Ev29n2p178.Pdf (546.8Kb)

News

World Health Day 1995 Focuses on Immunization

Each year, the 189 member countries CELEBRATION AT PAHO of the World Health Organization take advantage of the World Health Day- A ceremony in commemoration of held on 7 April, the anniversary of the World Health Day 1995 was held at PAHO adoption of the WHO constitution-to Headquarters in Washington, D.C. The raise awareness of a specific health issue celebration, cosponsored by PAHO, the through programs, activities, and media American Association for World Health coverage. The subject chosen by WHO (AAWH), and the U.S. Department of for this year’s World Health Day was the Health and Human Services, featured the worldwide campaign to eradicate polio presentation of World Health Day awards, by the end of the century, under the a panel discussion, and a keynote ad- slogan “Target 2000: A World Without dress by Hillary Rodham Clinton, First Polio.” Lady of the United States of America. With the declaration at the Pan Amer- The host of the program was Dr. Rich- ican Sanitary Conference last September ard L. Wittenberg, President and Chief that wild poliovirus transmission has been Executive Officer of AAWH, a nonprofit interrupted in this hemisphere, the Re- nongovernmental organization that serves gion of the Americas has already reached to educate about and promote the goals that target.’ Building on this historic of PAHOWHO in the United States. Dr. achievement, the Region is moving to- Wittenberg welcomed the many distin- ward elimination of another scourge of guished guests and then introduced Sir childhood-measles. In the United States, George Alleyne, PAHO’s Director. the focus of World Health Day 1995 was Dr. Alleyne reminded the audience of expanded to encompass all childhood the remarkable success the polio eradi- vaccine-preventable diseases, under the cation campaign had achieved in the theme “Immunize: Birth to Two, It’s Up Americas in the midst of political and to You!” social unrest in some of the countries and despite the persistence of poverty in some sectors. He credited, among other things, a high level of political commitment, ded- IThe last case of polio in the Americas caused by icated community participation, and the indigenous wild poliovirus occurred in Peru in Au- collaboration of governmental and non- gust 1991. Since that time, intensive surveillance governmental organizations, and he of acute flaccid paralysis cases has failed to confirm pointed out that the polio model must any other polio cases, and an independent com- mission has certified the Region polio-free, based now serve as the template for the measles on national surveillance data from all the countries. elimination effort. Noting that not all

178 Bulletin of PAHO 29(2), 1995 families are fully aware of the importance The Macedo Award, named in honor of vaccines-“one of modern science’s of Dr. Carlyle Guerra de Macedo, Direc- most cost-effective and important health tor Emeritus of PAHO, was given to Mr. interventions”-Dr. Alleyne said that this Gustav0 Gross, President of PolioPlus- World Health Day provided an oppor- Peru, a program of Rotary International. tunity to “drive home the message that The award recognized his dedicated work we must continue to educate the public in organizing the polio eradication effort and raise awareness about the benefits of in his country, which in turn helped mo- immunizing our children.” bilize activities in other countries. Following Dr. Alleyne’s address, the The Alleyne Award, named in honor Acting Commissioner of the Washing- of PAHO’s current Director, was given ton, D.C. Commission of Public Health, to the National Vaccination Council Dr. Marlene Kelley, read the proclama- (CONAVA) of Mexico for its contribu- tion of World Health Day in the District tion to the eradication of polio in that of Columbia, signed by Mayor Marion country. Since it was established in 1989, Barry. CONAVA has coordinated the immuni- The next speaker was Dr. Jo Ivey Bouf- zation activities of the health sector, and ford, Principal Deputy Assistant Secre- its techniques have been emulated in 24 tary for Health, U.S. Department of Health other countries. and Human Services. Dr. Boufford spoke The first of the domestic awards went of the importance of recognizing the to the All Kids Count Program, which community as the fundamental unit from was initiated and is partially funded by which any health initiative is carried for- the Robert Wood Johnson Foundation and ward. She emphasized that the United which operates out of the Carter Center States, through the U.S. Agency for In- in Atlanta, Georgia. The Program coor- ternational Development (USAID) and the dinates a variety of projects designed to Centers for Disease Control and Preven- increase vaccination coverage and seeks tion (CDC), would continue to work with to develop coalitions focused on child PAHO on immunization, as it had during health and survival. the polio eradication campaign, and she The Group Health Association of read a message from U.S. President Bill America (GHAA), the largest trade as- Clinton praising the accomplishment of sociation for health maintenance organi- polio eradication in the Western Hemi- zations (HMOs), was the recipient of the sphere and urging citizens of the United second award. GHAA was recognized for States to observe World Health Day. establishing a Childhood Immunization Program, which recruited 325 HMOs to offer low-cost immunizations in order to Awards boost coverage rates. The third award went to Every Child Dr. Peter G. Bourne, Chairman of the by Two, a network of influential public Board of AAWH, presented the 1995 figures founded by former First Lady World Health Day Awards, two for in- Rosalynn Carter and Betty Bumpers, wife ternational achievement and four for work of former Arkansas governor and U.S. within the United States. The recipients senator Dale Bumpers. This organization illustrate the variety of initiatives that focuses on developing innovative im- helped to defeat polio and that will con- munization programs, including the use tinue to improve immunization levels of computerized registries, and on pro- against other diseases. viding parental education.

