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Rewarded for his services to international public health by a commemorative medal dur- ing the 38th session of the WHO Regional Committee for Africa. this distinguished pioneer offered his impres - sions on the state of Africa and on the progress that WHO has achieved there during its 40 years of existence. "More and more people from the Third World today participate actively in the effi - cient running of the Organi- zation." he commented. "But the governments of the developing countries must make hea lth a major priority. so that their populations can live better and longer lives. and can contribute to devel - opment and peace in the world." Whi le Professor Togba appeared confident that WHO. one day. w ill manage to eradicate malaria as it did sma ll pox. he declared himself very worried about A ID S. "We have got rid of sma ll pox. we are trying to eliminate the other infectious diseases. and sudden ly there appears something we know nothing about" he said. and added " I am sure that when we have vanquished AIDS something else wi ll come up." Asked about any direct link between AIDS and promiscuity. the dean of all the African members of the WH 0 Executive Board pro- posed a new way of looking at things " I think that Afri- cans can avo id the practice of promiscuity because our ancestors did not practise it I think that polygamy as it was practised by our forefathers had its justification in that it prevented th em from changing partners indiscrimi- nately. outside the sma ll group of 'housewives· This is how it happens st ill among rura l popu lations and I do not think that A IDS is so wide- spread outs ide the urban regions. This is why I do not believe that AIDS orig inated in Africa The typical African does not traditiona lly practise promiscuity. He has several w ives. certain ly. and he goes from one to the other. but always within this little group that he knows well. " Grave though it may be. AIDS is on ly one problem among many that affect the African continent "I hope." Professor Togba concluded. "that health wi ll occupy a more and more preponderant place among the priorities of the African governments south of the Sahara. Through better health. we shall have better education. greater economic progress and increased productivity If a population is in good health. it wi ll be in a better position to work for the real develop- ment of the country. I shou ld like my own people to under- stand this very clearly." • Or Monekosso, WHO Regional Director for Africa, presents a commemorative medal to Professor J. N . Togba of Liberia. 30 No need to die in giving life. Mother and child are doing wel l ... A banal phrase in the developed countries. where it is rare for someth ing to go so badly wrong during a confinement that the mother loses her life. This is much less true in the Third World. especially in Africa. Every time a woman in Africa becomes pregnant she runs a risk of dying as a result which is over 100 times greater than for a woman in the industria lised world . South of the Sahara. an estimated 1 50.000 women die every year from the effects of pregnancy. In order to try to stop this waste of life. public health off icials. midwives. doctors and representatives of non- governmenta l organizations from 22 French-speaking African countries met recently in Niamey. cap ital of Niger. at a major conference on safe motherhood. Even though the sca le of the problem became clear on ly recently. as a result of ep idemiologica l stud ies. African governments decided to act rapidly to reduce maternal mortality. Apart from such specific causes as excessive blood loss. difficult confinements. infections and other complications. certain additiona l factors make the situation even worse - malnutrition. anaemia. malaria or simply overwork. Many Afr ican women toil from 1 2 to 14 hours a day But the heavy price that African women pay for maternity is not inevitable. Efficient cheap methods exist to put a stop to this si lent tragedy The most important are family planning. pre- and post-natal care. supervision of the confinement and recourse to well - equipped and well-staffed primary health care centres. As Dr Gottlieb Monekosso. WHO Regional Director for Africa. told the N iamey con feren ce: "Safe motherhood requires the setting up of adequate and efficient services at all levels. and both geographic and financial access to these services. In order to ach ieve this. there must be a considerable mobilisation of resources. and this can on ly be provided by a real national commitment and the impetus of international solidarity in an understanding partnership .. WHO. UNICEF. UNDP and the World Bank financed the conference whose aim was to ass ist countries to draw up their respective national plans of action. The government of N iger hosted the con ference. and the flags displayed in Niamey asserted "Motherhood if I want it and when I want it" Th is speaks volumes about the growi ng awareness aroused in that country. as in others. about the need to plan and space births fo r the sake of the health of both mother and ch ild • WOR LD HEALTH, April 1989 Health at Sea What should be done