•••••• ••••••• ••• ••• ••• •••••• •••••• ••••• • ••••••••••• Northeast Is Key ••••••• ••••••• ••• ••• ••• ••••••• • ••••••••••••••••••••••••••• 'Cold Ct)ain' Has ••• ••• •••••••••• ••• ••• ••• ••••••••• •••••••••••••••••••••••••••• ••• ••• ••• ••••••• in Brazil to ••• ••• ••••••• ••• ••• ••• ••••••••••••• ••••••••••••••••••••••••••• Meant Business for ••• ••• •••••••••• •••••••••••••• ••• ••• •••••••••• ••• • ••••••••••••••••••••••••••••••••••• Polio Eradication ••• ••• ••••••• ••••••••••••••••••••• ••••••••••••• ••• • •••••••••••••••••••••••••••••••••••• Developed World Brazil's programme to wipe An international pro- out polio depends essentially gramme to immunize children upon the increased immuni Cigarettes Smoked Outstrip in the developing world is zation of children under age Population Growth turning into a US $25 million a five in its vast northeast, and year business for indus Although more cigarettes per capita are being smoked in upon countering a sense of trialised countries, according industrialised than in developing countries, the steepest rise complacency. to WHO estimates. in smoking over the last decade has taken place in the Third According to WHO's regional World - even outstripping growth in the adult population. While developing countries office for the Americas, from Smokers over age 15 in the industrialised world consume an are increasingly expected to 70 to 80 per cent of all cases in estimated 2,000 to 3,500 cigarettes per person per year, share in this market, at Brazil have been reported fr0m . while those in the Third World generally consume less than present about 11 0 items of nine of the ten states of the 2,000 cigarettes, according to an analysis of per capita equipment-85 per cent of north-east, a region three mil consumption of adult populations for 1980-1982. the total - used to keep vac lion square kilometers in size. The analysis is based on tobacco production, imports and cines safe and potent from Up until 1979, Brazil re exports, and does not take into account the "cottage manufacturer to child are pro industry" production of both cigarettes and the bid/, a hand ported an average of 2,500 duced in the industrialised rolled cigarette commonly smoked in the Third World. WHO's polio cases yearly. However, World Health Statistics Annual 1986 comments: "Thus, the world. following the first year of a potential smoking hazard in many developing countries is The major producing coun nation-wide immunization comparatively higher than the consumption figures alone tries are Denmark, Italy, Lux drive in 1980, the incidence indicate." A comparison of" growth in cigarette consumption embourg, Sweden and the dropped almost by half to w ith the growth in adult population," the annual says, United States. 1 ,290 cases, declining to 45 " indicates that cigarette smoking is falling in Europe, is Among such items are cases reported in 1983. stagnant in the other developed countries, but is increasing in cards that monitor vaccine all parts of the developing world." Then because of a belief temperatures, syringes, cold that polio was as good as boxes, refrigerators- some gone, health officials say, a STATISTICS run by kerosene and others sense of complacency set in. powered by the sun-and a Health education and public % Cigarettes smoked and growth of adult population new fibre wick for kerosene information, for instance, be fridges w ith a capacity for came perfunctory. 41.5 burning for at least two years As a consequence, Im 40 These items are indispens munization decreased to 85 able to the "cold chain," the 35 ~C i garettes consumption per cent of ch ildren, and the name given to all of the equip number of cases climbed to ~ 30 0\ ment and the management over 300 by m id-1986- with gs t..J Adul t population techniques that have been the majority reported from b5 developed to protect vaccines (lJ Ol from spoilage. the north-east, particularly l'l 20 c from Bahia, Ceara and (lJ The cold chain is thus the u Alagoas states. o._:V 15 lifeline of WHO's Expanded To meet the emergency Programme on Immunization. "the Ministry of Health distri Launched in 1974, the pro buted 5.8 million doses of oral gramme aims at protecting all pol io vaccine to the state the world's children aga inst health secretaries," a WHO re six diseases- measles, diph port says, "with the expecta World Europe Other lnd. Africa Latin Asia theria, pertussis and tetanus, Countries America tion that approximately five pol io and tuberculosis- by million children would be vac 1990. cinated." In Europe the number of cigarettes smoked increased by At about the time of the A change in the dominant 5. 