Rest of world ready to follow this hemisphere's approach to eliminating polio in near future

Article Abstract:

One of the goals of the World Health Organization (WHO) is to eliminate polio from the world by the year 2000; it is possible that the last case in the Western hemisphere has already been identified. Ciro de Quadros, an official of the Pan American Health Organization (PAHO), the WHO agency that runs the vaccination program, has high hopes for its success. In fact, it has been so effective in the Americas that PAHO's program is now to serve as a model for the worldwide eradication program. An estimated 185,000 cases of polio occurred throughout the world in 1990. Between 1985 and 1990, however, the number of reported cases of polio climbed in Central and South America, while the number of confirmed cases dropped (from 1,100 to 10 in the latter year). This reflects better health care awareness of the disease, better reporting systems, and better prevention. In 1978, only 36 percent of children younger than one year old were vaccinated against polio; by 1989, however, this number had grown to 86 percent. PAHO's efforts were aided by businesspeople, particularly those in Rotary clubs, who organized vaccination drives, and by volunteers who carried out the vaccinations. A fee was paid to anyone who reported a confirmed case of polio. Other efforts are described. Mop-up operations begin when a case of flaccid paralysis (a kind of paralysis that can be polio) is reported; workers immediately vaccinated every child under the age of five in the neighboring area. Details of the few cases in specific countries are presented. Before this part of the world can be considered polio-free, virus must be undetected for three years. This is expected to occur by early 1994, according to de Quadros. New surveillance methods will be able to detect remarkably small levels of polio virus in sewage (as little as one viral particle in a sample). The agencies that have contributed funds to help eradicate polio in the Americas are listed. The cost per child for vaccination is 10 cents. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Children, Poliomyelitis, Central America, Vaccination of children, Vaccination, South America, World Health Organization, Poliovirus vaccines

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New guidelines expected in 1991 for relationship of continuing education, financial support

Article Abstract:

Continuing medical education (CME) programs benefit from billions of dollars contributed by pharmaceutical companies, but these elaborate expenditures may compromise the autonomy and quality of the CME programs. A two-day working conference was sponsored by the American Medical Association and other professional groups to bring together CME providers and the pharmaceutical industry. The purpose of the meeting was to reach an agreement on guidelines for an ethical relationship between the two groups. The generous support for physician training provided by pharmaceutical companies has in some cases included lavish indulgence in frequent flyer programs and trips to exotic locales. Questions have been raised regarding the ability of physicians to benefit optimally from CME programs in an atmosphere of intense marketing. A Senate committee chaired by Edward Kennedy may attempt to impose federal regulations on the relationship between CME programs and the pharmaceutical industry. Physician groups that have issued position papers on the topic are listed. The Pharmaceutical Manufacturers Association has endorsed several position statements of the American College of Physicians, but many feel the statements are too vague. Issues covered have included: the fee 'big name' medical professors are allowed to charge when they speak at CME programs; who should pay for physicians' travel to the programs; and how to engender an atmosphere of trust and respect between CME providers and the industry. Participants acknowledged a sense of urgency, and the action plan they generated places responsibility for enforcing the new standards with the accreditation system and those involved with it. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Ethical aspects, Continuing education, Medical ethics, Graduate medical education, Postgraduate medical education, Pharmaceutical ethics

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CDC minority health office: 'social epidemiology'

Article Abstract:

The CDC (Centers for Disease Control) has recently created an Office of Assistant Director for Minority Health, indicating its move into the realm of 'social epidemiology'. The goal of this office is improvement of health for African-Americans, Hispanic-Americans, Native Americans, and Asian-Americans, and non-US citizens of similar ethnic origin, such as migrant farm workers. Blacks have considerably higher mortality than whites: overall, rates for blacks exceed those for whites by 149 percent for the 35 to 44 age range, and by 97 percent for the 45 to 54 age range. Much of this difference is accounted for by lower income and six well-known risk factors (smoking, obesity, diabetes, excessive alcohol consumption, high blood pressure, and high blood cholesterol). The remaining one-third of the difference is unaccounted for, but possible explanations include unequal access to health care. Infant mortality rates, too, are higher for blacks, even when women studied are of equivalent educational levels. Another focus of the new CDC office is graduates of black health professional schools. Results of this study should be illuminating, because, after attending these schools, most black health care workers function in the black community. Hispanic physicians will be studied in a similar manner. An evaluation of the Head Start program is planned by studying children and their mothers 10 to 15 years after they participated in Head Start. The overall goal of this office is to 'depoliticize minority health'. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Reports, Medical care, Demographic aspects, Information services, Minorities, United States. Centers for Disease Control and Prevention, Minorities in medicine

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