if d isease or injury occurs in a ship at sea? From now on. all seafarers wi ll be able to con- su lt the second ed ition of the International Medical Guide for Ships published by WHO . This Guide pro- vides com plete informat ion and advice of special value to seafa rers. even if they have had no medical training. on w hat to do in case a hea lth problem arises on board This new ed iti on has been com pl ete ly revised and updated in th e l ight of scienti fic progress and devel- opments in seafaring. The numerous illustrations enable users to find immed iately the advice they may need on how to manage a given eme rg ency Other new features include chapters on preg nancy and gynaecolog i- ca l problems. on medical care of castaways and rescued persons. and on how to obta in externa l assistance in case of serious health prob- lems at sea. lt also includes informat ion on d iseases occu rring in fi shermen. Some 60 diseases and medical problems have been selected and listed in alpha - betical order The new edi- tion also features medica l advice for sh ips carry ing toxic chemica ls. including first-aid treatment of po ison ing. and a completely updated list of medicines and su rgica l supplies for the ship's medi - cine chest INTERNATIONAL MEDICAL GUIDE FOR SHIPS Thi s 368 -page Guide with its 152 illustrations an d 14 tables is cu rrentl y avai lable in English . French and Spanish edit ions are in preparation and shou ld be ava il able dur- ing the second half of 1989 . The Guide may be obtained from Distribution and Sa les. WHO. Geneva. Switzerland. for 60 Swiss francs or US$ 48 (Order No. 1152078) • WORLD HEALTH, April 1989 Nevvsbriefs AIDS- the scientific and social challenge. This is the theme of the Fifth International Conference on AIDS. to be held in Montreal. Canada in June. Sponsored bv WHO. the Canadian In ternational Development Research Centre and the Canadian Ministrv of National Health and Welfare. this conference will be attended bv specialists from all over the world Thev will tackle such aspects as AIDS and the individual. AIDS. societv and behaviour. ethics and the law. and the international implications and economic repercuss- ions of the disease The epidemiological. clinical and basic research aspects will also be reviewed in detail. For further information. contact the conference secretariat. Kenness Canad. Inc. 1010 ouest. rue Ste-Catherine. Suite 628. Montreal. Quebec. Canada. H3B 1 G7 Telephone. (5 14) 874- 1532 Sports and AIDS. The first -ever consultation on AIDS and sport. organized recentlv in Geneva bv WHO and the International Federation of Sports Medicine (IFSM) . con - cluded that the risk of transmitting the AIDS virus during even violent sporting activities is extremelv low In the presence of members of the Medical Commission of the International Olvmpic Committee (IOC) and of several sporting federations. Or Jonathan Mann. Director of WHO's Global Programme on AIDS. stressed that these conclusions "should go far towards putting to rest concerns on this issue in the sporting world" So as to avoid anv direct contact between two bleeding wounds. it was recommended that injured sportsmen's partiCipation should stop until the bleeding ceases and their wounds have been cleansed with an antiseptic and carefullv dressed legionnaires' disease. During the 83rd session of the WHO Executive Board. Or Hiroshi Nakajima. Director- General. announced that he would convene a meeting of experts on legionellosis this vear to discuss the epidemiologv and biologv of this respiratorv tract disease. Appearing mvsteriouslv in 1976. it is now known to be caused bv a bacterium called Leg/one/la pneumophilia The source of infection is usuallv in air-conditioning and air-circulating svstems in the interior of buildings. Because of the importance of the problems caused bv legionellosis. WHO is alreadv assisting its member states in the fields of vocational training and diagnosis. and this effort will be continued and increased in the future. Personalities. Mr Edward Uhde (United States) has been appointed Director of WHO 's Division of Budget and Finance to succeed Mr Adriano lmbruglia (ltalv) who has retired Mr Uhde first joined WHO 20 vears ago. and worked successivelv in the Regional Office for Africa in Brazzaville and that of the Western Pacific in Manila Former D.-G . Or Halfdan Mahler. Director-General Emeritus of WHO. has been appointed Secretarv-General of the International Planned Parenthood Federation (IPPF). a non-governmental organization which is based in London and maintains official relations with WHO He succeeds Mr Bradman Weerakoon of Sri Lanka. who had held that post since 1984 The poem bv Prima Levi appearing on page 25 is quoted bv kind permission of Andre Deutsch Ltd. London. In the next issue Particularly in those parts of developing count ries that are far removed from the ca pital city, the District Level Health System is the foca l po int for such hea lth services as exist The May issue of World Health exam in es the role and the funct ions of th is cruc ial sector of the infrast ru ctu re. and the ways in wh ich it operates in diffe rent cou ntries. 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