increasing support for strengthening research 

 capabilities in developing countries. 



Many of the priority diseases will probably require 

 investment of a decade or more before major advances 

 can be applied on a wide scale. Thus a progressive 

 buildup of trained manpower is needed in the United 

 States as well as in developing countries to form an 

 expanded next generation of laboratory researchers, 

 epidemiologists, and program planners and managers. As 

 far as possible, developing country personnel should be 

 trained in their own or in other developing countries 

 to strengthen the growth of local scientific 

 institutions. However, some specialized training in 

 developed countries would still be necessary. support 

 should be made available for the training of U.S. 

 scientific and program personnel both in the United 

 States and abroad. 



2. Water Systems 



More than half of the world's population has no 

 reliable and safe water supply; 70 to 80 percent have 

 no sewage disposal. And yet, whether in rural villages 

 or urban squatter settlements of developing countries, 

 adequate, convenient supplies of safe water and 

 sanitary facilities are essential to improving the 

 quality of life. Safe water prevents contact with 

 debilitating, often fatal, water-related diseases like 

 cholera, typhoid, enteric infections, hepatitis, 

 schistosomiasis, and malaria. Hygienic conditions in 

 the home help limit the spread of skin infections, 

 lice, mites, and trachoma. Convenient supplies of 

 water (not necessarily from costly in-house connections 

 but from simple courtyard standpipes) reduce the daily 

 burden of women and children who would otherwise spend 

 hours hauling water from distant sources to their homes 

 and permit more time to be spent on productive 

 activities such as producing food and attending school. 



The much larger use of water in towns and, 

 particularly, cities alters the character of the 

 primary problem from one of providing a reliable supply 

 of water in rural areas to one of pollution by sewage 

 flows in metropolitan areas. Improved disposal of 

 wastes and waste water, an integral aspect of water 

 systems, limits the transmission of waste-related 

 diseases such as hookworm, roundworm, and others. Such 

 systems need not be sophisticated, but appropriate to 

 the needs and resource levels of the community and 

 household. 



Despite the availability of engineering capability 

 in developing countries and substantial international 

 interest, relatively little gain has been made in 



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