Demographic surveillance sites and emerging challenges in international health

At present the long-term social economic and demographic impact of major diseases in developing countries can only be estimated using models since there are no empirical data on age and cause-specific morbidity and mortality. Reliable estimates require the input of accurate data into the models from as many geographical zones as possible. With the collapse of vital registration systems and the rudimentary state of health information systems in most of the developing world estimated projections are sometimes based on educated guesses and intuition rather than fact. The investment needed to improve health information in these countries is unlikely to be made in the near future. Strong national health research systems are needed to improve health. For developing countries to indigenize health research systems it is essential to build capacity.3 A local cadre of research scientists is urgently needed particularly in epidemiology statistics immunology and the clinical sciences. Global disease control initiatives exist in countries where there are fewer than four epidemiologists and only one statistician. Training abroad has been an invaluable stopgap measure but demand has consistently outstripped supply. The question remains: where is the next generation of research scientists in the developing world going to be trained? (excerpt)