Correction: Due to a printing er- ror, the figure for WHO's 1988-89 biennial budget appeared on page 30 of our November issue as US $33,980,000. This should have read US $633,980,000. We apologise to readers for this mistake. Public Outcry Led to Success Against Smoking Four countries which had scored successes against smoking by the mid-1980s- particularly in decreasing the number of male smokers- owe their achievements, in large part, to the initiative of ordinary citizens. Thei r outcry against tobacco-related dis- eases, combined with a spirit- ed public debate in the mass media, spurred governments on to act. The call to action occurred in the 1960s and 1970s, accord- ing to stories of anti-tobacco campaigns from Finland, Nor- way, Sweden and the United Kingdom told in "Successes Against Smoking," a 20-page booklet released by WHO for the 6th International Conference on Smoking or Health, held from 9-11 November 1987 in Tokyo. Here is a chronology of developments. Finland: In 1971, Finns peti- tioned their government to act following studies that showed them w ith the highest male mortality rates in the world from coronary heart disease. In 1976 the government launched a country-wide information and education programme under the National Bureau of Health, and Parliament passed the Finnish Tobacco Act. The result : by the early 1980s, the number of male smokers in North Karelia, the county w ith highest mortality, had decreased by 14 per cent - from 52 per cent in 1972 to 38 per cent in 1982. Norway: In 1967, a commit- tee set up by Norway's health ministry drew up a report, " In- fluencing Smoking Behaviour," proposing a national anti-tobac- co programme. This followed public outcry that resulted from front-page press coverage of the report on smoking and health by the U.S. Surgeon General in 1964 linking smok- ing to disease. In 1970, the Norwegian par- liament established a National Council on Smoking and Health, charging it w ith the task of carrying out " govern- ment measures against the harmful effects of tobacco." In 1975 it passed the Act on Re- strictive Measures for Market- ing of Tobacco Products. The result: by the early 1980s the number of male 30 The Villager's Voice: Prevent Tooth aches ! Even though no community is free from tooth decay or gum diseases, most health planners do not usually place oral health care high on a list of priorities. But when people liv- ing in small rural communities are asked, accord ing to WHO ex- perts, they invariably rank oral health care amongst their top problems. lt is easy to under- stand why - a toothache hurts, and pain is immediate. As a consequence of increa- sed sugar consumption, and a lack of preventive program- mes, more people in the devel- oping world than in the indus- trialised world suffer from Photo: WHO/Peter Ozorio toothaches today. "A toothache hurts, and The answer to decayed, pain is immediate." loose or missing teeth does not lie in training more and more dentists - it's too costly, and it takes too long. lt is rather through prevention by teams of ora l health workers led by a dentist. In courses lasting up to two weeks, Thailand is training personnel, called oral health examiners, to recogn ise a range of dental il ls; educators, to teach concepts of oral hygiene (for instance, " Clean your mouth daily," "Use sugar intelli- gently - limit sweets between meals"); and scalers, to re- move tartar from teeth. This preventive model project could serve as an example for other developing countries, where diseases of lifestyles are already emerging as problems. A major advantage of good ora l hygiene, wHo experts point out, is that it heightens awareness of the need for overall healthy lifestyles. ...... ....... ... ... ... ...... ...... ..... . .......... . ••••••• ••••••• ••• ••• ••• ••••••• • ••••••••••••••••••••••••••• ••••••• ••••••• ••• ••• ••• ••••••• • ••••••••••••••••••••••••••• ••• ••• ••• ••• ••• ••• ••• • •••••••••••••••••••• ... ... ....... ... ... ... ...... ....... ... ... ... . ..... . ... ... ....... ... ... ... ....... . ......................... . ••• ••• ••••••• ••• ••• ••• •••••• • •••••••••••••••••••••••••• ••• ••• ••• ••• ••• ••• ••• ••• • ••••••••••••••• ••• ••• ••••••• ••••••••••• ••••••• ••• • •••••••••••••••••••• ••• ••• ••••••• ••••••••••• ••••••• ••• • ••••••••••••••••••• ••• ••• ••••••• •••••••••• •••••• ••• • ••••••••••••••••• smokers had decreased by 13 per cent - from 53 per cent in 1974 to 40 per cent in 1982. In addition the numbers of teen- age smokers had also declined -for boys from 40 per cent to 26 per cent, and for girls from 41 per cent to 22 per cent. Sweden: In 1963, respond- ing to a call by 25 scientists for a tobacco campaign, Sweden established the National Smok- ing and Health Association to serve in an advisory capacity to its National Bureau of Health and Welfare. The results: by the mid- 1980s, the number of male and