WORLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANTE
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL
REGIONAL COMMITTEE
TECHNICAL DISCUSSIONS WP ;RClOIrn6 15 September 1959 ORIGINAL: ENGLISH
Tenth Session Taipei 16-22 September 1959
TOPIC I ffiEVENTION, INCLUDING HEALTH EDUCATION, BCG VACCINATION AND THE EANAGEMENT OF THE CHRONIC C:'I.SE Reference papers: a. b. Working Paper - WP ,/RClOjrDl, Section 2 Resource Paper - i~eview of BCG Vaccination Programmes, EB24/5, dated 1 May 1958 Suggested Points far Discussion 1 Health education of the public
1.1 Where a community has been accustomed to tuberculous illness over a long period of time and there are traditional attitudes, l-That is the relative value of posters, pamphlets, film strips, etc.? 1.2 What other means are there to communicate with the community which are available to us? Is didactic instruction effective, or is it necessary to use demonstrations of the efficacy of modern methods? 1.3 Through i"Thom should i"Je try to promote health education? Should the professional health educators l-J'ork on school teachers, community leaders, professional groups, or the general public? 1.4 Are "demonstration centres" or "pilot areas" effective in promoting public awareness, or should this approach be modifjed? 2 BCG vaccination
2.1 If it is accepted that ECG vaccination, correctly applied, gives a high level of protection against tuberculous disease, under what circumstances should it be applied? /2..2 As two •••
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page 2 2.2 As two elements are important in a BOG campaign, viz., the correct selection of persons for vaccination and the use of potert, vaccines, shoulc' a standard tuberculin test be applied in all countries? v-lhat criteria for selection should be applied and how are these to be determined?
2.3 As a potent vaccine is recessary, vlho is to c'etermine whether a particular vaccine is satisfactory? Do the administrative conveniences of a freeze dried vaccine vrarrant its use, despite some reservations? 2.4 How should a mass campaign be organized and conducted? Should there be special teams? Should there be a preliminary pilot project? Should vaccination be ke pt in the hands of specially trained :r:ersons? Need these people be of professional level?
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Management of the chronic case If so, how is it to be applied
3.1 Is segregation essential for such cases? and who will find necessary funds?
3.2 Can effective segregation be obtained vrithout special institutions? 3.3 Is it justifiable to attempt to enforce segregation against public opposition, at considerable cost, and 1ITi th its consequent problems?
3.4 Can the use
of combined drugs, in various combinations, be continued indefinitely with any hope of reducing infectivity? If so, who is to provide the costs?
3.5 Is it justifiable deliberately to attempt to provoke the appearance of INH resistant organisms? If so, under what circumstances? Is this approach by an attempt to produce bacterial changes rather than physical segregation sound public health practice?