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Epi Wit & Wisdom Articles
WHO Report Makes Recommendations
For Greater Use of Epi in Support of “Health For All”
Proposals Stalled by Lack of
Funds
A World Health Organization
expert group has issued recommendations to promote greater use of
epidemiology in support of public health strategies to achieve “Health
for All” by the year 2000. Described as a “good step forward” by WHO’s
Richard Morrow, the proposals are not yet being implemented because of
a lack of funds.
Resolution
In a resolution promoted by
former WHO Director Mahler, the World Health Assembly in May 1988
adopted a resolution urging member states to make greater use of
epidemiology in support of “Health for All” strategies and requested
the Director of WHO to convene an expert group to help define the
desired nature and scope of epidemiology for this purpose.
Expert Group
An expert group consisting of 20
epidemiologists from around the world met in Geneva at the end of 1988
along with more than a dozen WHO staff members. The group issued a
nine page report containing recommendations stressing the need to
enhance epidemiologic capacities, the need to make greater use of
epidemiologic data for program purposes, and the need to improve
training in epidemiology at different levels of the health care
system.
No Funds
The responsibility for
implementing these recommendations has been given to the Division of
Epidemiological Surveillance and Health Situation and Trend Assessment
headed by Dr. R. Hapsara. According to Jack Woodall, a member of this
Division, initial commitments to fund a program have fallen through
and his organization is “desperately looking” for funds to launch a
program based on the report which he labeled “a milestone for WHO.”
Even without funding, the report
has stimulated some interest. For example, an issue of WHO’s World
Health magazine has been devoted to epidemiology, and a discussion of
epidemiology and “Health for All” is on the agenda for the upcoming
meeting of the South East Asian Regional Office of WHO in late
September. The group will issue its own report and determine what it
can do to promote epidemiology in that region, according to Woodall.
Recommendations
The expert group which met in
Geneva made several recommendations. Briefly, these were:
1) That a more active use of
epidemiology be promoted in WHO and in the member states at all levels
2) That WHO support country
activities which enhance epidemiologic capacity (e.g., training and
research)
3) That WHO support member
states a) in using epidemiological research to identify health needs
and to design programs, b) in encouraging researchers to take part in
problem-solving research, c) in developing epidemiological research to
evaluate program progress, and d) in developing the capacity to
conduct epidemiological research, interpret and disseminate its
results, and promote the use of the results for health system
management
4) That WHO and member states
identify the epidemiologic skills needed at all levels of the health
establishments and that training programs be inventoried.
5) That WHO consider
establishing an advisory body to monitor progress in implementing
these recommendations.
Essential Epidemiology
A unique component of the
group’s nine page report is its definition of what epidemiologic
capacities are essential for each country to achieve the goals of
“Health for All.” While not all inclusive, these capacities constitute
the “essential epidemiology” needed for a country to independently
manage its health problems, according to the report. As such, these
capacities constitute a kind of “epidemiologic standard” against which
countries can assess the adequacy of their epidemiologic activities.
These basic capacities according to WHO include:
1) The capacity to measure the
health status of the population (i.e. the age-, sex- and cause-
specific morbidity, mortality and disability by geographic area and by
socio-economic characteristics)
2) The capacity to measure the
prevalence of exposure to risk factors of local importance.
3) The capacity to measure key
operational variables which describe the functioning and utilization
of the health services
4) The capacity to measure the
impact of interventions
5) The capacity to analyze and
interpret information of the types described above and to communicate
it to policy makers and planners in a manner that is timely and useful
Participants
Members of the expert group
included J. Balthazar (Philippines), R. Borges (Venezuela), C.
Sitthi-Amorn (Thailand), W. Dab (France), A. M. Davies (Israel), R.
Detels (USA), R. G. Feachem (United Kingdom), L. Gordis (USA), T.
Guirgis (Egypt), S. Hatano (Japan), F. Hatton (France), W. Holland
(United Kingdom), S. Loureiro (Brazil), S. Music (USA), E. Najera
(Spain), W. Osei (Ghana), C. Oveiide (Nigeria), S. Radhakrishna
(India), K. Zhang (People’s Republic of China), G. Zhukovski (USSR).
Published September 1989 v
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