female smokers between 1970 and 1984 had dropped to 30 per cent - in the case of males from 50 per cent, and of fe- males from 33 per cent. In addition, the number of 13- year-old smokers had sharply declined-for boys from 40 per cent to 5 per cent, and for girls from 16 per cent to 6 per cent. United Kingdom: In 1962 and 1971 the Roya l College of Physicians published reports on "Smoking and Health" that led to the founding of Action on Health, a citizens' group dedi- cated to ra llying voluntary ac- tion against smoking. In response the government established in 1986 what is re- nam ed now the Health Educa- tion Authority, and later the Scottish Health Education Group, to advise its Depart- ment of Health and Socia l Se- curity on campaigns against what was described as the leading avoidable cause of death in the United Kingdom. The result: by the early 1980s, the number of male smokers had declined by 27 per cent - from a high of 65 per cent in the late 1940s to 38 per cent in 1982 . And the number of female smokers dropped from 41 per cent to 8 per cent over that period. • A Study to Show How to " Keep Arteries Clean " A five-year study to deter- mine,how atheroscleros is-the narrowing of arteries-is condi- tioned upon lifestyles is now under way in 27 countries, five in Africa, seven in As ia ten in Europe and five in Latin America . The study is being carried out by WHO and the Inter- national Society and Federation of Card iology. Called the Study of pathobiological determinants of atherosclerosis in youth (PBDAY), its aim is to prevent disorders of the heart or blood. "The child is father of the man," WHO officials say. "it's little use starting at age 45. We need to say to the young : Keep your arteries clean." Earlier stud ies, of so ldiers in war, had shown individuals in the prime of life already aff li cted with signs of athero- sclerosis. Thus researchers plan to examine the structural changes in arteries of those be- tween ages 5 and 34 w ho die from other than cardiovascular diseases. Among the most common cardiovascu lar diseases is atherosclerosis, arteries so clogged by a build-up of fatty deposits that the flow of blood through them is impeded. Heart diseases result, or heart attacks ensue. The principal factors associ- ated w ith an increased risk of heart disease are a high-fat diet, a lack of exercise, and smoking - in short, unhealthy lifestyles . The habits of a life- time begin in childhood. Strokes, high blood pressure, rheumatic heart disease, and heart muscle disease are also Photo: WHO/Zafar "lt's little use starting at age 45." WoRLD HEALTH, December 1987 common form s of cardiovascu- lar disease. Taken together, they represent the No. 1 health problem in the industrialised world, and are fa st becoming a major worry to the developing countri es as well. Preventive measures have been aimed, by and large, at adu lts. No longer should this be so. Pointing to the example of regular dental check ups, some cardiologists even foresee a regular cardiovascular check-up for chi ldren. • Senior Citizens Not Responsible For Deficits The deficits in national health or social security schemes are often blamed on longevity. More people live longer and need more medical care, the argument goes, therefore cost- ing more money. Now a report by the Inter- national Labour Organ isation entitled "Demographic Devel- opment and Social Security " suggests that "other factors have helped to send medica l costs spira lling," namely, "more people seeking treat- ment more often, and more ex- pensive techniques of diagno- sis and cure resulting from new technology. » Studies in France and the Netherlands show that even though illnesses increase steadily with age, the effects of longevity on health schemes are "modest and cou ld be esti- mated at 0.5 per cent a year between 1985 and 2015." Yet since 1975 a number of European countries have cut back on expenses covered by national schemes, by passing more costs on to patients and by limiting the extent of ca re . In the United Kingdom, how- ever, the ILO report points out, the national health services pays doctors a higher fee for caringforpatientsover65, and in Yugos lavia senior citizens are "considered a va luable group and are accorded easier access to health care." Over 15 per cent of Europe- ans wi ll be 65 or older by the year 2015, accord ing to the UN demographic projections. They w ill include the follow ing per- centage of populations : • 15 to 20 per cent in coun- tries of eastern Europe, • 20 to 25 per cent in Den- mark, the Federal Republic of Germany, Luxembourg and Sweden, and • 25 per cent and over in Switzerland . • WoRLD HEALTH, December 1987 Newsbriefs • By Presidential Hand. Presi- dent Andre Kolingba, adminis- tered a polio shot to an infant at a health centre in Bangui to launch the accelerated phase of his country's programme to protect children against six