News 179 The final domestic award was pre- tion (ANA), saw the biggest challenge to sented to Dr. Walter A. Orenstein, Di- be reducing barriers to vaccination ac- rector of the National Immunization Pro- cess. ANA, in collaboration with other gram of the Centers for Disease Control organizations, has sought to reduce these and Prevention, under whose leadership barriers by operating mobile immuniza- CDC has made available unprecedented tion units in rural areas and offering vac- resources for immunization. cinations outside of traditional settings, for example, at carnivals. Noting that in Panel Discussion some states only physicians are allowed to give vaccinations, she pointed out that Under the theme “Using Past Suc- outreach by public health nurses had cesses,” six expert panelists were asked proved successful in boosting vaccination to give their insights on the lessons learned coverage of children in places in the United in past and ongoing immunization cam- States where doctors are in short supply, paigns that could be used to further im- as well as in other countries. prove immunization status. Dr. Bourne Dr. Walter A. Orenstein outlined four served as the moderator. points he considered vital as Director of Mrs. Betty Bumpers, cofounder of Every the National Immunization Program at Child by Two, spoke of her initial in- CDC: (1) the importance of a good dis- volvement in immunization programs ease surveillance system, which is the only while her husband was governor of Ar’ way to be sure that the target diseases kansas in the early 1970s. She empha- are being stopped; (2) the need for public/ sized that the initiative made use of ex- private collaboration at the national, state, isting agencies rather than creating any and, especially, local level; (3) the need new administrative structures, which was for innovative approaches to permit ac- why it became a model program for other cess to the preschool population, so that states. In her opinion, the most signifi- each child can be reached by age two cant boon to vaccination coverage was with the 11 vaccine doses currently rec- legislation requiring immunization for ommended; and (4) the importance of school entry. Every Child by Two seeks supporting disease prevention programs to extend full vaccination among young overseas, not only for humanitarian rea- preschoolers. sons but also for the protection of chil- Ms. Karen Ignagni, President and CEO dren in the United States from imported of GHAA, stated that she believed the cases of disease. two most important accomplishments of The next speaker was Ms. Karen L. her organization’s immunization initia- Ray, Project Director of the National tives were (1) the development of a sys- Health Program of the Congress of Na- tern within the affiliated health services tional Black Churches, an umbrella group for measuring progress and (2) the es- for eight historically black denominations tablishment of a community of individ- representing 19 million people nation- uals who shared their ideas and accom- wide. Her organization has entered into plishments-a network of people a cooperative agreement with CDC to in- communicating about strategies. Fur- itiate a preschool immunization project thermore, collaboration with CDC had ( promoted by the churches. She outlined spawned linkages with public health de- her view of the process involved in partments, allowing additional sharing of achieving any social goal: someone has a expertise. vision; the vision is communicated to Ms. Geraldine Marullo, Executive Di- others; political will and social resolve are rector of the American Nurses Associa- developed; boundaries-of race, class,