3 per cent against adult population growth of 9.8 per cent programme's launch, vac from 1971 to 1981. In five other industrialised countries type of pol io strain and low cinators in the Third World Australia, Canada, Japan, New Zealand and the United faced a host of problems that vaccine efficacy were also States - the numbers smoked increased by 13.6 per cent problems faced. While polio while the adult population grew by a comparable figure of centred mostly around re virus type 1 was the dominant 12.9 per cent. However, "for many years, the steepest rise frigerators. Not bu ilt for tropi strain in 1985, type 3 ac has been in developing countries" WHO says. cal countries, refrigerators counted for some 70 per cent The number of cigarettes smoked outstripped population then in use were inadequately of all cases in 1986, and is growth in all developing reg ions, and in the case of Africa was insulated, breaking down all "associated with low vaccine almost twice as great. Consumption there jumped by 41.5 per too frequently. efficacy," a study following cent aga inst a population growth of 23.4 per cent A survey of conditions at In Latin America, the numbers of cigarettes smoked the outbreaks showed. the time showed not only the increased by 31.4 per cent and in As ia by 28.5 per cent, need for equipment suitable In 1985, the countries of considerably more than the adult population growth of 24.5 the Americas singled out and 21.8 per cent respectively. to the developing world, but polio for eradication. "The Stating that in most of the developing countries th e also a lack of recognition that aim is to do so," says Dr "tobacco industry is expanding unchecked," WHO warns of vaccines lose potency if ex Carlyle Guerra de Macedo, di the dangers of a "smoking-related" disease epidemic- par posed to heat or light. rector of WHO's regional office ticularly lung cancer, chronic, bronchitis, emphysema and "We now know that thou for that region, "in a massive, ischaemic heart disease- in the Third World. • sands of children were being final five-year effort." • immunized with ineffective
30 W oRLD HEALTH , March 1987 vaccine." recalls John Lloyd, WHO technical officer. who Authors worked over the years help Newsbriefs ing to create the cold chain. of the Month An airport is usually the first • Ali Maow Maalin, 10 Years Later. This 26 October marks the Dr Fritz KA FERSTEIN is in tenth anniversary of the identification of the world's last case of stop for a batch of vaccine charge of WHO's Food Safety smallpox, which occurred in Merka, a seaport in Somalia, in 1977. fresh from the manufacturer. Programme and Ms Jacqueline Ali Maow Maalin, the victim, made a full But though marked "Rush StMS is Technical Assistant in recovery and is now 33 years old. - Store Below 8°C," vaccine the same programme. The WHO programme to eradicate the ancient crates could sit all day in a scourge was launched in 1967, thirteen years Dr M . .ABDDSSALAM was for roasting hot customs shed later, in May 1980, the disease was declared medy in'charge of WHO's Vet before being picked up. Even officially eradicated. erinary Public Health unit and while in refrigerated storage The savings to countries since then has been now works periodically as a in a capital city, vaccines estimated at US $1,000 million yearly- through consultant to the Food Safety could be affected by power not having to immunize against smallpox nor treat Programme. cuts and voltage fluctuations . cases, and being able to dispense with quarantine formalities. M~: Robert F. DAVIES is a In addition they could be scientist with the Foocl Safety subject to delays, truck break • Education Five Times Over. Apart from preventing transmis Programme. downs, and carelessness in sion by blood, "education, education, education, education and then some more education." Dr B. CHINSMAN is Director of handling during the transport That was the response given by Or Jonathan Mann, respon the Division of Technological -whether from provincial to sible officer for WHO programmes against AIDS (Acquired Consulting Services, The Afri- district levels, to small health Immunodeficiency Syndrome) when asked on "Worldnet" televi cqn Regional Cen~re for Tech centres, or to vaccination sion to list the