diseases. Almost a half of the children in the Central African Republic die before reaching their fifth birthday from diseases prevent- ed by immunization. " Immunization, " he said, paraphrasing WHO's World Health Day theme, "gives every child a chance for survival. " • Lobbying for Health. Readers of the Journal of Pain and Symptom Management, a quarterly published by the Depart- ment of Anaesthesiology, University of Wisconsin, in Madison, were asked by editor George Heidrich, to write to members of the US. Congress on behalf of WHO " Programmes like the cancer pain relief ("Freedom from Cancer Pain "), and efforts to control AIDS, affect persons in all nations, and depend on coordination from wHo, " he said in an open letter that urged readers to lobby for payment in full of the US. contribution to wHo. Wisconsin is a wHo demonstration state in cancer pain relief. • Off the Press. A ship's crew today is no longer likely to be all male. Thus, a chapter on pregnancy and women's medical problems has been added to the International Medical Guide for Ships in its first updating in nearly two decades. There are other new chapters in the second edition, for instance, on the medical care of castaways, and-reflecting the phenomena of the "boat people " - of rescued persons. Intended for those with little or no medical training, the guide is written in simple language. • Phasing-Out Smoking by Phases. Last April WHO's regional office for Europe in Copenhagen banned smoking from more public places - in addition to conferences rooms, where smok- ing had already been prohibited, in lobby and reception areas. In April, it offered cessation courses for smokers ; in Septem- ber it asked staff to voluntarily refrain from smoking in offices. Effective 1 January 1988, it becomes - except for certain designated areas-a smoke-free environment, the sixth of six regional offices committed to clean indoor air. In addition, Copenhagen relinquished the privilege of tax- free tobacco purchases accorded by the host government, Denmark. And it is making clear its preference to hiring non- smokers by stating in vacancy notices that "WHO promotes a tobacco-free working environment. " • Tobacco-Free Vojvodina. The province of Vojvodina in Yu- goslavia passed legislation, effective from last July, prohibiting smoking in work places and public spaces, according to Tanyug, the country's news agency. The law, the first of its kind in Yugoslavia, resulted from an initiative by the Union of Cancer Societies. In the next issue On 7 Apri l 1988, WHO wi ll ce lebrate 40 years of effort in international public health . The World Health Day issue of World Health, January-February, wi ll have a share in the celebrations, and wi ll underline the sense of public involve- ment in public health that is conveyed in our slogan for the Day : " Health for all - al l for health." Author~ of the Month Dr Richard DAwooo- himself an inveterate traveller- is the editor and compiler of "Travel- lers' Health." He practises medicine at University College Hospital , London , UK. Dr Chris CURTIS is especially interested in "appropriate tech- nology" for mosquito control and has field projects in Tan- zania. He works in the labora- tory at the London School of Hygiene and Tropical Medicine in the UK. Dr Louis MOLINEAUX is a medi- cal officer with WHO's unit of Epidemiological Methodology and Evaluation in the Malaria Action Programme, and Dr Jose A. NAJERA is Director of the Programme. Dr John DEBBIE, formerly a Scientist wi th WHO's Veterinary Public Hea.lth unit is now with the New York State Department of Health; Dr Takao FUJIKURA is a Scientist with the Veterinary Public Health unit in Geneva. Dr Jonathan MANN is Director of WHO's Special Programme on AIDS. Dr Hemda GARELICK is a re- search Fellow in the Department of Medical Microbiology at the London School of Hygiene and Tropical Medecine , UK. Dr John CLEMEN'"(S is a Medical Officer with WHO's Expanded Programme on Immunization. Professor Arie J. ZUCKERMAN is Professor of Microbiology in the University of London and Di- rector of the WHO Collaborating Centre for Reference and Re- search on Viral Hepatitis , Lon- don School . of Hygiene and Tropical Medicine , UK. Mr John MADELEY, a freelance journalist specialising in devel- opment and health, is based in the UK. - Lady Eileen CROFrON was for- merly Director of the Scottish Committee of Action on Smok- ing and Health , and lives in Edinburgh. WORLD HEALTH For readers everywhere 1987 Subscription Rates One year Two years Three years US$ Sw. fr. 14.- 25.- 24.75 45.- 33 .~ 60.- ORDER FORM Please enter my subscription to "World Health" as follows: dne year D Two years D Three years D I enclose cheque/international postal order in the amount of: - Name: ________________ __ Street: --------"--- City: _______ _ __ Country: --------- World Health, WHO, Avenue Appia, 1211 Geneva 27. Switzerland
