Infection and Illness in the Community— the Diagnostic Challenge of Tropical Diseases as seen by an Epidemiologist

Alfred A. BuckDepartment of State, Agency for International Development, Bureau for Development Support, Office of Health, Washington, D.C. 20523

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Mr. President, Dr. Sodeman, Ladies and Gentlemen: I am deeply grateful to the officers of the Society for the honour of presenting the 43rd Charles Franklin Craig Lecture. The invitation has come at a time when tropical medicine has entered a period of renaissance. During the 1970s, we have witnessed a dilemma of disease eradication concepts, with success in smallpox and failure in malaria. There has been a resurgence of yaws, kala-azar and filariasis, and a large-scale increase of schistosomiasis. While significant advances were made in reducing mortality and morbidity in cholera and other severe diarrheas through the development and widespread use of the rehydration therapy, drug resistance has become a major obstacle in the treatment of malaria, leprosy, tuberculosis, typhoid fever, and gonorrhea to name only diseases of global importance. An area-wide control program of onchocerciasis in West Africa now in its 5th year of operation has required new, unorthodox administrative and political approaches for its execution and funding.

Author Notes

Formerly: Chief Medical Officer, Research Coordination, Epidemiology and Training, Division of Malaria and Other Parasitic Diseases, World Health Organization, 1211 Geneva 27, Switzerland.