International infrastructure to control infectious diseases

Remarkable gains in the control of infectious diseases have occurred during the twentieth century. These have permitted life expectancles to approach 80 years for one fifth of the world's population. To effect reductions in child mortality to the rest, structured changes such as economic improvement, basic sanitation, education, reduced population growth and improvements in agriculture and nutrition are needed. Nearly US$40 billion in development investment supports these fundamental changes. For the near term, vertical programmes such as the Expanded Program on Immunization afford critical reductions in child mortality at relatively low cost. A network of multinational and bilateral agencies support structural and programmatic changes. Research holds the promise of improving still further the efficacy and cost-effectiveness of infectious disease control programmes. Leading causes of child mortality and their social and economic correlates are reviewed.