Correction: Due to a printing er- ror, the figure for WHO's 1988-89 biennial budget appeared on page 30 of our November issue as US $33,980,000. This should have read US $633,980,000. We apologise to readers for this mistake. Public Outcry Led to Success Against Smoking Four countries which had scored successes against smoking by the mid-1980s- particularly in decreasing the number of male smokers- owe their achievements, in large part, to the initiative of ordinary citizens. Thei r outcry against tobacco-related dis- eases, combined with a spirit- ed public debate in the mass media, spurred governments on to act. The call to action occurred in the 1960s and 1970s, accord- ing to stories of anti-tobacco campaigns from Finland, Nor- way, Sweden and the United Kingdom told in "Successes Against Smoking," a 20-page booklet released by WHO for the 6th International Conference on Smoking or Health, held from 9-11 November 1987 in Tokyo. Here is a chronology of developments. Finland: In 1971, Finns peti- tioned their government to act following studies that showed them w ith the highest male mortality rates in the world from coronary heart disease. In 1976 the government launched a country-wide information and education programme under the National Bureau of Health, and Parliament passed the Finnish Tobacco Act. The result : by the early 1980s, the number of male smokers in North Karelia, the county w ith highest mortality, had decreased by 14 per cent - from 52 per cent in 1972 to 38 per cent in 1982. Norway: In 1967, a commit- tee set up by Norway's health ministry drew up a report, " In- fluencing Smoking Behaviour," proposing a national anti-tobac- co programme. This followed public outcry that resulted from front-page press coverage of the report on smoking and health by the U.S. Surgeon General in 1964 linking smok- ing to disease. In 1970, the Norwegian par- liament established a National Council on Smoking and Health, charging it w ith the task of carrying out " govern- ment measures against the harmful effects of tobacco." In 1975 it passed the Act on Re- strictive Measures for Market- ing of Tobacco Products. The result: by the early 1980s the number of male 30 The Villager's Voice: Prevent Tooth aches ! Even though no community is free from tooth decay or gum diseases, most health planners do not usually place oral health care high on a list of priorities. But when people liv- ing in small rural communities are asked, accord ing to WHO ex- perts, they invariably rank oral health care amongst their top problems. lt is easy to under- stand why - a toothache hurts, and pain is immediate. As a consequence of increa- sed sugar consumption, and a lack of preventive program- mes, more people in the devel- oping world than in the indus- trialised world suffer from Photo: WHO/Peter Ozorio toothaches today. "A toothache hurts, and The answer to decayed, pain is immediate." loose or missing teeth does not lie in training more and more dentists - it's too costly, and it takes too long. lt is rather through prevention by teams of ora l health workers led by a dentist. In courses lasting up to two weeks, Thailand is training personnel, called oral health examiners, to recogn ise a range of dental il ls; educators, to teach concepts of oral hygiene (for instance, " Clean your mouth daily," "Use sugar intelli- gently - limit sweets between meals"); and scalers, to re- move tartar from teeth. This preventive model project could serve as an example for other developing countries, where diseases of lifestyles are already emerging as problems. A major advantage of good ora l hygiene, wHo experts point out, is that it heightens awareness of the need for overall healthy lifestyles. ...... ....... ... ... ... ...... ...... ..... . .......... . ••••••• ••••••• ••• ••• ••• ••••••• • ••••••••••••••••••••••••••• ••••••• ••••••• ••• ••• ••• ••••••• • ••••••••••••••••••••••••••• ••• ••• ••• ••• ••• ••• ••• • •••••••••••••••••••• ... ... ....... ... ... ... ...... ....... ... ... ... . ..... . ... ... ....... ... ... ... ....... . ......................... . ••• ••• ••••••• ••• ••• ••• •••••• • •••••••••••••••••••••••••• ••• ••• ••• ••• ••• ••• ••• ••• • ••••••••••••••• ••• ••• ••••••• ••••••••••• ••••••• ••• • •••••••••••••••••••• ••• ••• ••••••• ••••••••••• ••••••• ••• • ••••••••••••••••••• ••• ••• ••••••• •••••••••• •••••• ••• • ••••••••••••••••• smokers had decreased by 13 per cent - from 53 per cent in 1974 to 40 per cent in 1982. In addition the numbers of teen- age smokers had also declined -for boys from 40 per cent to 26 per cent, and for girls from 41 per cent to 22 per cent. Sweden: In 1963, respond- ing to a call by 25 scientists for a tobacco campaign, Sweden established the National Smok- ing and Health Association to serve in an advisory capacity to its National Bureau of Health and Welfare. The results: by the mid- 1980s, the number of male