Case Studies

Eradicating smallpox.

A massive global effort spearheaded by the World Health Organization eradicated smallpox in 1977 and inspired the creation of the Expanded Programme on Immunization, which continues today.

Preventing HIV and sexually transmitted infections in Thailand.

In Thailand, the government's "100 percent condom program" targeting commercial sex workers and other high-risk groups helped prevent the spread of HIV relatively early in the course of the epidemic. Thailand had 80 percent fewer new cases of HIV in 2001 than in 1991 and has averted nearly 200,000 new cases.

Controlling tuberculosis in China.

To address the problem of tuberculosis (TB) patients' early dropout from treatment, a national TB program in China implemented the directly observed treatment, short-course (DOTS) approach in which a health worker "watches" patients with TB daily for six months as they take their antibiotic treatment. The program helped reduce TB prevalence by 40 percent between 1990 and 2000 and dramatically improved the cure rate in half of China's provinces.

Reducing child mortality through vitamin A in Nepal.

Capitalizing on the discovery that vitamin A supplementation could save child lives, the government of Nepal began the National Vitamin A Program in 1995 that has averted nearly 200,000 child deaths.

Eliminating polio in Latin America and the Caribbean.

Beginning in 1985, a regionwide polio elimination effort led by the Pan American Health Organization immunized almost every young child in Latin America and the Caribbean, eliminating polio as a threat to public health in the Western Hemisphere in 1991.

Saving mothers' lives in Sri Lanka.

Despite relatively low national income and health spending, Sri Lanka's commitment to providing a range of "safe motherhood" services has led to a decline in maternal mortality from 486 deaths per 100,000 live births to 24 deaths per 100,000 live births over four decades.

Controlling onchocerciasis in sub-Saharan Africa.

A multipartner international effort begun in 1974 dramatically reduced the incidence and impact of the blinding parasitic disease and increased the potential for economic development in large areas of rural west Africa. Transmission has been virtually halted in west Africa today, and 18 million children born in the 20-country area are now free of the threat of river blindness.

Preventing diarrheal deaths in Egypt.

Using modern communication methods, a national diarrheal control program in Egypt increased the awareness and use of life-saving oral rehydration therapy, helping reduce infant diarrheal deaths by 82 percent between 1982 and 1987.

Improving the health of the poor in Mexico.

Since 1997, Mexico's Progresa (now known as "Oportunidades") has provided a comprehensive package of education, health, and nutrition interventions to rural families through a conditional cash grants program, resulting in lowered rates of illness and malnutrition and increased school enrollment.

Controlling trachoma in Morocco.

Since 1997, the incidence in Morocco of trachoma, the leading preventable cause of blindness, has been cut by more than 90 percent among children under 10 through a combined strategy of surgery, antibiotics, face washing, and environmental changes.

Reducing guinea worm in Asia and sub-Saharan Africa.

A multipartner eradication effort focused on behavior change reduced prevalence of guinea worm by 99 percent in 20 endemic African and Asian countries. Since the start of the campaign in 1986, the number of cases has fallen from 3.5 million to less than 35,000 in 2003.

Controlling Chagas disease in the southern cone of South America.

Through surveillance, environmental vector control, and house spraying, a regional initiative launched in 1991 has decreased the incidence of Chagas disease by 94 percent in seven countries in the southern cone of Latin America. Disease transmission has now been halted in Uruguay, Chile, and large parts of Brazil and Paraguay.

Reducing fertility in Bangladesh.

In Bangladesh, strong leadership of the family planning program, a sustained outreach strategy, and a focus on access to services increased contraceptive prevalence from 3 to 54 percent (and correspondingly decreased fertility from 7 to 3.4 children per woman) over two decades, far in excess of what would have been predicted based on changes in economic and social conditions alone.

Curbing tobacco use in Poland.

Starting in the early 1990s, the transition to a market economy and a more open society paved the way for health advocates to implement strong tobacco controls in Poland, a country that had the highest rate of tobacco consumption in the world. A combination of health education and stringent tobacco control legislation has averted 10,000 deaths a year, has led to a 30 percent reduction in the incidence of lung cancer among men aged 20 to 44, and has helped boost the life expectancy of men by four years.

Preventing iodine deficiency disease in China.

China's introduction of iodized salt in 1995 reduced the incidence of goiter among children, from 20 to 9 percent, and created a sustainable system of private provision of fortified salt.

Preventing neural tube defects in Chile.

Through a successful partnership between the flour industry and the national govern­ment, Chile began fortifying wheat flour with folic acid in 2002. This intervention has prevented life-threatening neural tube defects in infants and saved the health system millions of dollars in treatment costs.

Eliminating measles in southern Africa.

Measles vaccination campaigns in seven African countries nearly eliminated measles as a cause of childhood death in southern Africa and helped reduce the number of measles cases from 60,000 in 1996 to just 117 cases four years later.

Preventing dental caries in Jamaica.

Between 1987 and 1995 Jamaica's National Salt Fluoridation Program demonstrated up to an 87 percent decrease in dental caries in schoolchildren and has been regarded as a model for micronutrient interventions.

Treating cataracts in India.

An intensified cataract surgery program implemented in seven Indian states from 1994 to 2001, which was catalyzed by technical and operational innovations developed by a nongovernmental organization, saved more than 300,000 people per year from a lifetime of blindness.

Preventing Hib disease in Chile and The Gambia.

A national Hib vaccination program in Chile reduced prevalence of Hib disease by 90 percent in the early 1990s. In 1997, The Gambia introduced Hib vaccines into its national immunization program and has virtually eliminated the disease from the country.