180 Bulletin of PAHO 29(2), 1995 language, etc. -are crossed; partner- keynote address. She announced that the ships are built; and, with perseverance United States of America would join in and tenacity, success is achieved. support of the measles elimination initi- Mr. Jim Weill, General Counsel, Chil- ative and other hemispheric health dren’s Defense Fund, asserted that the care priorities by providing a five-year, greatest advances come from the mar- US$ 20 million grant to PAHO through riage of technical innovation and social USAID. The full text of the keynote ad- mobilization-an art that he said the dress appears below. United States should relearn from devel- oping countries and its own past. He be- lieved cost still constituted a barrier to vaccination and emphasized the need for Remarksby Hillary Rodham Clinton on the better insurance coverage. He affirmed Occasion of World Health Day 1995 the importance of bringing children for immunization in traditional, care settings, Thank you very much, Dr. Alleyne, and all so that they can also receive comprehen- of you who are gathered here today. I know sive medical care. you’ve already had an excellent program. I On the topic of traditional versus non- know some of the speakers who have already traditional vaccination settings and pro- addressed you and the work they have done viders, Dr. Bourne asked the panel to over decades on behalf of children and, in address the question of whether vacci- particular, on behalf of immunization. I am pleased to be here with all of you on nation in the United States was overreg- World Health Day. This marks a historic op- ulated. Mrs. Bumpers supported the idea portunity for all nations to come together to of providing vaccination separately from work to improve the health of our global fam- comprehensive health care. Ms. Marullo ily. I also want to thank all of you here at believed that the current movement to PAHO who are on the front lines every day restructure the health system offered an promoting better health throughout our hem- opportunity to change the idea that care isphere. I agree completely with Dr. Alleyne must always be provided in a traditional that you are the real champions of children, setting. However, Mr. Weill pointed out and it is your work every single day-your that some children would still be missed persistence, in many instances your begging, your challenging, your promoting the idea even if vaccination were taken to other that every child, every person is entitled to settings, such as day-care centers. Dr. health care-that really makes what we are Orenstein stated that while outreach was now celebrating, with the eradication of polio an important strategy at present, the ul- in this hemisphere, a reality. timate goal of providing comprehensive Nothing is more important to our shared care must be kept in mind. Ms. Ignagni future than the well-being of children, and acknowledged the practicality of using for that reason I am especially pleased that nurses and other health workers as vac- children are the focus of this year’s World cination providers, but agreed that im- Health Day. As you may know, I just re- munization should be viewed as a point turned yesterday from a lo-day trip to South of entry for a child into the health system Asia, where I saw firsthand some of the world’s so that he or she can receive other needed greatest health challenges and also some of the most innovative, thoughtful methods of care. bringing better health care to children and women in poor and remote areas. For me, Keynote Address that trip was an inspiring reminder of how much progress can be made when the will The First Lady of the United States, and commitment are there to help those ln Hillary Rodham Clinton, delivered the need.

