BERITA DARI WHO
Dibawah ini kami muat suatu berita dari World Health
Organization, yang perlu diketahui oleh dokter-dokter di
Indonesia.
Berita ini kami terima dari Dr M.A.M. El-Zawarhy.,
WHO
Programme Coordinator to Indonesia.
DRAFT FOR POSSIBLE EDITORIAL IN MEDICAL JOUR-
NALS OF SELECTED COUNTRIES.
It is proposed that as part of the effort to eliminate the pos
sibility of the escape of variola virus from laboratory stocks
during the poseradication era, a letter might be sent, through
WHO Regional Offices, to appropriate medical journals in
selected countries. The attached draft letter could be modified
as appropriate for particular countries, translated into the
appropriate language, and inserted, perhaps as an "Editorial",
perhaps signed on behalf of the Globel Commission, in the lo-
cal medical journal of the selected countries.
GLOBAL ERADICATION OF SMALLPDX : WHO S INSU-
RANCE POLICY
In the 1960s smallpox was an endemic disease in between
50 and 60 countries, and was periodically introduced into
otehr countries by travellers from endemic areas. In 1967 WHO
launched the Intensified Smallpox Programme,
and with
the collaboration of national health authorities,smallpoxwas
progressively eradicated from one country after another until
the last case of naturally acquired smallpox anywhere in the
world accurred in Somalia in October 1977. Eradication of
this ancient scourge of mankind is one of the preatest accom-
plishment of preventive medicine and is a tribute to internatio-
nal collaboration for human well-being.
In spite of the confidence engendered by the fact that
here has smallpox recurred after a country was declared free
of the disease (including such high risk areas as Indonesia
India and Bangladesh, where the last cases occured in January
1972, May 1975 and October 1975, respectively) the World
Health Organization has established an insurance policy to
guard agaiast any possible unexpected happening that may
cause smallpox to recur. This has several components. Active
surveillance is being maintained in Zaire, where a related virus
normally circulating in will animals occasionally sporadic
smallpox-like disease (human monkeypox) in humans. The la-
boratories in the USA and the USSR that provided diagnostic
facilities for WHO throughout the eradication campaign
maintain their capabilities. Special measures have been taken
to destroy stocks of variola virus in all but a very smallnumber
of laboratories, in order to minimize the risk of escape of
the virus from the laboratory. WHO has established a large re-
serve stock of freese-dried smallpox vaccine located in three
strategic places (Geneva, New Delhi, Toronto), and many na-
tional government have established their own reserves.
The last case of endemic smallpox occurred in (country)in
(year) Prior to that time speciments for smallpox diagnosis we-
re not uncommonly sent to hospitals, universities,or state diag-
nostic laboratories. Following common virological practice,
aliquots of some of these samples or virus recovered from them
might have been put in the deep-freeze units in units laborato-
ries for future reference. Some of these speciments may remain
there, long since forgotten. Such material could be dangerous,
and might at some future time constitute a source for further
cases of human smallpox. National health authorities have
been concerned about this possibility and have already colla
borated with WHO in a survey designed to identify laborato-
ries that were retaining variola virus. However,
we believe
that it would be wise for the directors of all laboratories where
smallpox diagnosis was ever conducted once more to examine
their deep-freeze storage cabinets for any such forgotten mate-
rial and incinerate any ampoules that may contain variola virus
or are not properly labelled.
The other way in which doctors in (country) can help
with the global insurance against any possible recurrence of
smallpox would be for them to be alert for any suspicious
human case and obtain material for laboratory study, and to
collect specimens from any wild animals found to have a pox-
like infection. All such specimens should be sent to WHO,
Geneva.
We believe that the world is now free of smallpox, for
ever, but the price of liberty is eternal vigilance, and against
this disease it is the doctors who need to maintain this vigilan-
ce.
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7
obat yang mahal-mahal atau perusahaan obat (beberapa)
malah menyodorkan kepada dokter. Dalam hal ini etika ke-
dokteran sebetulnya sudah baik tapi pelaksanaannya memerlu-
kan pendirian yang kuat. Seorang dokter seharusnya tidak mu-
dah tergoda oleh apa saja. Janganlah kita mentargetkan misal-
nya sesudah dua tahun harus memiliki Honda Civic, sepuluh
tahun harus memiliki Mercy dan sebagainya, maka bila ada
target-target seperti ini dedikasi akan kacau. Kepercayaan itu
penting, karena tanpa kepercayaan, hanya dengan kalkulasi
saja bisa meleset.
Pada prinsipnya saya tidak pesimis karena ada undang-undang,
sumpah dokter, dan kode atik. Jadi tiang-tiang penunjangnya
sudah ada tinggal kontrol penertiban mental, bagaimana cara-
nya agar orang-orang itu tidak materialistis.
Harapan saya melalui Cermin Dunia Kedokteran ini agar
etika kedokteran dapat semakin dilaksanakan dengan baik
dan semoga cerita saya ini ada gunanya.
3 8
Cermin Dunia Kedokteran No. 15, 1979