activities in the area of mortality and health policy. The Fund is currently providing collaborative assistance to the World Health Organization and the UN for a comprehensive project aimed at measuring mortality trends and examining the roles of socioeconomic development and selected interventions in the mortality decline in certain developing countries. At present there is a need for research on the persistence of high mortality in the least developed countries, the early levelling off of life expectancies in many countries, and the determinants of socioeconomic differentials in mortality. Understanding of the mortality situation in many developing countries has been hindered by a lack of descriptive data on mortality by socioeconomic, regional, and occupational status. The real challenge lies in the implementation of policies designed to reduce mortality; political, managerial, and cultural factors unique to each country, as well as pervasive poverty, make this a difficult process.
In: Mortality and health policy. Proceedings of the Expert Group on Mortality and Health Policy, Rome, 30 May to 3 June 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 270-88. (International Conference on Population, 1984; ST/ESA/SER.A/91)This paper reviews the technical cooperation efforts undertaken by the United Nations Department of Technical Cooperation for Development (DTCD) to help combat the high mortality levels in developing countries and to evolve policies in response to the World Population Plan of Action. Although the transfer of medical technology and the provision of drugs and other medical supplies remain important means of controlling death and disease, there is growing recognition of the need to develop national skills to deal with mortality, to maintain a continuous record of mortality and morbidity levels and their response to ameliorative programs, and to analyze the interrelationships between demographic, health, and socioeconomic variables. DTCD has focused on data collection and analysis, the integration of research findings into population policy formulation, and training and skill development to facilitate self-reliance. However, the lack of regular mechanisms for coordinating the activities of the various United Nations agencies that play a role in in technical cooperation in the areas of mortality and health policy has been a serious limitation. Another problem has been the dearth of tested alternative techniques for conducting simple health surveys whose results could be used in planning. Closer cooperation between United Nations agencies in this field is urged. It is also important that the recent reassignment of a low priority to data collection and analysis on the part of the United Nations Development Program be reversed. Unless data collection, analysis, and evaluation are reassigned a high priority, planners will be forced to depend on subjective judgments to evolve mortality policies. Finally, technical cooperation activities that aim to integrate mortality and morbidity control into population policies must be responsive to human rights.
Mortality and health policy: highlights of the issues in the context of the World Population Plan of Action.
In: Mortality and health policy. Proceedings of the Expert Group on Mortality and Health Policy, Rome, 30 May to 3 June 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 37-79. (International Conference on Population, 1984.; ST/ESA/SER.A/91)This paper reviews the major issues that have emerged in the analysis of mortality and health policy since the 1974 World Population Conference. The 1st part summarizes current mortality conditions in the major world regions and evaluates progress toward achieving the goals of the World Population Plan of Action. It is noted that the current mortality situation is characterized by continued wide disparities between the more developed and less developed regions, especially during the 1st year of life. The 2nd part focuses on the synergistic relationship between health and development, including social, economic, and health inequalities. It is asserted that mortality rates in developing countries are a function of the balance governments select between development strategies favoring capital accumulation and concentrated investments on the 1 hand and strategies oriented toward meeting basic needs and reducing inequalities in income and wealth. Data from developed countries suggest that economic development does not necessarily lead to steady gains in life expectancy. Some variations in mortality may reflect changes in family relationships, especially women's status, that are induced by social and economic development, however. The 3rd part of this paper analyzes the effect of health policies on mortality, including curative and preventive programs and primary health care. The lack of community participation is cited as a key factor in the weak performance of primary health care in many developing countries. In addition, there is strong evidence that the concepts and technologies of modern medicine must be adapted to existing systems of disease prevention and care to gain acceptability. The 4th section, on the implementation of health policies, discusses health care management, planning, and financing. It is noted that successful implementation of health policies is often hindered by scarcity, inadequate allocation, and inefficient utilization of health resources. Finally, more effective means to cope with rising costs of health care are needed.