Nt?WS181 Today’s world is one of great promise for parts of the world, and in our Region we must the 130 million children of our own hemi- turn our attention to another major health sphere: great promise because our children threat to children: measles. are obviously our lifeline to prosperity and My husband often talks about children as progress in the exciting and unpredictable the greatest resource of every nation, and one century that lies ahead; great promise because of the best ways to build on that resource is there are millions of healthy children across to invest in children, especially their health. the Americas whose futures are filled with And I would add to and echo Dr. Alleyne’s hope; and great promise because of historic comments: When we talk about health and commitments born at the Summit of the education for children, we’re not talking about Americas last December [in Miami], commit- a “soft” issue, about a marginal issue. We are ments that will translate into greater oppor- not talking about an issue that is the province tunity and justice for all children. Among other of women. We are talking about a core issue initiatives, government leaders endorsed the that will determine the future of every one of goal of making basic health services available our nations; and this is an urgent mission- to all citizens. That will be extremely benefi- that we understand fully how significant the cial to children, who are the most vulnerable health of our children is to the future of all to illnesses and unhealthy living conditions. of us. I also want to commend the First Ladies Because, just as we live in a time of great who participated in the symposium on chil- promise for children, we also live in a time dren in Miami and worked with Dr. Alleyne of great peril. More than half of the popula- to clarify our common vision and goals. Today tion in this hemisphere is under the age of these women across the Americas are turning 23, and too many of our young people in rhetoric into reality by helping launch PAHO’s every one of our countries suffer from pov- historic campaign to eliminate measles from erty, hunger, illiteracy, and inadequate health our hemisphere by the year 2000. Later this care. year, many of these women will convene in But the statistics need not be so grim. While Paraguay to review [their] efforts and share ushering children into the world is the prov- [their] experiences in working to meet this ince of families, protecting them from avoid- goal. able diseases must be viewed as the shared The campaign to eliminate measles is vital responsibility of our larger human family. We to all of our futures. It will save the lives of all know that a sick child has much less chance countless children in every country and will of learning, growing, and fulfilling his or her bring primary health care to every single vil- potential than a child who is healthy. A sick lage in our hemisphere. I can say this with child has much less reason to be hopeful and confidence, because we know from past ex- optimistic about the future, is less likely to perience that it can be done. develop into a healthy, productive citizen. That The Pan American Health Organization al- is why it is our responsibility as a community ready has led the world in getting rid of the of nations to insist that all children receive polio virus. Since the World Health Organi- the health care they need. zation resolved to [eradicate] polio in 1988, We have the technology. Vaccinations exist the number of polio cases around the world for most of the major childhood diseases, and has declined by 82%. Today, 145 countries they are far cheaper than long-term treat- are polio-free, and last year, as we already ments for the disabilities that result when heard, the Americas became the first region children become seriously ill. All we need now in the world to be declared formally free of is the commitment to make these immuni- polio, and not a single case has been detected zation campaigns succeed. in the Region since August of 1991. The United States has been a proud partner All of you here should take great pride in of past efforts to eliminate major childhood that achievement. You succeeded in getting diseases in this hemisphere. Nearly half of all many nations and private and public insti- external donor funding for the polio campaign tutions involved, and that is no small achieve- came from the United States Agency for In- ment. Now the work must continue in other ternational Development. The United States

182 Bulletin of PAHO 29(Z), 199.5 currently is providing nearly US$7 million as dients, we share a common future and a com- part of our child survival programs in the mon cause. We must not work in isolation to countries of the Americas. solve our problems, whether we are health Today I am pleased to announce that the organizations, NGOs, government leaders, [or] United States will join in partnership with private citizens. We must join together as PAHO in the campaign to eliminate measles partners who appreciate the value of sharing across the hemisphere. I’AHO has estimated our knowledge and experience. that an additional US$ 46 million is needed And we must remember that when it comes for immunization programs between now and to helping our children, words alone are not the end of the century. Through USAID, the enough; policy papers are not enough; press United States plans to extend a five-year, releases are not enough; documents and stud- US$ 20 million grant to PAHO to advance ies are not enough-we have had more than hemispheric health care priorities. Although our share of each. Instead, we must translate the United States, like many other nations, is into action what we can do and then get on operating under budget constraints, our gov- with the business of doing it. ernment hopes to allocate US$ 8 million di- Ultimately, we must be guided by a desire rectly to the regional Expanded Program on in our hearts to see that all children have the Immunization, which includes support to the gift of hope in their lives. As the wonderful measles campaign. At the same time, we have Chilean poet Gabriela Mistral once wrote: every expectation that, just as with the polio “Many things we need can wait; the child effort, USAID programs and technical sup- cannot.” And so today, as we celebrate this port across the Americas will help boost the very important effort, I hope each of us will campaign to eliminate measles. During the remember that the child cannot wait, and we polio campaign, those programs more than can do something to ensure that the child doubled our regional commitment. throughout this hemisphere has the oppor- One of the most important aspects of tunity to live up to his or her God-given PAHO’s campaign to eliminate measles is that potential. it will advance all of our immunization efforts. Thank you very much. Perhaps equally important, it does reflect a larger vision of health reform that extends a 7 April 1995 basic package of integrated health services Wd-zington, D. C. throughout the Region and, in that way, car- ries forward the Summit of the Americas Plan . . . of Action. It also provides us, through this measles campaign, continuing opportunities Following her remarks, the First Lady for surveillance throughout the Region, so that was presented with a special World Health we do remain very much focused on how Day Award from AAWH in recognition effective we are in delivering immunization of her many years of dedicated concern services. We have succeeded with respect to for the health and welfare of children. polio, but we must remain vigilant as to that disease and all others. The ceremony closed with a perfor- Although our specific health challenges may mance of “We Are the World” by a chil- differ from country to country, and our reci- dren’s choir from the Washington Inter- pes for progress may require different ingre- national School.

News 183