Professional Documents
Culture Documents
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A basic policy question is, How will
global goals and local priorities be balanced, and what are the ethical implications of current choices? The specific
underlying questions are as follows:
Should poor countries, with many health
problems that could be controlled, divert
their limited resources for a global goal
that has low priority for their own
children? When wild virus remains only
in a few sites, will rich countries, and the
global organizations they influence, promote eradication as a single-focus activity? Should poor countries expect donors
to improve upon past experience and use
the opportunity and financial benefits
from polio eradication to build sustainable
health systems for the world's neediest
children?
Who Will
:925).
Polio Eradication?
Progress
established health
already
have well-
infrastructures.2-'
Now
long they
costs
the
annually,
about 76%
United
which is
States
polio
$230
equivalent
to
of USAID contributions to
ties.23
However, a common negative effect
in the poorer countries was that targeting
of immunization programs caused diversion of resources and effort at "the
expense of other health activities." NegaAmerican Journal of Public Health 923
References
1. World Health Assembly. Global Eradication of Poliomvelitis by the Year 2000.
Geneva, Switzerland: World Health Organization; 1988. Resolution WHA 41.28.
2. De Quadros CA. Strategies for disease
control/eradication in the Americas. In:
Cutts FT, Smith PG, eds. Vaccintationi anid
World Health. Chichester, England: John
Wiley & Sons Inc; 1994:17-34.
3. Hull HF, Ward NA, Hull BP, Milstien JB,
de Quadros C. Paralytic poliomyelitis:
seasoned strategies, disappearing disease.
Lanicet. 1994;343: 1331-1337.
4. Progress toward global poliomyelitis eradication. MMWR Morb Mortal Wklv Rep.
1995;44:273-28 1.
5. Report of the 1st Meetinig of the Global
Commissioni for the Certification of the
Eradication of Poliomyelitis. Geneva. Switzerland: World Health Organization; 1995.
WHO/EPI/GEN/95.6.
6. Pub L 104-107, 110 Stat 706 (1996).
7. Sutter RW, Onorato IM, Patriarca PA.
Current poliomyelitis immunization policy
in the United States. Pediatr Anni. 1995;19:
702-706.
8. Bart KJ, Foulds J, Patriarca P. Global
eradication of poliomyelitis: benefit-cost
analysis. Bull World Health Organi. 1996;
74:35-45.
9. Murray CJL, Lopez AD. Quantifying
disability: data, methods and results. In:
Murray CJL, Lopez AD, eds. Global
Comparative Assessments in the Health
Sector Disease Burden, E.peniditiures anid
Intenrention Packages. Geneva, Switzerland: World Health Organization; 1994:5598.
10. World Bank. World Development Report
1993: Investing in Health. Oxford, England: Oxford University Press Inc; 1993.
11. Taylor ME, LaForce FM, Basu RN, Cutts
F, Ndumbe P, Steinglass R. Sustainabilitof Achievements: Lessons Leanied from
Universal Child Immuni,1ization-Report of
a Steerinig Conmittee. New York, NY:
United Nations Children's Fund; 1996.
12. Expanded Programme on Immunization.
Vaccinie Suppl!y The First Line of Defense.
Geneva, Switzerland: World Health Organization: 1993.
13. Health Strategy for UNICEF New York,
NY: United Nations Children's Fund;
1995.
14. Bridginig the Gaps. Geneva, Switzerland:
World Health Organization; 1995.
15. Cruz RR. Cuba: mass polio vaccination
program. 1962-1982. Rev, itnfec t Dis. 1984;
6:S408-S412.
16. Jamison DT, Torres AM, Chen LC, Melnick JL. Poliomyelitis: what are the prospects for eradication and rehabilitation?
Healtht Policy Planiii. 1991 ;6: 107-118.
17. Brenzel L. The Cost of EPI: Lessonis
Learnedfrom Cost anid Cost-Effectiveness
Stludies of Immiiiiuiziationi Programs.
REACH project paper 1990 (unpublished
document, Basics Project, Suite 300, 1600
Wilson Blvd, Alexandria, VA 22209).
18. Evans I. SAPping maternal health. LaIzcet.
1995;346: 1046.
19. Abel Smith B. The world economic crisis.
part I: repercussions on health. Health
Policy Plann1. 1986; 1 :202-213.
20. Greenough P. Intimidation, coercion and
Erratum
In: Rasmussen KM, Adams B. Annotation: cigarette smoking, nutrition, and birthweight. Am J Public Health.
1997;87:543-544.
The name of the second author, Barbara Abrams, was incorrectly printed as Barbara Adams.