The control of schistosomiasis, Second report of a WHO expert committee . Technical Report Series N°830
Second report of a WHO expert committee
Overview
The WHO Expert Committee on the Control of Schistosomiasis met in Geneva from 8 to 15 November 1991. Dr R.H.Henderson, Assistant Director-General, opened the meeting on behalf of the Director-General.
At its meeting in 1984, the Committee endorsed a strategy for the control of morbidity due to schistosomiasis . Over the past seven years this strategy has proved to be both feasible and effective. WHO has placed increased emphasis on the role of health education and safe and adequate domestic water supplies, as well as sanitation, in the maintenance of control of schistosomiasis, and some governments have given priority to programmes for the installation of safe and protected water supplies to help control the disease.
Experience is now demonstrating that the control of schistosomiasis is optimal when specific control tasks are carried out within the primary health care system. Although the integration process is slow, a growing number of countries are adopting this approach as an essential part of health care.
Schistosomiasis control requires a long-term commitment. While the prevalence of schistosomiasis can be reduced in the short term, long-term planning over at least 10-20 years, depending on a country's level of socioeconomic development, is required if adequate surveillance and control are to be maintained.
Schistosomiasis continues to be a major health problem where water resources are being developed, particularly in small reservoirs and irrigation systems, and planning directed towards control of the disease in these situations is often inadequate. Those responsible for development can now introduce effective control measures to reduce and even eliminate the risk of schistosomiasis.
Since the Committee's meeting in 1984, two more countries have notified WHO of the presence of schistosomiasis within their national boundaries and, owing to changes in political boundaries, 74 countries and territories are now considered to be endemic for the disease. Moreover, environmental degradation associated with water resources development and the movement of people because of civil strife have created new foci of transmission. Nevertheless, for the first time, a country previously endemic for the disease has requested WHO to consider criteria for achieving eradication.
Despite cautious optimism owing to the success of large-scale control programmes, economic constraints in developing countries impair the realization of the full potential of current approaches to control.
The Director-General of WHO, Dr Hiroshi Nakajima, has stated: ''We now know that the disease is preventable and curable. A new alliance is needed, whereby the international organizations, governments and the private sector join together to control this disease." In its report, the Expert Committee analyses the various successes and failures of the past seven years, and emphasizes how the strategy for the control of schistosomiasis can: be implemented flexibly within locally available systems for the delivery of health care. No single solution applies to all situations; this report therefore aims to present various options for control appropriate to the different health .and development objectives of individual countries where the disease is endemic.
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