and female smokers between 1970 and 1984 had dropped to 30 per cent - in the case of males from 50 per cent, and of fe- males from 33 per cent. In addition, the number of 13- year-old smokers had sharply declined-for boys from 40 per cent to 5 per cent, and for girls from 16 per cent to 6 per cent. United Kingdom: In 1962 and 1971 the Roya l College of Physicians published reports on "Smoking and Health" that led to the founding of Action on Health, a citizens' group dedi- cated to ra llying voluntary ac- tion against smoking. In response the government established in 1986 what is re- nam ed now the Health Educa- tion Authority, and later the Scottish Health Education Group, to advise its Depart- ment of Health and Socia l Se- curity on campaigns against what was described as the leading avoidable cause of death in the United Kingdom. The result: by the early 1980s, the number of male smokers had declined by 27 per cent - from a high of 65 per cent in the late 1940s to 38 per cent in 1982 . And the number of female smokers dropped from 41 per cent to 8 per cent over that period. • A Study to Show How to " Keep Arteries Clean " A five-year study to deter- mine,how atheroscleros is-the narrowing of arteries-is condi- tioned upon lifestyles is now under way in 27 countries, five in Africa, seven in As ia ten in Europe and five in Latin America . The study is being carried out by WHO and the Inter- national Society and Federation of Card iology. Called the Study of pathobiological determinants of atherosclerosis in youth (PBDAY), its aim is to prevent disorders of the heart or blood. "The child is father of the man," WHO officials say. "it's little use starting at age 45. We need to say to the young : Keep your arteries clean." Earlier stud ies, of so ldiers in war, had shown individuals in the prime of life already aff li cted with signs of athero- sclerosis. Thus researchers plan to examine the structural changes in arteries of those be- tween ages 5 and 34 w ho die from other than cardiovascular diseases. Among the most common cardiovascu lar diseases is atherosclerosis, arteries so clogged by a build-up of fatty deposits that the flow of blood through them is impeded. Heart diseases result, or heart attacks ensue. The principal factors associ- ated w ith an increased risk of heart disease are a high-fat diet, a lack of exercise, and smoking - in short, unhealthy lifestyles . The habits of a life- time begin in childhood. Strokes, high blood pressure, rheumatic heart disease, and heart muscle disease are also Photo: WHO/Zafar "lt's little use starting at age 45." WoRLD HEALTH, December 1987 common form s of cardiovascu- lar disease. Taken together, they represent the No. 1 health problem in the industrialised world, and are fa st becoming a major worry to the developing countri es as well. Preventive measures have been aimed, by and large, at adu lts. No longer should this be so. Pointing to the example of regular dental check ups, some cardiologists even foresee a regular cardiovascular check-up for chi ldren. • Senior Citizens Not Responsible For Deficits The deficits in national health or social security schemes are often blamed on longevity. More people live longer and need more medical care, the argument goes, therefore cost- ing more money. Now a report by the Inter- national Labour Organ isation entitled "Demographic Devel- opment and Social Security " suggests that "other factors have helped to send medica l costs spira lling," namely, "more people seeking treat- ment more often, and more ex- pensive techniques of diagno- sis and cure resulting from new technology. » Studies in France and the Netherlands show that even though illnesses increase steadily with age, the effects of longevity on health schemes are "modest and cou ld be esti- mated at 0.5 per cent a year between 1985 and 2015." Yet since 1975 a number of European countries have cut back on expenses covered by national schemes, by passing more costs on to patients and by limiting the extent of ca re . In the United Kingdom, how- ever, the ILO report points out, the national health services pays doctors a higher fee for caringforpatientsover65, and in Yugos lavia senior citizens are "considered a va luable group and are accorded easier access to health care." Over 15 per cent of Europe- ans wi ll be 65 or older by the year 2015, accord ing to the UN demographic projections. They w ill include the follow ing per- centage of populations : • 15 to 20 per cent in coun- tries of eastern Europe, • 20 to 25 per cent in Den- mark, the Federal Republic of Germany, Luxembourg and Sweden, and • 25 per cent and over in Switzerland . • WoRLD HEALTH, December 1987 Newsbriefs • By Presidential Hand. Presi- dent Andre Kolingba, adminis- tered a polio shot to an infant at a health centre in Bangui to launch the accelerated phase of his country's programme to protect children against six