Task force for the urgent response to the epidemics of sexually transmitted diseases in eastern Europe and central Asia

In summary, members of the TF/STD: share the common goal of reducing the STD burden and slowing the spread of HIV in the most affected and vulnerable countries in eastern Europe and central Asia. Contribute financially, technically or in-kind to the implementation of a joint strategy which aims: -- to create an enabling environment for STD prevention and control, and -- to strengthen the local capacity for STD prevention and care; engage in a continuous exchange of information, collaborative partnerships and coordination of activities at regional as well as country level through the TF/STD and in-country interagency working groups, respectively; concur with the priority areas for international support consisting of advocacy and policy, STD drugs, condoms, educational materials, training, applied research and surveillance; meet twice a year to review implementation progress and the need for additional assistance; as advocates of TF/STD, call on partners and other organizations to join in this important new initiative.

Strategies for safe injections

In 1998, faced with growing international concern, WHO set out an approach for achieving injection safety that encompassed all elements from patients' expectations and doctors' prescribing habits to waste disposal. This article follows that lead and describes the implications of the approach for two injection technologies: sterilizable and disposable. It argues that focusing on any single technology diverts attention from the more fundamental need for health services to develop their own comprehensive strategies for safe injections. National health authorities will only be able to ensure that injections are administered safely if they take an approach that encompasses the whole system, and choose injection technologies that fit their circumstances.

Reliability of clinical diagnosis in identifying infectious trachoma in a low-prevalence area of Nepal

The WHO Alliance for Global Elimination of Trachoma by 2020 has increased the need to identify ocular chlamydial infections by clinical examination in areas of both high and low prevalence. The relationship between clinically active trachoma (as defined by clinical examination) and chlamydial infection is known for areas with hyperendemic trachoma, but not for areas with a low prevalence of the clinical disease. In the present study, we examined, photographed, and DNA tested the conjunctivae of children in the Surkhet district of mid-western Nepal, an area known to have a low prevalence of clinically active trachoma. Although 6% of the children aged 10 years and under were found to have clinically active trachoma, none were found to have chlamydia infection by the most sensitive DNA amplification tests available. A very low prevalence of clinically active trachoma is not necessarily evidence of the presence of chlamydial infection. Therefore, the WHO policy of not recommending an intensive trachoma control effort when the prevalence of clinically active trachoma is less than 10% in children is appropriate for this area of Nepal.

Safety and efficacy of fertility-regulating methods: a decade of research

An international venture was launched in 1985 to fill a recognized gap in post-marketing surveillance of fertility-regulating methods. For this purpose a new task force was set up by the Special Programme of Research, Development, and Research Training in Human Reproduction, which is cosponsored by the United Nations Development Programme, the United Nations Population Fund, the World Bank, and WHO. Research priorities were chosen and epidemiological studies inaugurated, involving a total of 47 countries--mostly from the developing world. Important progress has been made, especially in helping to define the beneficial and possible adverse effects of oral contraceptives on the risk of neoplasia; in showing that the injectable contraceptive depot-medroxyprogesterone acetate protects against endometrial cancer and does not increase the overall risk of breast cancer, in clarifying which groups of women are susceptible to the rare cardiovascular complications of oral contraceptives (myocardial infarction, stroke, and venous thromboembolism); and in establishing the long-term effectiveness and safety of intrauterine devices. The research has already made a significant impact on family planning policies and practice. Critical appraisal of this venture, which has been modestly funded, confirms the value of mission-oriented research. It also illustrates the potential of collaboration that bridges the global divide between developing and developed countries.

Light on population health status

A new approach to illustrating and analysing health status is presented which allows comparisons of various aspects of health in a population at different times and in different populations during given periods. Both quantitative and qualitative elements can be represented, the impact of interventions can be monitored, and the extent to which objectives are achieved can be assessed. The practical application of the approach is demonstrated with reference to the health profiles to Tunisia in 1966 and 1994.