Dermatology

The Pan-American Sanitary Bureau thus affords a rather remarkable example of international cooperation in matters of health, and sets instructive precedents for other developing areas, some of which have much farther to go on the road to the provision of health services which can be regarded as adequate by modern standards. This is not to imply that the public health problems of Latin America (where the main work of the Pan-American Sanitary Bureau lies) are nearing solution. Some Latin American countries include large populations, living at subsistence level, whose conditions have changed but little in the last 200 years, and who have only recently become the object of major attempts to raise their living standards. In spite of some remarkable triumphs, a residue of the old problems remains. Malaria eradication has made good progress: 70,000,000 people have been freed from malaria; eradication programmes are now operative in areas with a population of a further 79,000,000; but for 17,000,000 the programme is stilI in the planning stage. Smallpox, surely one of the most eradicable of diseases, in 1966 still accounted for 3,000 reported cases, mostly in Brazil, but there are hopes of final eradication within the next decade. Yellow fever is unassailably entrenched in the monkey populations of the South American jungles, but it is powerless as a serious threat if its chief vector for man, Aedes /Egypt", can be eliminated. This has been done, in one of the most remarkable triumphs in the history of preventive medicine, over a large part of South America, but the mosquito still persists in some areas around the Caribbean. Child mortality, accepted as one of the best indicators of health standards, is still 10 times that of Canada and the United States, and accounts for about 40% of all deaths in Latin America. The main causes are intestinal infections, pneumonia and nutritional deficiency diseases.