1.0  Introduction
2.0  Recent WHO press releases
3.0  New WHO publications from HQ
4.0  Information from recent WHO periodicals
5.0  Information from WHO-produced newsletters
6.0  New WHO documents

1.0 Introduction

The 49^th session of the Regional Committee of the WHO African Region has just finished in Windhoek, Namibia. Dr Samba was re-elected as Regional Director for a further period of 4 years.

Eight Resolutions were passed and included:

• the Regional strategy for mental health
• Essential drugs
• the Integrated management of childhood illness
• a Review of the implementation of the Bamako Initiative
• Health sector reform
• the Regional Health-for-All policy for the 21st century.

The Annual report of the WHO AFRO Regional Director on the work in the African Region for 1998 was presented at the Regional Committee and can be requested from the AFRO Office in Harare (see address at end of List of documents)

The 50th session of the Regional Committee will take place in 2000 in Ouagadougou, Burkina Faso.

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2.0 Recent  WHO Press Releases

2.2 The WHO has released a new version of the International Classification of Functioning and Disability (Beta-2 version of ICIDH-2) for field trials. This is the last version to be tested and commented on throughout the world before it is finalized and submitted to the World Health Assembly in 2001. Field trials are due to finish in July 2000 and this version is open for comments by all individuals and organizations, including via the web from the WHO website.

2.3 Sunlight, an essential prerequisite for life, may be extremely dangerous to human health. Excessive exposure to the sun is known to be associated with increased risks of various skin cancers, cataracts and other eye diseases, as well as accelerated skin ageing. It may also adversely affect people’s ability to resist infectious diseases, and compromise the effectiveness of vaccination programmes.(Revised Fact Sheet no. 227, 3 August 1999)

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3.0 New WHO Publications from Headquarters

3.1 Teaching health statistics : lesson and seminar outlines, by S.K. Lwanga, Cho-Yook Tye, O. Ayeni. 2^nd ed. 1999. 230p. ISBN 9241545186

Price in developing countries: Swfr. 50.40

The topics covered form an internationally applicable basic curriculum for teaching health statistics to trainee health workers, which can be adapted to meet the needs of different groups of students. The book includes not only the conventional topics of data collection, presentation and analysis, probability and vital statistics but also health indicators, use of computers and rapid methods of interim assessment. It is not intended for use by students for self-instruction.

 

3.2 Safe management of wastes from health-care activities, edited by A. Pruss, E. Giroult and P. Rushbrook. 1999, 230p. ISBN 9241545259

Price in developing countries Swfr.50.40

The waste produced in the courses of health-care activities, from contaminated needles to radioactive isotopes, carries a greater potential for causing infection and injury than any other type of waste, and inadequate or inappropriate management is likely to have serious public health consequences and deleterious effects on the environment. The handbook pays particular attention to basic processes and technologies that are not only safe but also affordable, sustainable and culturally appropriate.

 

3.3 Environmental Health Services in Europe. Guidance on the development of education and training curricula, by Martin Fitzpatrick and Xavier Bonnefoy. (WHO Regional Publications, European Series no. 84) WHO Regional Office for Europe. Copenhagen, Denmark. 1999, 198p. ISBN 9289013508

Price: Swfr 45.-

The WHO Regional Office for Europe has been deeply involved in working with its Member States in producing a wide range of guidance instruments to assist them in reforming their environmental health services and developing their capacities in environmental health management.

 

3.4 Sustainable Development and Health for all : building the capacity of national health authorities. (WHO Regional Publication, South-East Asia Series no. 30) WHO Regional Office for South-East Asia. New Delhi, India. 1999, 83p. ISBN 9290222134

To obtain a free copy of this publication, please contact WHO/SEARO, World Health House, Indraprastha Estate, Mahatma Gandhi Road, New Delhi 110002, India.

While the health sector in most countries has the responsibility to promote health, it often finds itself handicapped in actually moving the levers to make health happen. This is so because health is not merely a medical issue, but a much wider concept of social well-being. Policy-makers in the national health sector, and those in related development sectors, should find the new insights provided by the author of immense value.

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4. Information from Recent WHO Periodicals

Tuberculosis control : progress in 1995-1997

(no. 27, 9 July)

Of the 22 highest-burden countries which account for 80% of all new TB

cases worldwide, the following are in Africa: Nigeria, South Africa,

Ethiopia, Democratic Republic of the Congo. Tanzania, Kenya, Uganda and

Zimbabwe. The marked upward trends in case notification rates from 1980-1997

variously reflect failing TB control (eastern Europe), the impact of

HIV (sub-Saharan Africa) and better case finding (China). For further

details, please request document WHO/CDS/CPC/TB/99.259 from WHO, CDS/CPC,

1211 Geneva 27, Switzerland. E-mail desplobainsm@who.ch

 

Progress towards measles elimination, southern Africa, 1996-1998

(no. 28, 16th July)

Despite routine measles vaccination coverage of more than 70% in Southern Africa during the early 1990s, low-level endemic transmission with periodic outbreaks of measles has continued to occur. Since 1995, 6 southern African countries (Botswana, Malawi, Namibia, South Africa, Swaziland and Zimbabwe) have launched measles elimination initiatives in accordance with the recommendations of the WHO Regional Office for Africa. Campaigns for each country were planned and implemented by national ministries of health with technical assistance from the WHO Regional Office.

