WHO in action

28 WHO in action New drug against schistosomiasis United Republic of Tanzania: In Pemba, one of the islands of Zanzibar off the east coast of Africa, one out of every five schoolchildren used to have red urine from bleeding in the bladder. Tests with a chemical reagent, developed in collaboration with WHO and other scientific organizations, helped to detect blood in more than half of these cases. The bleeding was due to schistosomiasis, or bilharzia, a parasitic disease caused by a flatworm, which enters the body through skin contact with contami- nated freshwater in rivers and ponds - for example, when bathing or fishing - and causes infection in the intestines and in the bladder. Some 15 years ago, the treatment for schistosomiasis was considered worse than the disease. Now, thanks to collaboration between the pharma- ceutical industry and WHO, an effective drug - praziquantel - is available. Used on a large scale by the schoolchildren in Pemba, it dramati- cally reduced the signs of the disease, without any serious side-effects. Unfortunately, praziquantel is expensive: up to US$ 1.00 to treat one patient. For Kenya, Malawi, Nigeria and Zambia, which together have more than 30 million infected people, treatment on a large scale would not be possible. It would cost as much as their total health budgets for a year! They have therefore requested WHO to negotiate a reduction in the price of Collection of urine samples will help to detect schistosomiasis. World Heolth • July-August 1992 the drug with the manufacturers. · UNICEF has joined WHO in these negotiations. Unless they succeed, the good results of the Pemba project cannot be repeated elsewhere. Schistosomiasis in East Africa is called "kichocho" in Swahili. This is also the title of a videotape produced by WHO with the German Pharma Health Fund and the Italian govern- ment on the programme in Pemba. A global information resource on drugs Over 20 000 drug-related documents and publications (more than 80 a day) are sent each year by WHO's Action Programme on Essential Drugs to World Heolth • July-August 1992 people in countries all over the world. Because of limited funds among health professionals in developing countries, the Action Programme may be the only possible source of techni- cal information for many of them. One young hospital pharmacist wrote recently from Ho Chi Minh City, Vi et Nam, "I seriously lack new informa- tion on pharmaceuticals. I'm very poor ... so I can't afford the new books. I need your help ... " The Action Programme's Documentation Centre, which contains a unique global collection of material related to essential drugs, also meets the needs of researchers, health professionals, educators and other development agencies. The centre · contains, for example, essential drug lists and therapeutic guides from over 100 countries. The Essential Drugs Monitor is the cornerstone of information activities. Through the Monitor, published in English, French and Spanish, and available free of charge, some 200 000 health professionals, educators, policy-makers, journalists and activists throughout the world regularly learn of new developments in drug policies, programmes, research and training. All these information activities are part of the Action Programme's commitment to sharing ideas and knowledge, particularly in parts of the world with limited access to technical information. Can we drink this water? Undoubtedly, one of WHO's "best sellers" has been the WHO Guidelines for Drinking-Water Quality. The last revision was published in 1984, and was in three volumes: Volume One, Recommendations; Volume Two, Health criteria and other supporting information; and Volume Three, Drinking-water quality control in small-community supplies. Those of us who simply wish to know "can we drink this water?" can go straight to Volume One, whereas those who need to know (and are capable of under- Two. Volume Three is only applica- ble, as the title suggests, to rural areas. The publication has been widely used by many countries to set their own national standards, confident that the guideline values set are based on sound toxicological evidence. Now that new toxicological data, and even new "pollutants", are on the scene, the Guidelines are being revised. WHO will host a big meeting this September with participants from about 32 countries and some 40 experts to review the draft of the revision. Will the new version also be a "best seller"? We think so! • standing) "why" can refer to Volume Water flows· it is safe, it means health. 29