Rubella elimination programme strengthened through measles elimination programme in Catalonia

The drastic fall in rubella cases recorded in Catalonia from 1988 on, when the second dose of Measles-Mumps-Rubella (MMR) vaccine was implemented, and especially from 1998, when the measles elimination programme began, led to the introduction, in May 2002, of the rubella and congenital rubella syndrome elimination by 2005 programme. From May 2002 to May 2004, 13 suspected rubella cases were reported to the Statutory Disease Reporting System; of these, one postnatal case and one congenital rubella case were confirmed (15.4%), both being imported cases. Through the screening of viruses established in the measles elimination programme, 28 possible cases were analyzed and six (21.4%) confirmed imported postnatal rubella cases were detected. The small number and imported nature of the cases of rubella and the detection of the majority of the confirmed cases through the measles elimination programme, strongly suggests that both programmes should continue.     

Expanded programme on immunization

The Expanded Programme on Immunization (EPI) was established in 1974 to develop and expand immunization programmes throughout the world. In 1977, the goal was set to make immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles and tuberculosis available to every child in the world by 1990. Problems encountered by the Programme have included: lack of public and governmental awareness of the scope and seriousness of the target diseases; ineffective programme management; inadequate equipment and skills for vaccine storage and handling; and insufficient means for monitoring programme impact as reflected by increasing immunization coverage levels and decreasing incidence of the target diseases. When the EPI was initiated in 1974, fewer than 5% of children in developing countries were receiving a third dose of DPT and poliomyelitis vaccines in their first year of life. These coverage levels have now surpassed 50% in developing countries, and millions of cases of the target disease have been prevented. Over 700,000 measles deaths were prevented by immunization in developing countries in 1987, and an increasing number of neonatal tetanus deaths is now being prevented by maternal immunization and improved childbirth conditions. Poliomyelitis immunization efforts have been so successful that the Pan American Health Organization is leading a drive to eradicate poliomyelitis from the Americas by 1990. The successes of the Programme represent a major public health achievement, but much remains to be done.(ABSTRACT TRUNCATED AT 250 WORDS)     

Implementing a teledermatology programme

Although teledermatology has been beneficial and cost-effective in some settings, many programmes have failed, not because of the technology but because teledermatology was implemented in isolation. A thorough understanding of an organization's business process and business model is crucial before teledermatology is begun. Unless teledermatology is integrated into the current business process and model, the likelihood of success is greatly reduced. Important steps therefore include: (1) understanding how the organization delivers care; (2) analysing the alternatives, including cost-benefit analysis; (3) obtaining organizational support; (4) formulating an execution plan; (5) training staff and monitoring the process. If implemented correctly in the appropriate setting, teledermatology can significantly improve access and quality of care, while reducing or containing costs.     

BCG-vaccination programme in Pakistan

The authors outline the development and organization of the BCG-vaccination campaign that was launched in August 1949 by the Government of Pakistan, with assistance from the International Tuberculosis Campaign. They present some statistical data on the work done up to the end of December 1954 and briefly discuss the pattern of tuberculin sensitivity found in various parts of the country.     

National STDs control programme

In 1947 the Bhore Committee recommended that sexually transmitted diseases should be dealt with by special organizations within the provinces, but the institutions were not adequate, and there was no coordinated plan. Before the 1st 5-year plan, there were 50 state-administered sexually transmitted disease clinics in India. During the 1st 5-year plan, facilities were upgraded, the central government took over certain aspects of the program, and the World Health Organization Venereal Disease team submitted a report on control of venereal diseases in India. By the end of the 5th 5-year plan, the government had set up another 187 clinics. Until the 6th 5-year plan, the central government supplied material, equipment, and drugs to the clinics, but the operating costs were borne by the states. During the 6th 5-year plan, the central government took over all aspects of the program. It is estimated that 20 million Indians suffer from venereal disease. With World Health Organization assistance, group educational activities in sexually transmitted diseases are being organized in different parts of the country, so that all personnel will be better equipped to treat patients. Group educational activities for treatment of yaws are also being organized for paramedical personnel who will have to deal with yaws in tribal areas. The UN Childrens Fund is also providing funds for communication and social mobilization against venereal diseases.     

Who's vaccine development programme

The World Health Organization is playing a major international role in encouraging, coordinating, and where appropriate commissioning, research and development activities relevant to the control of high priority infectious diseases.The Expanded Programme on Immunization would be the vehicle for the introduction of new or improved vaccines. In many parts of the developing world the health infrastructure is strained to breaking point by the heavy load of disease. It has failed to make the best use of the already available technology. Immunization provides the simplest, least expensive and most effective intervention technology. Every effort is therefore needed to extend immunization coverage and lighten the burden on the health infrastructure and accelerate the overall development of the vast rural and peri-urban communities in the developing world.WHO has, on the one hand, to call on the most eminent scientists to give effective and simple interventions, and on the other, on the politicians, social leaders, economic managers, medical profession and all public health workers to build up the infrastructure to put intervention technologies into action.     

A new population studies programme

The Wellcome Trust supports research in the biomedical sciences and in the history of medicine. It supports the work of academic staff in universities, medical, and veterinary schools, from the basic sciences related to medicine to the clinical aspects of medicine and veterinary medicine. In January 1995, the Trust held a workshop on population to identify areas of research relevant to human population growth and development. Following the workshop, the trust committed up to US$75 million over five years to a new Wellcome Trust Population Studies Program. The program's advisory committee has defined research priorities and begun to develop a portfolio of funding schemes. The need to address areas of research neglected by other funding bodies is of particular importance. Where appropriate, however, collaboration with other organizations active in the population and reproductive health fields may be considered. The author considers Africa's challenges for the 21st century.     

The Italian national telemedicine programme

The Italian national telemedicine programme included a broad range of research projects, but they all served the common purpose of bringing about improvements in health-care management and performance. The programme consisted of seven projects, each of which had specific research and training objectives, and a three-year duration. The systems developed in the course of the programme were not experimental prototypes:they were intended to be pre-commercial systems. The functional and clinical merits of the products and systems developed were evaluated, and their costs and benefits measured with reference to those already in use. The seven projects were completed in 1999. The Italian Ministry of Universities, Research and Technology granted research funds totalling 50,000,000 Euros for the whole programme. While the results of the research were promising, successful projects alone are not sufficient to reduce costs in health-care. Indeed, far more money can be saved simply by encouraging the uptake on a larger scale of many technologies and practices that already exist.