A total of 23 million children were vaccinated during the catch-up campaign overall a coverage of 92% was reported in the 6 countries. The catch-up vaccination campaigns have been highly effective in reducing morbidity and mortality due to measles and none of 70 suspected measles cases tested in Botswana and Zimbabwe were laboratory confirmed, which suggests that measles transmission may have been interrupted. However to sustain the elimination initiative in the long term all WHO-recommended strategies will need to be continued.

 

Malaria in Kenya

(no. 29, 23 July)

Malaria epidemics in Kenya have been characterized since 1980 by transmission upsurges in the highlands in the western part of the country and more recently in the semi-arid north-eastern area, after the 1997 El Nino rains. These outbreaks were generally contained by case management but the strategy began to fail with increasing chloroquine resistance. In spite of epidemic preparedness activities which began in February and the delivery of antimalarial drugs to all epidemic districts in April, there has been a marked increase in the number of cases since the beginning of May in the vulnerable district with an attendant high mortality. Mortality rates are still at emergency level and they are not expected to decrease as the number of new cases continues to rise. Environmental conditions are still suitable for mosquito breeding. Malaria control activities are being coordinated in collaboration with NGOs.

 

Human African trypanosomiasis (sleeping sickness)

(no. 30, 30 July)

Sleeping sickness has a major impact on the development of rural areas by reducing the labour force and hampering production and work capacity. In countries such as Angola, Democratic Republic of the Congo, and Sudan, the operational capacity to respond to the situation has been largely surpassed. In 1995 a new WHO programme against human African trypanosomiasis was established and new objectives were defined. It is expected to achieve harmonized deployment of activities and uniformity in the tools used to take decisions and make strategic choices. For further details and more specific documentation, contact: WHO, CDS/CSR, 1211 Geneva 27, Switzerland. E-mail: janninj@who.ch

 

Progress towards polio eradication, Somalia and Southern Sudan January 1988-June 1999.

(no.30, 30 July)

Both Somalia and parts of Southern Sudan have populations living in areas where there is ongoing armed conflict and the infrastructure is poor. Under these conditions, it is difficult to achieve the first recommended strategy of polio eradication (a strong routine EPI programme), high coverage during national immunization days (NIDs) and acute flaccid paralysis surveillance. The following factors made achieving high coverage during the NIDs possible in both countries: strong partnerships between UN agencies, NGOs, local leaders and communities; the enthusiasm generated by a full-scale collaborative effort with extensive involvement of Sudanese and Somali nationals compared with health activities limited to selected areas or agencies; effective social mobilization; commitment of funds and other resources necessary to overcome the limitations of existing infrastructure.

 

Cholera 1998

(no. 31, 6 August)

The year was marked by an increase of nearly 100% in cholera cases on all continents, although there was no new major event which could have contributed to increase transmission such as population movements or wide-spread natural disasters. The global case-fatality rate (CFR) decreased slightly from 4.3% in 1997 to 3.5% in 1998. Of all continents, Africa suffered the most with 29 countries reporting cholera to WHO, and accounts for 72% of total number of cases. Major outbreaks occurred in Democratic Republic of Congo, Kenya, Mozambique, Uganda and Tanzania.

 

Malaria 1982-1997 (no. 32, 13 August)

Malaria is at present endemic in over 100 countries and territories worldwide. The lack of reliable information from many countries makes it difficult to assess annual world malaria incidence. WHO estimates that in 1998 almost 300 million clinical malaria cases occurred, with over 1 million people dying of the disease. Almost 90% of these deaths occurred in Africa South of the Sahara, where young children are the most affected. Reporting from Africa has increased considerably from an average of 5 million cases annually over the period 1962-1981 to an average of 19 million cases annually over the period 1982-1997.

Geographical information systems (GIS): mapping for epidemiological surveillance.

No. 34, 27 August.

Spatial analysis and mapping in epidemiology have a long history but until

recently their use in public health has been limited. However the late

1990s have seen a significant expansion in information and mapping

technology etc. This article gives an overview of the use of GIS in public

health. For more information on how to start using GIS and the Health

mapper contact: WHO/UNICEF Joint Programme on Data Management and Mapping,

WHO, CDS/CSR, 1211 Geneva 27, Switzerland. E-mail: surveillancekit@who.ch;

internet www:who.int/emc/healthmap/healthmap.html

 

4.3 WHO DRUG INFORMATION 1999

VOL. 13, NO. 2

WHO round table with the International Generic Pharmaceutical Alliance. This meeting, held in February 1999, offered an opportunity for both sides to address issues of public health concern including WHO essential drug concept, intectual property issues and ensuring quality control and developing good manufacturing practice within the generic industry. Short-course zidovudine in perinatal HIV transmission: more evidence and debate. Following discussion on the results of two clinical trials in Thailand and in the USA which documented a 50-68% relative efficacy of short-course zidovudine in prevention of perinatal HIV transmission in non-breast-feeding women, complementary studies from two African trials have now been published. The studies carried out in breast-feeding women in Burkina Faso and Cote d’Ivoire demonstrated a 37-38% relative efficacy. Since the African trials were stopped prematurely following the positive results of the Thailand trial, their power to address definitively the efficacy of zidovudrine in breast-feeding women is limited. The reduction of transmission in the zidovudine group was statistically significant in newborns. None the less, whether efficacy will decline with continued breastfeeding can only be determined through follow-up of infants enrolled in these studies.

Ninth International Conference of Drug Regulatory Authorities (ICDRA) The Recommendations from the Ninth Conference which took place in April in Berlin, Germany are included in this issue.