five most important measures to avoid the spread of nology, Dakar, Senegal. sites in a distant village. the dread disease. Dr Diane ROBERTS is Deputy With neither treatment nor vaccine in sight, AIDS can only be D .irector of the Food Hygiene prevented through information aimed at high risk groups and at Laboratory, Central Public health officials. Health Laboratory, Colindale, In a related developm.ent, Or Halfdan Mahler, WHO's Director London, U.K. General, vowed to seek US $200 million for AIDS programmes this year. During a news conference at United Nations headquarters in Dr H.abiba H. W ASSEF is the New York, he called for international support against the disease to WB,O Representative in Dji match in magnitude the campaign that wiped out smallpox ten bouti. years earlier. Dr Ramesh V. BHAT is Assis "All of us have been underestimating it, and I in particular, " he tant Director at the Food and admitted, in reckoning that 100,000 are afflicted worldwide, that a Drug Toxicology Research million more suffer from AIDS-related disorders, and that up to Centre, National Institute of 10 million are infected with the virus without vet showing symp .Nutrition, Hyderabad, India. toms- and are thus able to spread the disease. • Kangaroo Mothers. The lives of premature babies, often Mr.\falery ABRAM.OVis a Pub weighing as little as two pounds and a half, are being saved in lic Information 'Officer ·in • Colombia by bundling them in a sling close to their mother's ·WHO's, Division of Public In- In catalogue: 136 products. breast- thus affording them care in much the same wav as a baby formation and Education for kangaroo receives it while in its mother's pouch. Health. "The flaws in the cold This keeps the newborn baby warm, close to breast milk and also to the mother's hear.t-beat, with its emotional reassurances, chain were a major obstacle according to ,world Development Forum, a newsletter published to immunization." says by the Hunger Project in Washington, D. C. WORLD HEALTH Or Ralph Henderson. Director A report made at an international conference held at the Carter of the WHO programme. Centre (named for former US President Jimmv Carter), in Atlanta, For r,eaders everywhere That is no longer so, for two Georgia said that babies are so treated until they gain normal 1987 Subscription .Rates reasons. Firstly, WHO officials weight and size. US$ Sw. fr. put to use equipment already • "This is another way to say' I love One year 14.--'- 25.- on the market; they modified you, Daddy'". That's the caption of Two years 24.75 45.- equipment found; and they this car.toon by Hank Ketchum, creator Three years 33.- 60.- designed equipment- some of that irresistible little tyke, Dennis the 50 items all told-for the cold Menace, seen here cheerfully dispos ORDER FORM chain. ing of all things related to tobacco Please enter my subscription to including his father's pipe, cigars and And secondly, they pro "World Health "as.follows: cigarettes. duced manuals and set up The cartoon appeared in US news Oneyear 0 courses that have trained papers as part of the "Great American Two years D. tens of thousands of health Smokeout Week," during which smok- '.'.: workers- among them store ers are asked to quit. Three years 0 keepers. nurses. doctors, and Another cartoonist who has taken a I . enclose cheque/inte'rnational virtually every type of worker public stand against smoking is Maurice de Bevere. or Morris. His postal order in the amount of: _ · creation Lucky Luke, Europe's most renowned cowboy, has along the cold chain-in man Name: ___~~--~~--~- agement techniques. kicked the habit and taken to chewing grass instead. Street: ------'--~~-- "E'quipment ts certainly City· .__ ..:...... :...... ,___~-- -- much less a problem than when we started," says James Cheyne. WHO technical In the next issue World Health, WHO,' Avent,Je Appia, · 1211 Geneva 27, Switzerland officer "What we Deed now How much progress has been made since WHO chose as its are the skilled people to make ~· World Health Day slogan for 1976 · "Foresight Prevents World HeaLth is 'also distribUted. through the network of international bookstores sure that the vaccines arrive " Blindness" 7 Our April issue examines efforts in different and subscripti9nagencies' For payment in the right quantities, at the parts of the world to overcome preventable blindness. in national currencies, please right time." • · yourusual bookseller.
WoRLD HEALTH, March 1987