In: Ghosh PK, ed. Health, food and nutrition in Third World development. Westport, Connecticut, Greenwood Press, 1984. 125-52. (International Development Resource Books No. 6)Malnutrition is a serious problem which can be solved only through the development of an effective international network of organizations and agencies committed to nutritional intervention. The magnitude of the malnutrition problem is described, the inadequacies of the current international structure to deal effectively with the problem are delineated, and suggestions for overcoming these inadequacies are provided. 1.3 billion individuals, or 2/3 of the population of the developing countries, suffer from some form of nutritional deficiency, and 900 million or these individuals, or 50% of the population of the developing countries, have a severe daily deficit of 250 calories. The major cause of malnutrition is poverty rather than food shortages. Other factors which contribute to malnutrition include cultural practices, health beliefs, cooking practices, intrafamily food distribution patterns, and deficient food production and distribution systems. Inaction in addressing these problems stems from a lack of coordination between the many agencies which deal with the problem, the failure to develop national and international nutrition policies, and a lack of knowledge about nutrition problems and the relative costs and benefits of different types of nutrition interventions. Currently there are a vast number of organizations and agencies which deal with nutrition either as a primary or secondary task. The majority of these organizations, committees, groups, and agencies are part of the UN structure. Many other national and voluntary agencies which have nutrition programs also have links with agencies within the UN. Although these diverse groups all interact with each other, there is a glaring lack of coordination between them. The functions performed by this loosely structured network include 1) collecting and dissemination information; 2) providing food, supplies, and technical assistance; 3) financing; and 4) coordination. Each of these functions is described, and the major organizations which perform these tasks are noted. Factors which reduce the effectiveness of the network include 1) inadequate coordination, 2) a failure to allocate responsibility and to delineate lines of authority, 3) inadequate review and evaluation mechanism, 4) a failure to depoliticize staff recruitment policies, and 5) the hesitancy of international agencies to take a stand on nutrition issues for fear of being accused of lacking respect for national sovereignty. Efforts to improve the current situation should include revamping the structure of the UN's nutrition network and expanding the role of the recently created World Food Council (WFC) of the UN. The WFC should assume the role coordinating the international network and of delineating the tasks of each agency or group within the network. The capacity of the WFC to function effectively in a leadership role will be realized only if the member states, especially the US and USSR, are willing to delegate sufficent authority to the WFC. In addition, nations and international agencies must place a higher priority on eradicating malnutrition and develop policies in accordance with this priority. Research directed toward identifying the costs and benefits of specific types of nutrition interventions can facilitate the development of effective policies.
London, England, IPPF, 1984 May. ii, 59 p.The Bellagio consultation was held in July, 1983 on the initiative of the Programme Committee of International Medical Advisory Panel to consider more closely what the needs of adolescents are and what more should be done to meet them. Participants from several countries--within and outside of IPPF--were invited. Before the Consultation, participants exchanged information, experience and ideas in writing as a basis for their discussion. 3 topics were focused on: 1) needs and problems; 2) information, education, and counselling; and 3) reproductive health management. An action plan for the next 3 to 5 years was drawn up. It offers broad suggestions about the kind of activities that would be appropriate for family planning associations and IPPF to take. Adolescents all over the world are in need of much better education and health care related to fertility, these are not the same in each society. A comprehensive approach to adolescent needs is favored. The recommendations form part of a broad discussion about how adolescents can best be helped to behave responsibly. Adolescent fertility has implications for health, psychological, social and economic well being. General program and operational guidelines are given, as are 8 areas for action: 1) creation of awareness and advocacy; 2) youth leadership and participation in adolescent programs; 3) information and education; 4) counseling; 5) fertility-related services; 6) sharing of experience, information and resources; 7) training and skill development; and 8) research. A list of participants and background papers is given.
