Leadership in Health for All in developing countries: quo vadis?

Health For All by the Year 2000 and enhancing child survival are goals of the world health community. However, attainment of these goals will occur only if there is leadership that mobilises effectively the social and technical forces required to do the job. Focusing on this endeavour and choosing the correct direction require understanding of the basic principles together with a systems approach to effective public health practice, which is the raison detre for health leadership. A review of the elements of the system and the ultimate focus of the Health for All strategy is presented

Meningococcal disease in Louisiana 1978-1985

Data were analyzed from 729 meningococcal cases reported to the Epidemiology Section, Office of Preventive and Public Health Services, Louisiana Department of Health and Human Resources from 1978 through 1985. A total of 122 deaths (16.8%) occurred from these cases, with the highest case fatality rate (23.7%) noted in 1981. The eight-year average incidence rate per 100,000 population was 2.1. For individual years, the incidence rate was highest (3.6) in 1978 and lowest (0.8) in 1985. Although incidence rates per 100,000 population were greater for males during all years except 1978 and 1985 and greater for nonwhites in 1978, 1980, 1981, 1983 and 1984, the eight-year average incidence rates by sex and race were almost the same. Incidence rates were found to be highest in the less than one, and one to four-year age groups. For all eight years, over half of the cases were in the four years and under age group; the same was true for deaths, except in 1982 (46.7%). February was found to be the month with the highest frequency of reported case onset and death. The mean difference between date of disease onset and death for all fatal cases was 2.716 days (S.D. = 6.48). Ten of the 64 Louisiana parishes reported no meningococcal disease cases from 1978-1985. There were 25 parishes with an eight-year average incidence rate of greater than 2.1. The overall incidence rates in Louisiana were greater than rates in the United States for the time periods reviewed.

Sir William Petty: modern epidemiologist (1623-1687)

William Petty, physician, epidemiologist, political economist, demographer, cartographer, and administrator was an intellectual product of the seventeenth century. Petty was born in the year 1623 in Romsey, England of lower middle class parents; however, by the time of his death in 1687 he had become a knight of the realm, founder of the Royal Society, and friend of kings. Petty's life reflected the northern renaissance which induced such dramatic changes in science, technology, politics, and entrepreneurship. His education was eclectic, nonetheless he took his Doctor of Physic degree from Oxford in 1649 and became an Oxford don, where he spent the next few years as an academic before undertaking a definitive survey of Ireland on behalf of the Cromwell government. Ireland changed Petty's destiny and he became a man of the world and entrepreneur which stimulated his interest in public policy formulation and economics. It was Petty's peculiar genius to be innovative in the application of measurement, statistics, and mathematics to socioeconomic and demographic phenomena. As a physician he related his knowledge of health and disease to these phenomena in what in the modern context would be called human ecology or social epidemiology. These relationships and their measurement were employed to establish an objective set of data which could be analyzed for the purpose of rational public policy planning by the state. This scientific approach to public policy places Petty squarely in the context of modern epidemiologic and public health practice and marks the initiation of a major use of the epidemiologic method.