diseases. Almost a half of the children in the Central African Republic die before reaching their fifth birthday from diseases prevent- ed by immunization. " Immunization, " he said, paraphrasing WHO's World Health Day theme, "gives every child a chance for survival. " • Lobbying for Health. Readers of the Journal of Pain and Symptom Management, a quarterly published by the Depart- ment of Anaesthesiology, University of Wisconsin, in Madison, were asked by editor George Heidrich, to write to members of the US. Congress on behalf of WHO " Programmes like the cancer pain relief ("Freedom from Cancer Pain "), and efforts to control AIDS, affect persons in all nations, and depend on coordination from wHo, " he said in an open letter that urged readers to lobby for payment in full of the US. contribution to wHo. Wisconsin is a wHo demonstration state in cancer pain relief. • Off the Press. A ship's crew today is no longer likely to be all male. Thus, a chapter on pregnancy and women's medical problems has been added to the International Medical Guide for Ships in its first updating in nearly two decades. There are other new chapters in the second edition, for instance, on the medical care of castaways, and-reflecting the phenomena of the "boat people " - of rescued persons. Intended for those with little or no medical training, the guide is written in simple language. • Phasing-Out Smoking by Phases. Last April WHO's regional office for Europe in Copenhagen banned smoking from more public places - in addition to conferences rooms, where smok- ing had already been prohibited, in lobby and reception areas. In April, it offered cessation courses for smokers ; in Septem- ber it asked staff to voluntarily refrain from smoking in offices. Effective 1 January 1988, it becomes - except for certain designated areas-a smoke-free environment, the sixth of six regional offices committed to clean indoor air. In addition, Copenhagen relinquished the privilege of tax- free tobacco purchases accorded by the host government, Denmark. And it is making clear its preference to hiring non- smokers by stating in vacancy notices that "WHO promotes a tobacco-free working environment. " • Tobacco-Free Vojvodina. The province of Vojvodina in Yu- goslavia passed legislation, effective from last July, prohibiting smoking in work places and public spaces, according to Tanyug, the country's news agency. The law, the first of its kind in Yugoslavia, resulted from an initiative by the Union of Cancer Societies. In the next issue On 7 Apri l 1988, WHO wi ll ce lebrate 40 years of effort in international public health . The World Health Day issue of World Health, January-February, wi ll have a share in the celebrations, and wi ll underline the sense of public involve- ment in public health that is conveyed in our slogan for the Day : " Health for all - al l for health." Author~ of the Month Dr Richard DAwooo- himself an inveterate traveller- is the editor and compiler of "Travel- lers' Health." He practises medicine at University College Hospital , London , UK. Dr Chris CURTIS is especially interested in "appropriate tech- nology" for mosquito control and has field projects in Tan- zania. He works in the labora- tory at the London School of Hygiene and Tropical Medicine in the UK. Dr Louis MOLINEAUX is a medi- cal officer with WHO's unit of Epidemiological Methodology and Evaluation in the Malaria Action Programme, and Dr Jose A. NAJERA is Director of the Programme. Dr John DEBBIE, formerly a Scientist wi th WHO's Veterinary Public Hea.lth unit is now with the New York State Department of Health; Dr Takao FUJIKURA is a Scientist with the Veterinary Public Health unit in Geneva. Dr Jonathan MANN is Director of WHO's Special Programme on AIDS. Dr Hemda GARELICK is a re- search Fellow in the Department of Medical Microbiology at the London School of Hygiene and Tropical Medecine , UK. Dr John CLEMEN'"(S is a Medical Officer with WHO's Expanded Programme on Immunization. Professor Arie J. ZUCKERMAN is Professor of Microbiology in the University of London and Di- rector of the WHO Collaborating Centre for Reference and Re- search on Viral Hepatitis , Lon- don School . of Hygiene and Tropical Medicine , UK. Mr John MADELEY, a freelance journalist specialising in devel- opment and health, is based in the UK. - Lady Eileen CROFrON was for- merly Director of the Scottish Committee of Action on Smok- ing and Health , and lives in Edinburgh. WORLD HEALTH For readers everywhere 1987 Subscription Rates One year Two years Three years US$ Sw. fr. 14.- 25.- 24.75 45.- 33 .~ 60.- ORDER FORM Please enter my subscription to "World Health" as follows: dne year D Two years D Three years D I enclose cheque/international postal order in the amount of: - Name: ________________ __ Street: --------"--- City: _______ _ __ Country: --------- World Health, WHO, Avenue Appia, 1211 Geneva 27. Switzerland