The global programme of smallpox eradication Dotaz Zobrazit nápovědu
- MeSH
- lidé MeSH
- mezinárodní spolupráce MeSH
- pravé neštovice epidemiologie prevence a kontrola MeSH
- Světová zdravotnická organizace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
In 1967, when the intensified global eradication programme was launched, smallpox was still endemic in 35 countries with a total population of 1200 million and caused an estimated 10-15 million cases, resulting in 2 million deaths. Ten years and ten months later, on 26 October 1977 through intensified public health activities, the chain of smallpox transmission was finally broken in Merka, south Somalia; the World Health Organization missed its ten-year target line by ten months. In December 1979, the Global Commission concluded that the global eradication of smallpox had been achieved and the Organization formulated its policy for the post-eradication era. In May 1980, the 33rd World Health Assembly endorsed the Commission's conclusion and officially confirmed the international acceptance of smallpox eradication as the most outstanding achievement in international public health. This achievement has unmistakably demonstrated that the concept of disease eradication is correct and feasible. WHO encouraged countries to discontinue smallpox vaccination and/or the need for a smallpox vaccination certificate from international travellers. However, WHO is continuing its vigilance over the disease and promoting further research on orthopox viruses. Globally, US$ 313 million were spent on the eradication of smallpox from the world. However, conservative calculations indicate that in the post-eradication era, concrete economic returns resulting from the eradication of smallpox throughout the world, are estimated at US$ 1000 to 2000 million, annually. For the last five years of smallpox-free status, savings of about US$ 5000-10 000 million could be diverted for other health projects, which has had a major impact on international public health. However, there are other dividends similarly worthy as those of economic value. The most important of these are the hundreds of thousands of experienced and dedicated health workers who remain now in the countries as a solid base for implementing other important public health programmes.
- MeSH
- dospělí MeSH
- lidé MeSH
- pravé neštovice ekonomika epidemiologie prevence a kontrola MeSH
- předškolní dítě MeSH
- Světová zdravotnická organizace MeSH
- vakcína proti pravým neštovicím aplikace a dávkování MeSH
- vakcinace ekonomika MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- vakcína proti pravým neštovicím MeSH
Based on analysis of eleven-year intense epidemiological intervention against smallpox, a number of findings and demands ensued which should be met by an infectious disease to be included into the programme of eradication or elimination. The author mentions several episodes from the programme of smallpox eradication in which he participated as a member of a WHO team. Part of the paper is a detailed explanation of the terms eradication and elimination. The main part of the article is a characteristic of infections where the global programme of eradication or elimination is underway. At present the eradication of poliomyelitis and dracunculiasis is completed and elimination of tetanus of neonates as well as leprosy, all by the year 2000. By 2010 measles, possibly German measles and mumps should be eradicated and possibly leprosy and Chagas' disease and onchocerciasis should be eliminated. Also for other infections such as lymphatic filariasis, trachoma and non-veneric treponematoses more remote terms are given or are not yet given. Depending on the decision of WHO on the programme of global eradication, under precisely defined conditions seven other infections may be included: cysticercosis (Taenia solium), diseases caused by Haemophilus influenzae b, viral hepatitis A, rotavirus enteritis, diphtheria, whooping cough and tuberculosis. In the case of viral hepatitis B only elimination is foreseen.
Many lessons and experiences were learned during the global programme of smallpox eradication, the most important being those which could be generalized and applied to other health programmes. This does not mean imitating or implementing smallpox eradication techniques to other diseases, since each infection requires its own strategy. It is difficult to dissect out the single key element or to equate the various factors responsible for the success, as these always worked together, in combination, depending one on others. For global eradication, the element of essential importance was international cooperation and close coordination of activities between nations. This would be impossible without proper mechanisms dedicated to international cooperation in the field of health, provided by the World Health Organization, which also assured mobilization of world resources for national programmes and application of appropriate techniques across international borders. The established specific, practical and measurable goals, objectives and targets made every programme worker clearly understand what was to be accomplished and to find his own role in achieving these objectives. Operational techniques had to be flexible, modified appropriately from country to country to make them suitable to present epidemiological situations, local administrative and health structures as well as to demographic and geographic patterns. It was the effective system of surveillance and outbreak-containment that ultimately proved to have been the key to eradication. However, application of skillful management, sound epidemiological principles, advanced technology and adequate logistic support contributed significantly to the achievement of the final goal.(ABSTRACT TRUNCATED AT 250 WORDS)
- MeSH
- lidé MeSH
- mezinárodní spolupráce MeSH
- pravé neštovice epidemiologie prevence a kontrola MeSH
- Světová zdravotnická organizace MeSH
- vakcinace * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH