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Publications; Correspondence and Drafts
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1963
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APP
EDITORIAL
THE
OFFICES
SATURDAY
EVENING
POST
FOUNDED
ASTOR
GERALD
666
BY
eso
Se
ne
1, 1963
April
Dear
Mr.
In regard
he eught
take.
Bluestone:
te Mr.
¥
article
Reuther's
te begin with
Te wit:
AVENUE
FIFTH
NEW YORK CITY !9
Bau Pha hen
SENIOR EDITOR
2 1963
a more
statement
fer
ef the
Cold War began 18 years
the
"Since
basic
en a strategy
age,
peace,
pesitien
is my
it
that
he
feeling
States
the United
is
going
has
\
that
te
cone
|
y
r
a
t
i
l
i
m
t
s
e
i
t
h
g
i
m
e
th
te
in
lf
se
it
g
n
i
d
l
i
u
b
by
e
ac
pe
e
th
ep
ke
to
ed
rk
wo
y
l
t
n
a
t
s
i
s
r
eu
en
ak
we
we
at
th
t
es
gg
su
te
sh
wi
t
ne
de
I
e
il
Wh
n.
ow
kn
er
ev
s
ha
d
rl
wo
e
th
pewer
lt
ha
te
ne
de
t
ne
is
g
n
i
h
t
e
m
o
s
if
at
th
k
in
th
I
,
me
ti
is
military potential at th
y
g
e
t
a
r
t
s
ve
ti
si
pe
a
is
w
ne
ed
ne
we
at
Wh
e.
su
en
st
mu
r
wa
r
ea
cl
nu
,
ce
ra
nt
me
ma
ar
the
an
th
er
th
ra
r,
wa
f
e
y
t
i
l
i
b
i
s
s
e
p
e
th
s
e
t
a
n
i
m
i
l
e
y
l
e
v
i
t
c
a
at
th
g
n
i
h
t
e
m
o
s
e,
ac
pe
r
fo
e
ur
nt
ve
a
ly
st
ce
o
to
r
wa
ke
ma
te
s
ek
se
ly
en
h
ic
wh
y
the current negative strateg
s
hi
ke
ta
ed
de
in
I
if
r,
he
ut
Re
.
Mr
at
th
n
ai
rt
ce
am
I
fer any natien." Naturally,
.
er
tt
be
is
th
se
ra
ph
n
ca
y,
tl
ec
meaning corr
y
er
st
hi
e
el
wh
e
th
at
th
nt
me
gu
ar
s
hi
p
le
ve
de
r
he
ut
Re
Then I weuld suggest that Mr.
l
a
c
i
g
e
l
se
al
n
ca
He
r.
wa
te
ad
le
e
y
d
l
l
a
u
t
n
e
v
e
s
ce
ra
ms
ar
at
th
s
ew
sh
d
rl
wo
e
ef th
e
th
is
y
g
e
t
n
u
t
s
e
ac
pe
ve
ti
ga
ne
t
en
rr
cu
e
th
ef
s
ct
fe
de
e
th
ef
e
en
at
th
t
eu
t
in
ly pe
y
av
he
ch
su
em
fr
e
su
en
st
mu
h
ic
wh
x
le
mp
ce
l
a
i
r
t
s
u
d
n
i
~
y
tendency teward the militar
,
v
e
h
c
s
u
r
h
K
at
th
t
eu
g
n
i
t
n
i
e
p
r
fe
e
ac
pl
l
ca
gi
le
e
th
is
is
Th
.
s
t
n
e
m
a
m
r
a
te
s
t
n
e
m
t
i
cemm
em
st
sy
e
s
i
r
p
r
e
t
n
e
e
at
iv
pr
e
el
wh
e
th
d
an
r
be
La
,
et
re
St
ll
Wa
at
th
es
ev
li
be
f,
el
ms
hi
g.
in
ge
y
m
e
n
e
c
e
S.
U.
e
th
ep
ke
te
x
le
mp
ce
l
a
i
r
t
s
u
d
n
i
y
r
must depend upen this milita
a
at
th
t
bu
,
e
u
r
t
n
u
ly
en
t
ne
is
is
th
at
th
l
a
t
t
u
b
e
r
e
th
r
e
f
f
e
w
ne
y
ma
r
e
h
t
u
e
R
Mr,
.
s
e
l
p
m
a
x
e
s
hi
te
ci
d
an
e
ac
pe
r
fe
h
c
r
a
e
s
e
r
in
d
e
g
a
g
n
e
e
good many U.S. firms ar
in
e,
ac
pe
r
fe
y
g
e
t
a
r
t
s
s
u
e
i
t
i
b
m
a
s
hi
.
th
wi
d
r
a
w
o
f
me
co
n
ca
r
e
h
t
u
e
R
.
Mr
,
y
l
l
a
n
Fi
,
r
e
w
s
n
a
te
d
e
r
a
p
e
r
p
be
st
mu
r
e
h
t
u
e
R
.
Mr
k
in
th
I
.
m
a
r
g
e
r
p
d
ai
n
g
i
e
r
e
f
ge
hu
a
g
n
volvi
te
t
gh
eu
he
,
e
l
p
m
a
x
e
r
Fe
.
m
a
r
g
e
r
p
a
ch
su
ef
s
c
i
t
i
r
c
e
th
ef
me
se
,
t
n
e
m
u
g
r
a
is
th
in
r
e
h
t
e
h
w
er
s,
an
le
of
t
n
e
m
y
a
p
e
r
h
g
u
e
r
h
t
d
e
p
u
e
c
e
r
e
b
ll
wi
s
e
i
n
e
m
e
th
r
e
h
t
e
h
w
suggest
.
S
.
U
d
y
i
b
a
p
s
e
x
a
m
t
f
r
o
e
f
e
th
in
k
c
a
b
y
e
n
e
m
s
it
t
ge
ll
wi
t
n
e
m
n
r
e
v
e
g
.
S
.
U
e
th
y,
sa
te
t
gh
eu
r
e
h
t
u
e
R
.
Mr
.
e
l
u
d
e
h
c
s
t
n
e
m
y
e
l
p
m
e
ll
fu
a
businesses on
arse esi
werkers and
steel industry,
fer example, what the
r
fe
be
l
al
d
ai
e
th
d
l
u
e
tribute. W
d
l
u
o
h
s
er
g,
in
th
ef
rt
se
‘and that
scheels and
feather
the
reads? Hew
peckets
can
we
be
of the leaders
new running far under
leng term capital
it be in the area
certain
that
the
capacity,
weuld cen-
y
r
e
n
i
h
c
a
m
y
v
a
e
h
,
t
n
e
m
p
e
l
deve
ke
li
s
t
c
e
j
e
r
p
s
rk
we
c
i
l
b
u
p
ef
funds
in an underdeveleped
will
net
nation
simply
er that
be
used
the meney
te
w
He
?
l
e
r
t
n
e
c
r
e
d
n
u
e
c
a
l
u
p
e
p
e
th
p
e
e
k
te
d
e
s
u
s
t
n
e
m
a
m
r
a
te
in
d
e
n
r
u
t
be
y
l
p
m
will si
—
te
g
n
i
t
p
m
e
t
t
a
is
h
c
i
h
w
S.
U.
e
th
in
y
r
t
s
u
d
n
i
e
t
a
v
i
r
p
h
t
i
w
g
n
i
t
e
p
m
o
c
d
i
o
v
can we a
r
e
h
t
u
e
R
.
Mr
es
de
t
a
h
w
d
An
d?
ai
t
eu
g
n
i
h
s
i
d
e
ar
we
e
r
e
h
w
s
e
i
r
t
n
u
o
c
y
r
e
v
e
th
sell te
,
s
e
e
g
y
e
v
r
u
s
t
a
h
t
r
o
f
,
d
i
a
n
g
i
e
r
o
f
en
t
r
e
p
e
r
e
e
t
t
i
m
m
e
C
y
a
l
C
e
th
t
u
e
have to say ab
r
e
h
t
u
e
R
e
th
t
s
n
i
a
g
a
y
l
t
c
e
r
di
The specifics I am
aware that fereign
asking
aid is
plan.
,
h
c
u
m
e
te
t
bi
@
m
e
e
for may s
e
Th
.
t
n
i
e
p
l
a
c
i
t
i
r
c
a
new at
e
ar
u
e
y
t
a
h
t
e
r
u
s
am
I
but
principle seems fine te
ye
PO
Pe era
eS
TO
Mr.
Irving
Bluestene
ot
| April
1,
1963
mest people, but the practices seem to defeat the pregrams and unless ene can
spell eut beth principles and practices, nebedy is geing te be enthusiastic.
I think that this article sheuld run abeut 2,500 werds and the mere
detes and lively material that can be crammed in the better it will
have any questiens, please let me knew.
Sincerely,
Cb CH
Mr. Irving Bluestene
United Autemebile Werkers
8000 East Jeffersen
Detroit 1), Michigan
GMA/bek
At Weed
eeA
s
at
EY I
RENO
A ete
a peat al nthe
anni i
Prins
cinaeials
ef America
quetes, aneebe. If yeu
AT LE EETNIE 2 NEE
—
NATIONAL
135
EAST
APR 15 1963
HEALTH
FORTY-SECOND
EDUCATION
STREET,
NEW
YORK
COMMITTEE,
17,
NEW
April
Dear
YORK.
4th,
«©
ING.
YUKON
6-7110
1963
Walter:
I thought the enclosed fact booklet on the World Health Organization's
activities and accomplishments would be of interest to you.
WHO has made remarkable progress against disease and premature death throughout the world and
could achieve even more dramatic results if more adequate financial resources
could be provided by its member countries,
against
The fact sheet points
such
world-wide
killers
up the
and
successful
cripplers
as
campaigns
malaria,
waged
by WHO
tuberculosis,
yaws,
yellow fever, leprosy and trachoma.
The investments in these campaigns have
been repaid many, many times over in lives saved and disabilities prevented.
Large economic gains have been realized by the countries so helped through the
increased productivity of the people.
|
Many of the diseases weakening the populations of the under-developed
countries can be successfully treated with drugs already known and used in the
Western World and the more developed countries.
WHO could do much toward
accomplishing the goal of improved health as an integral part of foreign aid to the
under-developed countries if sufficient funds were provided to expand the kinds of
campaigns
discussed
in the
fact
booklet
on
a major
scale.
However,
WHO
will
spend during 1963 only about $36 million from all sources.
Unless these diseases
are controlled or eliminated they will continue to negate the potential benefits of
all other economic aid programs to the under-developed countries.
While the funds which the United States can contribute to the ''Regular
Budget'' of WHO are limited by resolutions passed by the World Health Assembly,
additional monies can and should be given for specific projects, such as the elimination of tuberculosis, malaria and other diseases, and could be provided through
Congressional action,
have
your
Won't you let me know if.you agree
interest and support?
smmmnnim,
i
With
all best wishes,
and if such
Cordially
Mrs.
MIKE
GORMAN
NATHAN
MRS.
*
FARBER, M.D.
SIDNEY
S.
MRS.
JOHN
+
KLINE,M.D.
EDWARD
HOWARD
©
EMERSON
McSWEENEY
RUSK,M.D.
*
PAUL
GUNTHER
V.
GREGORY
W. SANGER,
MRS.
+
FOOTE
RUSSEL
+
+
LEE,M.D.
PINCUS,
*
MRS. ALBERT
D. LASKER
MRS.
SC.D.
M.D. * JEREMIAH
*
MAURICE
D,.
Lasker,
GOLDBLATT
+
LEONARD
W.
STAMLER,
M.D.
*
RICHMOND
FREDRICK
+
MRS.
M. D.
GOLDENSON
KILLION
* GEORGE
MARMORSTON, M.D.
*
FREDERICK
would
Chairman
E. De BAKEY,
C. CROCKETT « MICHAEL
HOAGLAND, PH. D.
HUDSON
JESSIE
«+
MAHONEY
FLORENCE
GUNTHER
JOHN
+
programs
yours,
Albert
DAVID
JR.»
BLAIR,
FORDYCE
ALICE
LIST
Chairman,
McC.
+ WILLIAM
BARKLEY
MEMBERS MRS. ALBEN
SPONSORING
expanded
SAMUEL
J. STARE,M.D.*
ROSENSOHN
EUGENE
J. TAYLOR
INCOMPLETE
Executive
Secretary, JANE
E. MCDONOUGH
WHAT
COU
ARE
THE
FACTS
a
INST tl:
VR eC
ABOUT
VO Bs
ARE
WHAT
THE
THE
ABOUT
WORLD
WORLD
HEALTH
Major
FACTS
HEALTH
AND
ORGANIZATION?
facts obtained by courtesy of the
World
Health Organization
and compiled by the
National Health Education Committee, Inc.
135 East 42nd Street, New York 17, N.Y.
1963
INDEX
What countries
II
have the highest and lowest death rates?
What are the leading causes
of death in the world?
Ill
What specific diseases is the World
helping to eradicate?
IV
What has W.H.O.
to combat malaria?
of W.H.O.'s
world wide offensive
against malaria
VI
What has W.H.O.
done to combat tuberculosis?
13
Vil
What has W.H.O.
done to combat yaws?
19
Vill
What has W.H.O.
done to combat yellow fever?
18
IX
What has W.H.O.
done to combat leprosy’?
18
*
The importance
done
Health Organization
What has W.H.O.
done to combat trachoma?
19
Have death rates been cut between 1946 and now (1958-1959-1960)
aided by W.H.O.
as a result of these programs
22
financed?
23
What is W.H.O.
XIV
What individual programs
supporting now?
spending
and how
What programs has the World Health Organization supported in
major areas to combat these diseases and at what cost?
What has W.H.O.
done in medical
XVII
What has W.H.O.
in Africa?
accomplished
XIX
are these programs
is the World Health Organization
XVI
XVI
21
Has the life expectancy been increased in any of those countries?
XIII
XV
?
How
much
is the World
education and training’?
in its medical training program
Health Organization spending for research?
What needs to be done to make
these programs
more
effective?
24
29
28
30
32
36
I,
WHAT
COUNTRIES
countries
Many
tration of deaths,
HAVE
do not have
In all probability,
for which no,
any
HIGHEST
AND
LOWEST
organized
scheme
DEATH
for the
RATES?
regis-
systematic
and thus it is impossible to state with any certainty which country
have the highest crude
or countries
THE
death rates.
the highest death rates are to be found in those countries
or very little data are available.
Moreover,
those countries
ve
ati
ent
res
rep
ly
ari
ess
nec
not
are
ble
ila
ava
are
s
tic
tis
for which sta
or areas
of the region or
continent to which they belong.
When using mortality
of health,
1,
2.
3 essential points,
etc.,
must be borne
statistics to evaluate
geographic
variations
in levels
tending to limit both comparability and reliability,
in mind: -
Extreme
The
observations
or rates tend to occur in small geographic
major factor producing
registration
of deaths.
inaccuracy
This very
apparently low death rate,
in mortality
often tends to give
entities,
rates is under
some
countries
an
where environmental conditions would lead
one to expect a high death rate.
Some countries also exclude deaths of
h.
rt
bi
of
on
ti
ra
st
gi
re
re
fo
be
g
in
dy
s
nt
fa
in
3,
The
ality.
age
structure
If one crude
of the population has
an important
influence
on mort-
on
ti
or
op
pr
e
rg
la
a
ng
vi
ha
on
ti
la
pu
po
a
to
rate applies
of older persons where
mortality is extremely high,
while another rate
r,
we
lo
is
h
at
de
of
y
it
il
ab
ob
pr
the
h
ic
wh
in
refers to a young population
it is obvious that they will not reliably reflect environmental conditions
under which the respective populations
HIGHEST
RATES
DEATH
Reliability of Data
Death Rate“
Year
Group
Country/Pop.
live.
India (rural pop. )
1958
19.4
Estimated from sample data
Guatemala
1960
17.5
Fairly reliable
South Africa (Coloured Pop.)
1960
16.6
Fairly reliable
West Berlin
1961
16.2
Fairly reliable
LOWEST
DEATH
RATES
Group
Country/Pop.
Reliability of Data
Death Rate”
Year
Irak
1960
4,2
Unreliable,
incomplete
Lebanon
1959
0.2
Unreliable,
incomplete
1960
D. 7
Fairly reliable,
1960
D. t
Unreliable, incomplete
registration
Israel,
Jewish Pop.
Syria
The lowest reliable death rates are
registration
registration
structure
cause age
probably to be found in countries such
as the following:
Netherlands
1960
7.6
Australia
1960
8.6
1960
8.8
Finland
1960
8,9
United States
1960
9.9
New
Zealand,
(Sources:
excl. Maoris
1960 U.N. Demographic Yearbook
1962 Second Report on World Health Situation)
“1962 Second Report
SB
Death Rates
Per
1000 Population
2.
II,
WHAT
Causes
THE
ARE
LEADING
of death statistics,
the public health and demographic
CAUSES
The
two
main
reasons
1.
The lack of physicians
point of view,
are
(in the cases where
from both
they exist)
and are perhaps the least comparable
of any
of mortality.
for deficiencies
of the basic
data are:
either to attend the ill person and certify to the
the evidence produced by witnesses
or to examine
WORLD?
to examine the decedent and give an opinion as to the cause of
the cause of his death,
death,
IN THE
which are of the greatest importance
unfortunately subject to many defects,
data relating to the characteristics
OF DEATH
which killed the person.
Even in Some
as to the possible disease
European countries death certificates are
still established by lay persons.
2.
The variations in terminology,
coding and classifying,
national statistical classification and standard rules for selection,
lack of comparability
Leading Causes
despite an inter-
also result in
in the data.
of Death
Statistics of causes of death are not available for every country,
they are available,
their quality is sometimes
ible as yet to ascertain the leading causes
questionable.
and where
It is therefore
of death for all countries,
not poss-
not even for
all those which publish statistics.
sses
pos
ies
ntr
cou
for
ed
ain
obt
be
only
can
on
ati
orm
inf
l
gfu
nin
mea
and
ful
Use
ing reasonably reliable statistics of causes of death.
One indication of their relia-
bility is the proportion of total deaths assigned to "senility , ill defined and unknown
3,
If this proportion is high,
causes".
death is liable to be distorted.
always
This does not mean,
reliable when this proportion is low,
countries which possess
LEADING CAUSES
however,
than 30
more
of death.
- 1959
OF DEATH
.
Noreliable data available.
% to total deaths
Death Rate*
SOUTH EAST ASIA
Influenza & Pneumonia
3.
Gastritis,
Heart
71.5
O1 Oo) =I
1.
55.9
diseases
49.8
etc.
rm 0
©
Ceylon (1)
2,
Japan (1)
1.
2.
3.
MID
EAST
CENTRAL
20.7
153.7
Vascular lesions
13.2
10.0
98,2
74,2
Cancer
Heart diseases
. No
..........
& SOUTH
reliable
data available.
AMERICA
3.
INDIA
Influenza
etc.
& Pneumonia
Heart diseases
...........
WESTERN
The
.
». No reliable
10.
132,9
104, 8
67.0
data available.
WORLD
order is the same
1.
2.
3.
in all countries possessing
reliable data:
Heart diseases - basic cause is arteriosclerosis
Cancer
s
i
s
o
r
e
l
c
s
o
i
r
e
t
r
a
e
is
s
u
a
c
c
i
s
s
a
- b
Vascular lesion
rn
ste
“We
up
gro
the
in
ed
lud
inc
e
thos
m
fro
ects
resp
y
man
in
er
diff
(1) — The leading causes of death in these countries
.
tful
doub
e
efor
ther
is
ity
abil
reli
r
thei
and
n
atio
stig
inve
gh
rou
tho
a
for
call
es
These differenc
World”.
a
2.
Gastritis,
er
Colombia (1)
1.
of
that statistics are
and there are scarcely
reliable data on causes
..........
AFRICA
E
E
E
F
E
r
E
r
r
a
E
t
the picture obtained from statistics of causes
O11 CO ©
r
a
r
E
r
c
E
E
E
E
Almost
about
50% of the people die of arteriosclerosis of the heart and brain and
every 3 deaths are caused by arteriosclerosis
means
This
World.
in the Western
cancer
15% die from
or cancer
CARDIOVASCULAR
that about 2 out of
in the Western World today.
DISEASES
(cause principally is arteriosclerosis)
DISEASES
HEART
Death
Canada
USA
Germany
Denmark
Fed. Rep.
Finland
France
Norway
Netherlands
Un. K-England-Wales
Scotland
N. Ireland
Sweden
Switzerland
Australia
Rate*
% of Tot.
Deaths
CANCER
VASCULAR LESIONS
"Strokes"
Death
Rate*
% of Tot.
Deaths
Rate*
Death
% of Tot.
Deaths
277.0
363.4
216.8
280.6
34,5
38,7
20.0
30.3
89.7
108.5
171.7
115.9
11.2
11.5
15.8
12.5
127.5
147.4
204.0
211.4
15,9
15.7
18.8
22.8
276.4
210.0
247.2
202.3
31.4
18.7
27.7
26.8
117.5
136. 4
146. 8
95.4
13.4
12,2
16. 4
12.6
151.5
193.5
163.0
163.2
17,2
17.3
18.3
21.6
370.7
403. 4
385.3
304. 8
219.9
306.5
31.9
33.5
35.2
32.0
29.3
34.6
165.6
188, 2
148, 2
137.9
122.1
118.4
14,2
15,6
13.5
14,5
12.8
13.4
214.0
210.5
166.5
178.8
194.8
131.6
18.4
17.9
15.2
18.8
20.4
14.8
* — Death rates per 100, 000 population.
Il.
WHAT
SPECIFIC
HELPING
DISEASES
IS THE
WORLD
HEALTH
ORGANIZATION
TO ERADICATE?
The
World Health Organization is conducting campaigns
1,
Malaria
2.
Communicable
diseases,
Tuberculosis
such as
against:
Yaws
Venereal diseases
3.
Virus diseases,
such as
Poliomyelitis
Hepatitis
Smallpox
Trachoma
Respiratory virus infections
Yellow fever
4,
Parasitic diseases,
such as
Bilharziasis
Onchocerciasis
5.
Bacterial diseases,
and Filariasis
such as
Typhoid
Diarrheal diseases
6.
Leprosy
In addition,
W.H.O.
and in such other public health problems
sanitation,
maternal and child health,
W.H. O.
programs
studies on cancer
also supports
as nutrition,
and heart diseases
air pollution,
environmental
etc.
have contributed greatly to the decline in cholera and
smallpox cases.
The number
of reported cases of cholera in all countries
a recent report of W. H, O.) shows
and territories
(in
a marked downward trend with 12, 806 deaths in
1960 compared with 59, 101 deaths in 1957.
The number
of cases of smallpox reported throughout the world fell from
6.
335, 208 in 1950 to 59, 578 in 1960,
IV,
WHAT
HAS W,H.O.
DONE
a reduction of approximately 82%.
TO COMBAT
MALARIA?
Out of a total population of 1,381 million living in currently or former
malarious areas from which information is available,
living in areas where
malaria has been eradicated,
305 million,
or 22.9% are now
while over 767 million,
or
55.54% are covered by malaria eradication programs.
During
dation phase"
1960 alone,
areas inhabited by 28 million people entered the ''consoli-
- which means the end of local transmission.
the causes of such delay have been clearly
progress has been less satisfactory,
recognized and the operational adjustments
The Eighth World
In those countries where
Health Assembly
Organization should take the initiative,
necessary for improvement
decided,
in 1955,
have been made.
"'that the World Health
provide technical advice,
and encourage
research and co-ordination of resources in the implementation of a program
eradication of malaria. "'
as its ultimate objective the world-wide
In 1961,
and,
a qualitative assessment
as a result of this assessment,
malaria eradication more
W.H. O.
research,
of the progress
of the work done was made
it is now possible to judge the prospects
of
objectively.
activities in the malaria field include expert committee
statistical services,
(204 in 1961),
having
advisory
other forms of training,
services to governments,
and publications.
meetings,
fellowships
Spraying operations against malaria in the old
caravanserai near the village of Kamaradi, Iran.
V.
THE
IMPORTANCE
OF W.H.0.'S WORLD
WIDE
OFFENSIVE
AGAINST
MALARIA*
WHAT
DOES
ECONOMIC
MEXICO
MALARIA
COST
COUNTRIES
THROUGHOUT
THE
WORLD
IN
PRODUCTIVITY ?
- $150 million a year loss
Economic
losses due to malaria have been evaluated at $150 million a year.
In the state of Campeche,
cultivated.
only 10% of arable land (530, 000 hectares) is
Out of 2,500,000 hectares of forest and pasture land,
only
430,000 hectares are used to some extent.
*Extra Issue
- MALARIA; WORLD HEALTH, The Magazine
Organization, November 1961.
of the World Health
EL SALVADOR
Mr.
- $40 million a year loss
Under-Secretary
Bustamenta,
Caceres
R.
declared in 1951:
''Malaria alone causes
lent to $40 million."' At that time,
of State for Public Health,
an annual loss of production equiva-
El Salvador had 200, 000 cases of malaria
with 3,000 deaths annually out of a population of 2.5 million.
INDIA
- 2, 400 million rupees
A W.H.O.
absence
a year loss
consultant writes:
''Assuming that an attack of malaria causes
from work for 6 days a year at a minimum
and that some
25% of the people
salary of 2 rupees
affected are salary earners,
amounts to 150 million rupees in income
alone.
a day,
the annual loss
Furthermore,
if it be con-
sidered that malaria decreases the output of the individual by about 25% a
year,
the total loss on this account would be about 2,250 million rupees a
year,
making in all a loss of 2, 400 million rupees a year, "’
THAILAND
- 150, 000 tons of rice lost
Before
days,
1950 malaria entailed an annual loss in agriculture of 50 million mana figure that corresponds
acres of rice,
producing
some
to the planting and harvesting of 400, 000
150,000 tons.
would bring in about $15 million a year.
The export of such a quantity
The anti-malaria program
for
1954-58 only cost $518, 000 a year.
PHILIPPINES
- $54 million a year loss
.
rly
yea
n
lio
mil
$54
st
lea
at
es
pin
lip
Phi
the
t
cos
In 1957 malaria
island in 1946,
several large concerns
On Negros
needed to engage a labor force of 300
persons for a real need of 200 since daily absenteeism
amounted to 35%.
Among
absenteeism
school children,
malaria work in the Philippines,
In 7 of these,
settlement.
reached
With progress
of
21 new districts have been opened up for
the area planted with rice increased by 20.53% and
the area planted with maize by 27.95%.
by 30.16% and 33.34%.
40-50%.
Rice and maize production increased
The number of requests for the granting of land in-
creased from 11, 560 in 1953 to 50, 893 in 1957.
Roads & fisheries saw great
development.
It was in March 1960 that the regular distribution
of anti-malaria salt began in the province of
The region includes
Battambang, Cambodia.
18,000 people. The product distributed is ordinary kitchen salt containing 0.05% of pyrimethmine which stops the fever and prevents development of the malaria parasite. This medicated
salt keeps all its power even when used in
boiled dishes. It is transported by train, truck,
even ox-cart when the isolated settlements are
not
accessible
to
motor-vehicles.
MALARIA
IC
OM
ON
EC
IN
MEAN
N n
ERADICATIOn
cS
n
WHAT
DOES
PERU
- Population increase
The prettiest port on the Peruvian coast,
iron,
which handles coal and
n
io
at
ic
ad
er
the
r
te
af
l
ti
un
ly
al
ic
om
on
ec
ng
did not succeed in developi
of malaria.
SPAIN
Chimbote,
GAIN?
The population increased from
- Irrigation and agriculture
Following
5, 000 in 1942 to 10, 000 in 1947.
increased
malaria eradication,
the building of barrages
and irrigation systems
10.
r
[
I
I
F
£
E
f
E
f
and industry to be developed in areas that were previously
enabled agriculture
New
malarious.
settlements were
created and employment possibilities have
the Guadiana,
greatly increased in the valleys of the Tagus,
and the Guadal-
quivir.
- More
PORTUGAL
rice planted
The area planted with rice was doubled between
- Rice cultivation now possible
MOROCCO
Until 1950,
incidence
TRANSVAAL
1949 and 1957.
|
the cultivation of rice was not feasible for it increased the
of malaria.
turnover
- Increased
E
The disappearance of malaria led to the development of the town of the
E
r
c
E
E
E
E
E
E
a
G
Groblersdal and the settlement of 300 families.
The ''Letaba Citrus Estate"’
increased from 700 acres of irrigated land in 1940 to 12, 000 acres in 1950.
The price of land in the district of Tuinplaats rose by 400% between
1948.
on the anti-malaria campaign
Expenditure
largely covered by agricultural development
in these regions has been
and increased revenue
Production increased by more than 400% and the turnover
cerns rose from
CEYLON
- Waste
lands
1944 and
and taxes.
of cooperative con-
$1, 070, 000 in 1945 to $3, 561, 000 in 1948.
for
settlement
Thanks to malaria eradication,
over a million people have been settled on
lands that used to be deserted.
Rice production has increased by 50%,
11.
ROUMANIA
- Industrial development
Malaria eradication in the Danube delta resulted in the development of
fisheries and agriculture.
E
In Roumania, the Danube delta used to be a stronghold of malaria but has now reached the surveillance stage.
- More
GREECE
rice
The area planted with rice increased
CAMBODIA
10 times between
1938 and 19954,
- Rise in land prices
Anti-malaria work has been pursued in the district of Chamcarien
1953.
The population increased from
since
19, 000 in 1955 to 40, 000 in 1959.
The
a
ls
rie
000
10,
and
000
5,
n
wee
bet
to
ls
rie
200
m
fro
sed
rea
inc
d
lan
of
price
hectare.
RYUKYU
- An island
Because
oped.
rehabilitated
malaria has disappeared,
People
the island of Iriomote can now be devel-
are again settling on the island.
12.
INDONESIA
- More rice
In the bay of Banten (Northwest Java),
an area of 10, 000 acres of good riceafter the Japanese
producing land remained uncultivated for several years
occupation.
Since
WHAT
VI,
1952,
The malaria epidemics of 1944 struck 80% of the population.
spraying has made
HAS W.H, 0,
recultivation possible.
TO COMBAT
DONE
TUBERCULOSIS?
than 360,000,000 people have been tuberculin tested and of these
To date more
more than 140, 000, 000 have been BCG vaccinated in W.H. O. -assisted programs
covering
58 countries.
scientific trials,
communities
When
realized
have 80 per cent.
less chance of developing tuberculosis in the
the need for international
1940's
the substantial increase
BCG
vaccination was
in community
scale and because
action in the field of tuberculosis
the first obvious
research problems,
choice
was
because
of
resistance that could be obtained through its
of its comparatively
The application of BCG vaccination on a mass
cheap and easy application.
scale raised a number
of
inacc
t-v
pos
ry
cto
sfa
ati
uns
the
ng
bei
ant
ort
imp
t
mos
the
one of
ation allergy observed when the campaigns were
regions.
according to controlled
where they live than if they had been left unvaccinated.
in the late
use on a mass
These vaccinated children will,
extended to subtropical and tropical
In extensive field investigations directed by W.H.O.,
it was found that the
day
e
ens
int
and
t
hea
to
re
osu
exp
by
d
uce
red
y
idl
rap
potency of the BCG vaccine is
light.
As a consequence
of these studies,
protective
measures
could be introduced,
13.
a
see
Nr
eg
Recently it has been shown in W.H,.O.
co-ordinated studies that it is possible to
a freeze-dried BCG vaccine with a high degree of heat-resistance.
produce
able efforts were
simultaneously
made
standardized quantitative procedure
Consider-
to develop the tuberculin test into a reliable
by defining and eliminating various
of
sources
error in the test technique.
out
held
gs
dru
is
los
rcu
ube
i-t
ant
nt
pote
of
ent
adv
the
that
ing
liz
rea
y
Full
promises
for a direct attack on the infecting agent,
and assisted the setting up of a number
W.H.O.
immediately
stimulated
of high-quality research projects in the Asian,
wkno
c
basi
new
this
t
adap
to
ed
ign
des
s
ion
reg
n
nea
rra
ite
Med
African and Eastern
ledge to the level of field application in the developing countries.
e
hom
r's
yea
one
that
is
ies
stud
e
thes
of
ings
find
ant
ort
One of the most imp
treatment with these drugs is as effective
conditions
- even under adverse
socio-economic
gs,
dru
me
sa
the
h
wit
on
uti
tit
ins
an
in
t
en
tm
ea
tr
r's
yea
one
as
-
.
ion
ect
inf
of
k
ris
l
cia
spe
any
to
ts
tac
con
t's
ien
pat
not expose the
In Viet-Nam where this small boy is receiving
protective BCG vaccination, the government is
carrying out, with the help of UNICEF and WHO,
an overall BCG vaccination program in an effort
to curb tuberculosis.
and does
This finding has
Patients are being cured at home in Madras: the
advent of powerful anti-tuberculosis drugs such
as streptomycin and isoniazid has brought hope
of recovery throughout the world to millions of
people who previously had none.
14,
completely changed the outlook for developing effective tuberculosis
grams
in the economically
Specific means
less favoured countries.
have thus been developed and perfected both for increasing
infection
of unavoidable
against the consequences
of the community
the resistance
control pro-
rcle
tube
the
on
ck
atta
ct
dire
a
ugh
thro
n
ctio
and for reducing the transmission of infe
bacillus.
m.
gra
pro
sis
ulo
erc
tub
e
tiv
ven
pre
ly
tru
a
for
st
exi
now
The tools
is now assisting countries
of national pilot projects W. H.O.
In a large number
through careful evalua-
p,
lo
ve
de
to
e
dg
le
ow
kn
s
thi
of
e
us
le
ib
ss
po
st
be
to make the
comprehensive
tion of each operational feature,
munity-wide
deployment
local resources.
of preventive,
diagnostic
In a few highly developed
ing and assisting Governments
public health programs
and curative
communities
to study the methodology
W.H.O.
with com-
services within
is even stimulat-
for the eventual epidemio-
logical eradication of tuberculosis.
VII.
WHAT
HAS W.H.O.
Eleven years ago,
DONE
TO COMBAT
YAWS?
me
so
re
we
e
er
th
at
th
d
te
ma
ti
es
s
wa
it
50 million cases of
By the end of 1961,
yaws
s.
ea
ar
al
ic
op
tr
in
sk
ri
at
le
op
pe
n
among the 200 millio
some
rsu
re
d
an
s
ey
rv
su
l
ia
it
in
in
ws
ya
r
fo
ed
in
am
ex
en
be
d
ha
le
op
pe
0
00
0,
90
8,
27
veys for mass
campaigns
Asia and the Western
assisted by W. H.O.
in Africa,
the Americas,
South-East
Pacific Regions.
During these campaigns
yaws or latent cases or contacts,
some
35, 809, 000 people,
either patients with active
.
in
ll
ci
ni
pe
g
in
ct
-a
ng
lo
th
wi
t
en
tm
ea
received tr
15.
TOTAL WORK
DONE
IN YAWS
CAMPAIGN
Cumulative
- GLOBAL
SUMMARY
Estimated Data Through
1961
Examinations
Area
Survey
Resurvey
Total
Treatments
Africa
22,057, 099
38, 341, 183
60, 398, 282
19,173, 377
Asia
60, 656, 235
215, 241, 860
275, 898, 095
11,112,185
3, 203, 119
3,255, 727
6, 458, 846
4,172,271
TOTAL
85, 916, 453
256, 838, 770
342, 755, 223
34, 457, 833
Source:
UNICEF Memorandum "Programme
for 1962" 30 April 1962
The Americas
Targets
& Achievements
The results have everywhere been most impressive,
1961 & Targets
and the disease may
now be considered to be in regression in most of these areas.
Before
In Haiti,
mass
campaign
After
Treatment
for example,
in 1950,
yaws was,
one of the major
prevalence of 40 to 60 per cent.
Treatment
prior to the start of a W.H. O. -assisted
public health problems,II with an estimated
Four years later the whole population had been
16.
and treated,
examined
sample
and only a few sporadic cases could be found.
Recent
surveys confirm the practical elimination of the disease.
PAM (short for procaine penicillin with aluminum
monostearate, which cures yaws lesions in a few
days) is the name of a steam launch which takes
a yaws eradication team to the remote islands in
Indonesia (92 million inhabitants spread over
three thousand islands). The Indonesian yaws
eradication program is the largest yaws program
in South East Asia and is supported by WHO and
UNICEF. WHO helped Indonesia acquire the
Before 1950, when the campaign started,
15% of the Indonesian population had the
PAM.
about
While the immediate
of further rural
cooperation of the people in order to stimulate the promotion
health services
The gains
of the mass
campaign
integrated into the established permanent health structure
W.H.O.
assistance to the yaws
tioned regions provided
VDT field,
advisers
tions and statistics made
meetings,
has assisted in procuring drugs,
can then be
of the area concerned.
in the above-men-
fellowships for training in the
W.H.O.
it possible for W.H.O.
cal policy for the organization of programs
UNICEF
territories
endemic
and consultants,
while expert committee
finally rid of
objective is to win the confidence and
and ultimately eradicate it, the broader
in their country.
be
is to control yaws
campaigns
objective of the mass
to
hopes
disease. Indonesia
yaws in 1965.
conferences
to formulate
and publica-
a practical techni-
aiming at the eradication of yaws.
supplies
including transport and
equipment.
17.
VIII.
WHAT
DONE
HAS W.H.O.
TO COMBAT
YELLOW
FEVER?
c,
ffi
tra
l
ona
ati
ern
int
in
se
rea
inc
nt
sta
con
the
of
te
spi
In
yellow fever did not
in 1960.
spread beyond its natural foci in Africa and South America,
to the International Sanitary regulations
credit for this result is due
At least partial
as amended
and administered by W.H.O.
IX.
WHAT
DONE
HAS W.H.O.
Leprosy
TO COMBAT
afflicts about 10 million sufferers throughout the world,
and it is usually contracted in infancy or childhood,
causing tuberculosis,
manifesting itself till later in life.
cured by sulfone drugs. Many
tion.
To be effective,
If detected in time,
often not
leprosy can be completely
can be healed as out-patients without breaking up their
treatment
must be regular
and of sufficiently long dura-
Three years of treatment is required in early cases,
1.
of which
It is caused by a bacillus not unlike the one
only 20% receive treatment of any kind.
families.
LEPROSY’?
six years in advanced.
What meetings have been held?
W.H.O.
was one of the sponsors
in Leprosy held in Vellore,
India,
of a Scientific Meeting on Rehabilitation
at the end of 1960.
Another conference
held in Istanbul in 1961 dealt with the organization of leprosy
services
ods
meth
rol
cont
e
rmin
dete
to
ects
proj
pilot
of
use
the
and
case finding
suitable for particular
tion of results.
areas
as well as the training of personnel
Agreement was
reached
and
most
and evalua-
on criteria for ''arrested cases",
schedules for treatment and chemoprophylaxis
and methods
for use in drug
trials.
18,
Programs
and were
planned in several countries
of leprosy have been started or
further developed in others,
mostly
and UNICEF.
with the help from both W,H.O.
2.
treatment
for the ambulatory
What are the difficulties in the fight against leprosy?
shortage
The
is one of the biggest
of personnel for leprosy campaigns
difficulties in arranging leprosy control projects in countries in which
To help overcome
leprosy is an important problem.
is organizing
What is being done in research
W.H.O.
W.H. O.
leprosy training
a series of inter-regional post-graduate
the first of which was held in the Philippines in November
courses,
3.
this difficulty,
1961.
against leprosy?
is continuing to support and coordinate
research
in this area
and controlled clinical and field trials of anti-leprosy drugs with long-lasting
repository
effects were
started in four centers.
Methods
have been drawn up
for a model experiment to assess the value of BCG in leprosy prevention.
X,
HAS W.H.0O,.
WHAT
Some
of trachoma,
400 million people,
TO COMBAT
TRACHOMA?
s
im
ct
vi
e
ar
,
on
ti
la
pu
po
s
d'
rl
wo
e
th
- one-sixth of
a painful eye infection causing damage
in turn can produce
1.
DONE
Where
scar formations,
deformity,
to the eyelids
and cornea,
and total or partial blindness.
is it prevalent?
,
ca
ri
Af
of
s
ea
ar
y
nd
sa
y
dr
e
th
in
t
en
al
ev
It is especially pr
ranean,
which
Pakistan,
North India,
the Mediter-
and in parts of East Asia.
19,
various forms
In some areas where trachoma occurs,
are even more widespread.
Repeated
attacks
of conjunctivitis
of trachoma but protract its course
the transmission
of conjunctivitis
not only aid in
and add to its compli-
cations.
2.
What treatments
are available?
Not until the discovery
possible.
Now,
of antibiotics was control of these diseases
the application of aureomycin or terramycin ointment is
helping to cure millions of victims.
Recently,
been isolated in several widely
of this virus may well prove
separated
Before
Treatment
The successful cultivation
areas,
a turning point in developing
tion agents and thus open up large new
eye infection.
the trachoma virus has
as a result of laboratory research,
approaches
for combatting this age-old
(1)
After
Treatment
.
61
19
n,
io
it
Ed
nd
co
Se
,
VII
l.
Vo
,
um
di
en
mp
(1) UNICEF Co
.
nd
Fu
's
en
dr
il
Ch
s
on
ti
Na
ed
it
Un
the
by
d
he
Publis
effective immuniza-
During
1961 W.H.O.
continued to assist trachoma research by helping
of information between workers,
the coordination of studies and the exchange
by providing technical advice on the design and evaluation of field trials and
by providing material assistance to a number
W.H.O.
trol projects.
XI,
in the
continued to give practical assistance to governments
study of local disease patterns,
UNICEF
of research projects.
and the planning
Sixteen W. H. O. -assisted projects
is cooperating,
were
and implementation
of this kind,
of con-
in which
in operation at the end of 1961.
HAVE DEATH RATES BEEN CUT BETWEEN 1946 AND NOW (1958-1959-1960)
AS A RESULT
OF
THESE
PROGRAMS
AIDED
1,000
Death Rates per
BY W.H. O. ?
Population
(best available data)
Africa
Asia
Mauritius
Egypt
29.4 (1946)
24,9 (1946)
Ceylon
20.3 (1946)
Taiwan (China)
Thailand
Cyprus
Bur ope
Oceania
Fiji Island
13.1 (1946)
62%
33%
55%
5%
42%
33%
(1946)
(1946)
(1946)
(1948)
Greece
Ireland
Italy
Yugoslavia
Statistics,
11. 3 (1960)
14.6 (1946)
8.5 (1946)
9.9
14.0
12.1
13.5
These
11.8 (1958)
16.6 (1958)
Percent
Decline
26%
18%
23%
28%
7.0 (1958)
figures were taken from W.H.O.'s
which are based on figures made
Annual Epidemiological
50%
and Vital
available by national health administra-
21.
tions.
It is often impossible
cause
a large number
to assess the practical results in statistical terms be-
of countries have yet to establish adequate
for instance,
Afghanistan and Nepal,
are two countries
statistical services.
part of health work is assisted by the international organizations,
are available.
For Africa,
the only countries
Furthermore,
UAR
XII,
HAS
THE
LIFE
(Egypt)
and the Union of South
it is difficult to differentiate between the results obtained by
and the efforts of national health authorities.
alone on the one hand,
W.H.O.
but no statistics
or territories providing specific
death rates per 1,000 population are Mauritius,
Africa.
a large
of Asia where
EXPECTANCY
BEEN
INCREASED
OF
IN ANY
THOSE
COUNTRIES?
There has been a definite improvement
connected with dropping
mortality rates.
since life expectancy
is directly
(See Appendix I on expectation of life at
birth for various countries.) In addition to the figures listed under question XI,
following infant mortality figures show
accepted
a similar trend.
the
Infant mortality is widely
as one of the leading factors in assessing life expectancy.
Infant Mortality
Albania
St. Helena
S.W. Africa (coloured
population)
Zanzibar (European population)
Per
1,000 Live Born,
during
1st Year of Life
103.9 (1955)
76.5 (1959)
41.7 (1957)
28.2 (1959)
(1957)
117.0 (1959)
117.9
35.9 (1957)
In the more developed parts of the world,
|
22.3 (1959)
where
economic
progress
and
22,
industrialization create problems
ing with radiation protection,
diseases
XI.
and
of a different nature,
W.H.O.
air and water pollution,
mental health,
deal-
has programs
cardiovascular
so forth.
WHATIS
ARE
THESE
PROGRAMS
the World Health Organization will spend currently
In summary,
about $36 million,
AND HOW
SPENDING
W.H.O,
FINANCED?
(1962)
as follows:
$24, 863, 800
Effective working budget (regular)
Malaria Eradication Special Account
3, 416, 667
Technical Assistance Funds
8,109, 452
$36, 389, 919
W,H. O. 's effective working budget,
amounts to
fixed by the World Health Assembly,
$24, 863, 800 for 1962.
The Malaria Eradication Special Account
voluntary contributions
- expended
- specially established to receive
$3, 777, 891 in 1961 and is scheduled to spend
be
to
m
ra
og
pr
a
ri
la
Ma
the
of
s
st
co
the
of
n
io
rt
po
$3,416, 667 in 1962 (excluding that
financed by a contribution from the Regular
The United Nations
Budget).
Technical Assistance
amounted to $5, 596, 331; and the corresponding
Funds
earmarkings
for 1962 amount to
d,
fun
y
nc
ge
in
nt
co
the
om
fr
ed
nc
na
fi
be
to
ts
ec
oj
pr
$8,109, 452 (including
ing the administrative
and for which lump
the Expanded
and operational
services costs
sum reimbursements
Program
Since W.H.O.
in 1961
expended by W.H.O,
but exclud-
merged with the Regular
Budget
are received from the Special Account of
of Technical Assistance).
er
mb
Me
by
ed
id
ov
pr
n
io
at
rm
fo
in
l
ca
ti
is
at
st
on
relies
States,
23.
it is often difficult to obtain comparable
especially from countries concen-
material,
who have not yet been able to
trating on disease control and eradication measures
set up adequate
XIV.
WHAT
statistical services.
INDIVIDUAL
SUPPORTING
PROGRAMS
IS THE WORLD
HEALTH
ORGANIZATION
NOW?
The World Health Organization had 825 projects in 137 countries and territories in operation in 1961.
This includes an average
of about 100 projects per Region,
For the sake of clarity,
plus 15 Inter-Regional projects,
W.H.O.'s
work can be
divided into:
1.
"Common
Member
denominator
subjects" which are of equal interest to all
such as:
States,
a.
Medical research;
b.
Adoption of international standards for biological substances;
c.
Establishment of specifications
names
d.
for the more
Control of air,
and selection of non-proprietary
important pharmaceuticals
e,
2.
Regulations,
and the Epidemiologi-
Service.
Fostering and study of comparable
countries
on the market;
land and sea traffic from the point of view of health,
through the International Sanitary
cal Intelligence
coming
health statistics from
as many
as possible;
f.
World-wide
g,
Exchange
control
(with the U.N.) of habit-forming drugs;
of scientific information.
Direct assistance to governments,
according to their requests,
24.
in efforts to:
a.
Control or eradicate communicable
b.
Improve
c.
Establish maternal and child health services;
d.
Develop general public health administration and rural health
conditions
diseases;
of environmental
sanitation;
services;
XV.
e.
Train medical
f.
Other
health
PROGRAMS
WHAT
IN MAJOR
AREAS
programs,
W.H.O.
and auxiliary personnel;
matters.
HAS
THE
HEALTH
WORLD
THESE
TO COMBAT
in general,
DISEASES
are aimed
pose of strengthening national health services.
AND
at serving the all-important pur-
In the proposed program
only 23% will be spent on the control and eradication of communicable
14% on projects
are as follows
for 1962,
while
diseases
and
exclusively related to education and training.
specifically,
the main programs
(figures quoted represent
Expanded program
Account,
COST?
AT WHAT
63% of estimates for field activities are devoted to that aim,
approximately
More
SUPPORTED
ORGANIZATION
of W.H.O.'s
Regional
1961 expenditure for Regular
of Technical Assistance
organizations
Budget,
and the Malaria Eradication
the
Special
and estimated expenditure under other sources such as (1) United Nations
Special Fund;
(2) Pan American Health Organization;
mainly for supplies and equipment,
and (3) UNICEF
allocations,
etc.)
25.
WHO
REGIONAL
AREAS SERVED,
Regional
for Africa
iS
1.
OFFICES
AND
AS AT 31 DECEMBER
Office
Regional
South-East
AREAS
THEY
SERVE
1961:
Office for
Regional
Asia
Eastern
Office for the
Mediterranean
Regi ° na
the Western
J Regional Office for
the Americas/ PASB
What is the estimated expenditure in the African Region?
The chief aim of the regional program
ments in communicable
nutrition,
disease control,
and in the development
health problems.
is to continue
measures
Pacific
$8,958, 066:
assistance to govern-
against malnutrition and sub(particularly rural health)
of public health services
to enable them to absorb and administer
2.
THE
special services
Education and training are of paramount
created to solve special
importance
?
as
ic
er
Am
e
Th
in
e
ur
it
nd
pe
ex
d
te
ma
ti
es
What is the
to the Region.
$16, 004, 442
(including
a
ri
la
ma
l
cia
spe
its
and
on
ti
za
ni
ga
Or
lth
Hea
an
ic
er
Am
Pan
funds provided by the
fund):
s.
ad
he
in
ma
e
re
th
r
de
un
d
pe
ou
gr
be
n
ca
on
gi
re
s
thi
The work of
ening of national health services;
technical personnel;
(1) strength-
(2) education and training of professional
(3) eradication or control of communicable
and
diseases.
26.
3,
What is the estimated expenditure in South-East Asia?
Modern
$7, 920, 337:
have helped to reduce death rates substantially,
scientific methods
yess in this part
gl
e sickn
preventabl
ence ofin
re
incidss
but there is still a disthigh
standards
and extremely poor
a
suffer from
and rapidly increasing populations
large
of the world where
of undeveloped resources.
of sanitation because
What is the estimated expenditure in Europe?
$3, 870, 337:
With the increasing longevity of European populations,
(arteriosclerosis,
with chronic diseases
together with epidemiology
ground,
like tuberculosis.
diseases
cancer)
problems
and gerontology
and health statistics,
Education and training
malnutrition
come
connected
to the forefor
of special importance
(including fellowships) retain the
foremost place in regional programs.
D.
What is the estimated expenditure in the Eastern Mediterranean?
The control and eradication of communicable
than 50% of regional funds in 1960.
assistance has decreased because
but more
assistance
bilharziasis,
6.
is required
In certain fields,
more
diseases
still absorbed
such as tuberculosis control,
national staff have not taken over the work,
and granted for research
into and prevention of
What is the estimated expenditure in the Western Pacific?
is placed on the socio-economic
of countries to provide
health programs.
more
and other diseases.
trachoma,
Emphasis
$6, 371, 938:
conditions
$3, 616, 098:
and potential resources
lic
pub
m
er
-t
ng
lo
of
ion
cut
exe
and
ng
nni
pla
the
for
is
bas
a
The result of the mass
campaigns
but it is difficult to maintain an adequate follow-up
ive rural health services
have been most
in some
satisfactory,
areas where
fully effect-
are still lacking.
27.
WHAT
XVI.
HAS W.H.0O.
IN MEDICAL
DONE
EDUCATION
TRAINING?
AND
The World Health Organization is currently spending about $2, 177, 000 on
education and training activities,
gramme
out of its own Regular
of Technical Assistance,
Budget,
the Expanded
Pro-
and other extra-budgetary funds.
One of the main tasks of the World Health Organization since its inception
has been to assist national governments
field of health - a problem
to overcome
personnel
shortages
in the
most acutely felt in the newly developing countries.
The specific activities in which W.H.O.
is engaged for the express purpose
ed
iz
ar
mm
su
be
can
ng
ni
ai
tr
and
n
io
at
uc
ed
l
ca
ni
ch
of promoting professional and te
as follows:
1431
ded
awar
O
(WH
ad
abro
ning
trai
nced
adva
in
obta
to
ers
work
th
heal
onal
nati
ing
As well as help
rge
enla
and
ove
impr
h,
blis
esta
to
nts
rnme
gove
aids
WHO
),
1959
in
ad
abro
ies
stud
for
fellowships
or
doct
k
Gree
A
ed.
need
ntly
urge
l
onne
pers
th
heal
of
army
the
for
es
liti
faci
ning
trai
their own
be.
to
t
ough
s
onse
resp
’s
baby
d
ente
cont
al
norm
a
what
es
nurs
k
Gree
demonstrates to a class of
1.
General surveys
and studies of particular institutions,
with a view to
t
en
em
ov
pr
im
y
rl
de
or
for
s
an
pl
e
at
or
ab
stocktaking and assisting to el
,
es
ti
li
ci
fa
ng
ni
ai
tr
d
an
n
io
at
uc
ed
of
t
en
pm
lo
ve
de
efforts and assistance from
or
within which indigenous
outside are brought to bear.
28,
2.
Assignment
to specific institutions for the purpose
of visiting professors
of filling deficiencies or of establishing adequate conditions and training for
local personnel to take over later.
3.
Sending for a short period advisory and demonstration groups
of pro-
fessors in one or several scientific disciplines.
4,
part of a more
5.
inclusive plan of assistance.
Grants to teaching and research
actual investigation,
6.
Fellowships
itself of,
for new,
or assistance to,
evolving,
teaching institutions
or neglected subjects of study.
and travel grants for advanced
and grants to permit attendance
for the exchange
institutions for research coordination or
these institutions being also often utilized for training.
Organization by W.H.O.
in organizing courses
7.
in so far as this is
supply of literature and teaching equipment,
Limited
studies and observation abroad
at educational meetings
organized by W.H.O.
of scientific information among participants.
and the end of 1961,
(Between
1947
13, 498 fellowships were granted for the benefit of
170 countries and territories in all parts of the world.)
8.
Obtaining and making widely
available collective expert opinion on matters
of education and training of medical and allied personnel,
meetings
9.
of expert committees
by organizing
and study groups.
on
and
ons
uti
tit
ins
ng
chi
tea
on
on
ati
orm
inf
of
on
ati
lic
pub
Collection and
the teaching
of individual subjects.
29,
The ultimate
ually to make
objective of these varied W.H.O.
countries
event-
self-sufficient in the preparation of their basic health
This is the only permanent
personnel.
however,
activities is,
but it is still a long-term
solution,
solution.
XVI, WHAT HAS W.H. 0. ACCOMPLISHED IN ITS MEDICAL TRAINING PROGRAM
IN AFRICA?
The magnitude
of the task facing W.H.O.
alone,
In 1961
is taking place today in Africa.
is perhaps best exemplified by what
fact-finding surveys have been under-
taken in 12 countries with a view to assisting in the establishment
of long-term
plans of development.
According to a 1958-60
survey
(excluding the Union of South Africa),
7,143
medical practitioners
of countries in the W.H.O.
Region of Africa
there was one doctor per 20, 000 population,
(foreign or local,
university graduate
or with lower
qualifications) for an estimated population of 145 million.
This contrasts to about one doctor for every 900 in the population in Europe
and North
and Central
America.
In order to raise this proportion even to one physician to every 10, 000
inhabitants would mean an additional 7, 000 physicians.
The estimated increase of
n
tio
por
pro
a
in
obta
to
year
per
s
tor
doc
500
of
ning
trai
the
for
s
call
e
alon
population
of one to 10, 000 new inhabitants.
The training of a physician requires
of secondary
secondary
education,
and the problem
school graduates
a minimum
of six years
after completion
is further complicated by the paucity of
in most of the newly developing countries
and by the
30.
competition for their services.
In the calendar year
1961 alone,
candidates from 31 countries
W.H.O.
has awarded 340 fellowships to
and territories of its Region of Africa.
of these were for basic professional
studies abroad,
More than half
mainly in medicine,
because
no such facilities were available locally or in the area.
Two years after independence there, were only
two Congolese doctors in the Congo and the
medical
country's
trusted
services
to international
fellowships to
complete their
as full medical
lowing courses
Tshishimbi,
North Kasai
are temporarily en-
teams.
WHO
supported
former “‘assistants medicaux’’ to
studies and return to the Congo
doctors. 108 of them are now folat 5 French universities. Martin
in
assistant
30, was a medical
for 3 years after 6 years of study in
Leopoldville. He is now in Lyons (France) with
his family as a 5th-year medical student. If all
goes well, he will graduate in 1963.
Out of 172 projects of technical assistance in the Region,
partially concerned with training,
73 were at least
48 being specifically for education and training
of medical and para-medical personnel.
In addition,
there were
also seven projects
consisting solely of educational meetings.
W.H.O.
ized agencies,
cooperates
and particularly UNESCO,
areas of joint concern where
ing governments
actively with the United Nations
in carrying
and the other special-
out surveys
and establishing
coordinated and integrated action is essential in assist-
and populations
of developing countries.
31.
XVII.
HOW
MUCH
IS THE
WORLD
HEALTH
ORGANIZATION
SPENDING
FOR
RESEARCH ?
The Eleventh World
W.H.O.
Health Assembly
in 1958 adopted
to expand its role in international research,
the coordination and stimulation
of research
especially in connection with
activities throughout the world.
to this effect was undertaken in 1958 with the assistance
the United States Government.
A Study
of a $300, 000 grant from
The Director-General presented to the Assembly
the following year a concrete plan for an expanded
proved
a resolution asking the
research program.
This was
ap -
and is now being implemented.
In the last 4 years,
the effort made by W.H.O.
to facilitate and stimulate
research has been considerably intensified and this is reflected in the amounts
on this type of activity in the years
1959,
in
1958,
1959,
1960 and 1961.
the total amount devoted to research planning was
around
Whereas
spent
in 1958 and
$300, 000,
it went up
to $341, 105 in 1960 and $612, 144 in 1961.
Unlike national research
institutions,
made
W.H.O.
(a)
uses existing national centers and facilities whose services are
available by responsible
to which W, H,O.
problems
only world-wide
organizations which operate through their own
national authorities.
The main categories
of research
can most usefully lend its support include particularly:
which occur
experience
in large geographical
areas
can furnish the necessary
and problems
comparative
facts,
the tuberculosis immunization
for which
such as
and tuberculin
allergy studies carried out by W.H.O.,
well as W.H.O.'s
as
studies on the chemotherapy
32.
and chemoprophylaxis
to determine
under
of tuberculosis to try
the best methods
of treatment
conditions prevailing in the less devel-
oped parts of the world.
(b)
the investigation of rare conditions for which sufficient information can be
collected only by pooling the experience
world,
of many
countries or large areas of the
such as,
the cardiomyopathies,
which include several
syndromes which present themselves
ically as heart failure.
clin-
Endomyocarial
fibrosis and cryptogenic heart disease in
Africa appear to have different clinical and
pathological features
and a peculiar geo-
graphical distribution.
In connection with cardiovascular
tions in Chagas' Disease,
manifesta-
extensive studies
are needed to evaluate not only the prevalence
of trypanosoma
populations
cruzi infection among the
living in triatomid infested areas,
but also the frequency,
of cardiac
severity
and digestive forms
relationship.
Research
and evolution
and their
is needed in the
geographical distribution,
etiology and
33.
pathophysiology
of cor pulmonale
antecedent conditions.
surveys
and its
Studies in hospitals,
on defined populations
and inter-
national surveys of chronic respiratory
diseases including the study of the effect of
air pollution and smoking habits are needed.
(c)
studies of the incidence
and in contrasting environments,
and prevalence
of disease
in different countries
such as
the epidemiological
studies of W.H.O.
in
the field of cancer being conducted in different geographical
areas with contrasting
incidences of the same type of tumor.
(d)
the provision of services to research for programs with an international
Significance.
Priority has been given to the solution of
problems
needing international cooperation
and to those major problems where
action is inadequate or where
initial development
local
it is in the
stages.
To the fields of research indicated by the
W.H.O.
's established public health
program
(communicable diseases,
control,
nutrition) have been added research
vector
34,
in cardiovascular diseases,
cancer, radiation
health,
To insure that
and human genetics.
the research programs
are soundly based,
certain advisory bodies have been established
- the Scientific Groups
and the Advisory
Committee on Medical Research
NUMBER
OF PROJECTS
IN THE
DIFFERENT
Subject
Communicable
FIELDS
(ACMR).
OF RESEARCH
Number
of Projects
diseases
Virus diseases
Tuberculosis
16
19
Leprosy
Treponematoses
10
12
Enteric diseases
Zoonoses
Bilharziasis
Onchocerciasis and filariases
Malaria
4
6
8
5
23
103
Insecticide resistance
Antiobiotics
and vector
Immunology
Biological standardization
Cancer
Cardiovascular
Human
genetics
control
22
2
1
10
13
5
diseases
4
Nutrition
Radiation health
6
9
12
Status
at 31 December
1961
175
35.
XIX.
WHAT
NEEDS
TO BE DONE
TO MAKE
THESE
PROGRAMS
MORE
EFFECTIVE?
The basic conditions for making
the present W.H.O.
programs
effective are increased funds and cooperation on the part of W.H.O.
The W.H.O.
could effectively spend
Member
States.
$75 million during the coming year.
The type of international work undertaken by W.H.O.
only if skills and knowledge
more
can be carried out
are pooled and put at the disposal of all countries which
need them.
Member
states have requested 350 projects totaling an estimated
in the 1963 budget which cannot be implemented
would be requested if more funds were
made
for lack of funds.
available.
Much
In addition,
$5.6 million
larger
funds
there are
requests for $4.3 million in Category II projects which can only be implemented to
the extent that substitutions
approved
may be effected or economies
estimates for Category I projects.
The under-privileged countries
Member
personnel
realized within the
States of W.H.O.,
laboratorians,
constituting more
than 75% of
will have to draw increasingly on the specialized health
available in the technically
cians in all branches
of the world,
of medicine
more
developed
and public health,
countries.
nurses,
This
sanitary
means
physi-
engineers,
and others are needed.
36.
E
[
i
[
[
[
E
[
E
E
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APPENDIX I
EXPECTATION
OF LIFE
AT BIRTH:
1940-1960
(in years)
COUNTRY
YEAR
EXPECTATION OF LIFE
MALE
FEMALE
IN YEARS
BOTH
AFRICA
Angola
1940
30
Central African Republic
1959
32
Congo (Leopoldville)
African population
1950-52
Ghana
1948
Guinea
Rural population
Urban population
1954-55
1954-55
Ivory Coast
Indigenous population
Mali
Mauritius
ex,
dep.
37,64
40. 00
—
38
26.0
30.5
30,8
1956-58
39
1957
26
1942-46
1951-53
32.25
49.79
33.83
02.29
Mozambique
1940
45
Rhodesia and Nyasaland, Fed.
of Northern Rhodesia
1950
37
1948
1953-55
49
Southern
Rhodesia
48
49
Senegal
1957
Seychelles
1960
60. 8
65.9
1945-47
1950-52
00, 70
00. 07
49.75
04,75
1945-47
1950-52
41.70
44.82
44,00
47.77
South Africa
Asiatic population
Coloured population
37
37.
COUNTRY
YEAR
South Africa (continued)
White population
Swaziland
African population
Zanzibar
Pemba
NORTH
1945-47
1950-52
EXPECTATION OF LIFE
MALE
FEMALE
63. 78
64,57
68. 31
70. 08
1946
48
(1958
42.8
1958
40.3
AMERICA
British Honduras
1944-48
44, 99
48. 97
Canada
1940-42
1955-57
62, 95
67. 61
66. 29
72, 92
Rica
1949-51
O4, 75
Ov, 05
El Salvador
1949-51
49, 94
D2. 40
Greenland
1946-51
1952-59
32, 17
ol. 40
37, 49
O3. 60
1951-55
D0,
o9,
Guatemala
1949-51
43. 82
43. O2
Haiti
1950
Mexico
1940
37, 92
39. 19
Panama
1941-43
1952-54
00, o4
60, 41
O3. 46
63. 09
Costa
Guadeloupe
and Martinique
32.61
Puerto
Rico
1939-41
49. 12
46. 92
United
States
1939-41
1959
61.
66.
65. 89
73
Indies
Barbados
1945-47
49, 17
D2. 94
Grenada
1945-47
47. 22
D2. 46
West
IN YEARS
BOTH
38.
E
COUNTRY
YEAR
EXPECTATION
MALE
OF
FEMALE
1945-47
1950-52
01.25
a0, Ta
04, 58
58. 89
1946
49.53
04. 76
1945-47
1957
02.98
09. 88
56. 03
63.35
1947
56.9
61.4
Bolivia
1949-51
49.71
49.71
Brazil
1940-50
39.3
45.5
E
British Guiana
1945-47
49,32
52.05
FE
Chile
1940
1952
40.91
49. 84
43.16
03. 89
E
ASIA
FE
Cambodia
1958-59
44,2
43. 3
Ceylon
1945-47
1954
46.79
60.3
44.72
59.4
r
China (Taiwan)
1936-41
1959-60
41.08
61. 33
45.73
65. 60
Fr
Cyprus
1931-46
1948-50
57.3
63.6
59.3
68. 8
E
Federation of Malaya
1956-58
09.18
08.19
fF
India
1941-50
32.45
31. 66
E
Israel
Jewish population
1949
1960
65,21
70. 67
67.91
73.47
E
Japan
1945
1959
23.9
65.21
37.5
69. 88
E
Philippines
1946-49
48.81
03. 36
r
West Indies (continued)
Jamaica
r
Leeward
Fr
E
r
r
F
Islands
Trinidad & Tobago
SOUTH
LIFE
IN YEARS
BOTH
AMERICA
Argentina
39.
r
E
EF
COUNTRY
YEAR
EXPECT
OF A
LIT
FE I
INOYEN
ARS
MALE
FEMALE
Ryukyu Islands
1955-57
65.8
72.0
Thailand
1947-48
48.69
51.90
1950-51
46.00
50. 41
Turkey
Provincial
Capitals
E
EUROPE
Fr
Austria
1949-51
61.91
66.97
r
Belgium
1946-49
62. 04
67. 26
Czechoslovakia
1949-51
1958
60.93
67.23
65.53
72.30
Denmark
1936-40
1951-55
63.5
69.79
56. 8
72.60
Finland
1931-40
1951-55
54.45
63.4
59.55
69.8
F
France
1946-49
1960
61. 87
67.2
67. 43
73.8
r
Eastern Germany
1952-53
65. 06
66.13
69. 07
70. 68
E
Federal Republic of Germany
1946-47
1959-60
o7, 72
66. 69
63, 44
r
Berlin
1947
50.96
59,97
F
West Berlin
1949-51
63.70
68. 39
Hungary
1941
1958
54,92
65.14
58.22
69. 36
E
Iceland
1931-40
1941-50
60,9
66.1
65.6
70,3
E
Ireland
1940-42
1950-52
59.01
64,53
61. 02
r
Italy
1950-53
1954-57
63.75
65.75
67.25
70, 02
rf
r
r
fr
1955-58
BOTH
71.94
67.08
40.
COUNTRY
YEAR
Luxembourg
1946-48
61. 69
65, 75
Malta and Gozo
1946-48
1957-59
09. 69
66.34
ot, 12
70, 29
Netherlands
1953-1955
65.5
71.0
67.2
73.9
Norway
1932-41
1951-55
64. 08
71.11
67.55
74. 70
Poland
1948
1958
00.6
62.8
62.5
68.9
Portugal
1939-42
1957-58
48,58
09. 8
02, 82
65.0
Spain
1940
1950
47.12
08. 76
03. 24
63. 50
Sweden
1931-40
1959
63.76
71.69
66.13
75,24
Switzerland
1931-41
1948-53
60. 93
66. 36
64, 84
70. 85
1948
1960
66, 39
68.3
71.15
74.1
Northern Ireland
1950-52
1958-60
65.5
67.51
68. 8
71.94
Scotland
1948
1960
63.76
66. 41
67. 63
71.90
1952-54
06, 92
09, 33
Australia
1946-48
1953-55
66. 07
67.14
70. 63
72.75
New
1950-52
1955-57
67.19
68, 20
71.29
73.00
1954-55
1958-59
61
64
67
72
United Kingdom
England & Wales
Yugoslavia
EXPECTATION OF LIFE
MALE
FEMALE
IN YEARS
BOTH
OCEANIA
Zealand
USSR
Source:
1961 Demographic
Yearbook,
United Nations,
New York.
4]
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