[A possible objective from now to the year 2000: reduce infant mortality in the third world by half] Un objectif possible d'ici 1' an 2000: reduire de moitie la mortalite infantile dans les pays du tiers-monde
Hygiene Mentale. 1984 Jun; 3(2):41-9.Every day 40,000 children die throughout the world, most of them in developing countries. There is a close relationship between infant mortality, life expectancy at birth, the adult literacy rate and national income per capita. Why such huge differences between the infant mortality rate of 7/1000 (live births) in Sweden and 208 in Upper Volta? The 4 scourges which afflict developing countries: hunger (malnutrition), disease, ignorance and poverty are responsible for this state of affairs. The author suggests that coordinated action by governments and International Agencies should be taken to halve the infant mortality rate by the year 2000. He notes that in the past 3 mistakes were made which should not be repeated. The 1st was to improve the living conditions of the population. The green revolution in India provides a striking example of an important progress which benefited only the wealthier farmers. A 2nd mistake was to believe that only a medical approach reduces the infant mortality rate. A 3rd error was to overlook the importance of health education and not to seek the active participation of the people concerned. The author recalls that the International Union for Health Education carried out a sanitary and social program from 1975 to 1978 in Africa, south of the Sahara. To this effect, the IUHE had to find out what the people really wanted, whether they could be motivated to increase the welfare of the villagers by measures adapted to existing possibilities, and to study how the people could recruit health workers among the villagers and train them to create village health committees. 4 weapons used together should reduce the infant mortality rate by 1/2 in the developing world before the end of the century. They are: the promotion of breast feeding, the extended coverage of vaccinations, the early detection of malnutrition and the treatment at hoem of diarrheic diseases thanks to oral rehydration. (author's modified) (summaries in ENG, SPA)
Australian Society. 1984 Jun 1; 3(6):27-8.An estimated 15 million infants, largely from Africa, Asia, and Latin America, died in 1983. Many countries in the Third World have infant mortality rates of 150-200/1000 live births. UNICEF has outlines 7 steps that could significantly reduce the infant mortality rate: 1) use of growth monitoring charts, 2) oral rehydration therapy, 3) breastfeeding for at least 1 year, 4) a massive immunization campaign, 5) food supplementation for pregnant women and children at risk, 6) a family spacing education campaign, and 7) extension of female education. 2 other measures not emphasized by UNICEF but important for the health and survival of children are a government system of welfare for the care of the aged to partially solve the need for children and the equal valuation of male and female children. Concerned Australians are urged to spread the word about the UNICEF report, provide funds, and influence the Australian government to offer help through UNICEF to developing countries. Technically qualified people can go to Third World countries and work for better conditions. It should be noted, however, that Australia has its own Third World sector. The Aboriginal population is severely disadvantaged in terms of all the major indicators of quality of life. The infant mortality rate among Aboriginals is 25/1000 live births, which is 2.5 times the Australian national average. Life expectancy at birth is 53 years, or 20 years less than the national average. 80% of Aboriginals have no educational qualifications, and 80% are unemployed. Aboriginal households have less than 60% the average income available to non-Aboriginal households and the housing of the majority of the Aboriginal population is substandard.
Global distribution of schistosomiasis: CEGET/WHO Atlas. Distribution Mondiale de la schistosomiase: Atlas CEGET/OMS.
World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales. 1984; 37(2):186-99.Schistosomiasis, the most prevalent of the water-borne diseases, is endemic in 74 tropical developing countries and infects over 200 million persons in rural and agricultural areas. However, recent advances in diagnostic techniques, new antischistosomal drugs, and accumulated understanding of the epidemiology of the infection offer improved prospects for schistosomiasis control. Morever, adaptation of quantotative parasitologic techniques for the diagnosis of schistosomiasis will make more data available for use in national control programs. The World Health Organization (WHO) has been instrumental in providing reliable reference material on the geographic distribution of schistosomiasis and, on the basis of a survey of Member States, collaborated with Centre d'etudes de geographic tropicale (CEGET), in the development of an Atlas. This volume consists of topographic relief maps that identify the presence of absence of schistosomiasis by village or locality. There are wide variations in the prevalence, intensity of infection, ans species of parasite according to ecologic differences, snail intermediate hosts, and occupational and cultural norms. The Atlas also highlights the relationship of water resource development projects to schistosomiasis endemicity. Attention to such data may lead to the selection of project areas known not to be endemic. More sophisticated geographic analyses based on land form, soil and geologic characteristics, ground water level, and agricultural land use have been used predictively in Japan. The Atlas is expected to serve as a reference point to evaluate the global progress in schistosomiasis control.