Providing enough water of good quality to all human communities is a difficult task, which has been satisfied only recently and only for the developed world. A large part of the developing world still suffers from scarcity and/or bad quality of water supply. Examples from the past are described, including the cholera epidemics of London 1848-1853 and the chromium pollution of the Milan area, 1958. A synthetic description of the different kinds of biological and chemical pollution are also described, then the complex mechanisms of biological and chemical pollution of the waters are illustrated, which require complicated interventions for reclamation after pollution or, better, even more complicated surveillance to avoid pollution. Finally the problem of safeguard of waters during the distribution is illustrated, when a bad maintenance of the aqueducts can inactivate all the precautions taken during the supply an the treatment of waters.

Health↗

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[Hospitals between present and future].

What role will hospitals play in the future of the healthcare system, and how this role will be changing? Hospitals of the future will confront difficult challanges: new kinds of disease, rapidly evolving medical technologies, aging of the population and evolving budget restrictions. All features that make it difficult to foresee the hospital of the future. The aim of this paper is to analyze the different challanges that hospital have to face in a modern scenario of evolution of public health services.

Forecasting↗

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[Preventive measures suggested to protect health workers from the risk due to a potential exposure to SARS agents].

The Authors describe the personal and environmental preventive measures suggested to protect health workers from the risks due to a potential exposure to SARS agents. The Authors stress the need that workers are allowed to wear individual protective disposable complying with technical regulations in order to be assured the best protection.

Humans↗

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[The role of economic evaluation for the implementation of vaccination strategies].

The analysis described below tries to underline the major economic aspects of vaccination strategies both in childhood (polio, diphtheria, tetanus, H influenzae, measles, rubella, mumps, et) and in the elderly (limited to influenza control). As a result we could demonstrate that, in spite of the formal recognition of the paramount importance of prevention in general, and of vaccinal prevention in particular; vaccinations are at present very poorly considered by policymakers and politicians. This in contrast with the fact that the studies so far examined show that vaccinations are among the most productive interventions (lowest cost per year of life-year spared, very good cost-benefit ratio, thanks to the cases of diseases avoided). Such a convenience is highest when, in front of a given disease, the vaccinal strategy has been duly selected. Therefore, it is suggested that additional resources should be provided in the future to complete the framework and to increase the coverage of vaccinations, including the new offers against Varicella, N meningitidis and Str pneumoniae: and, in the future, against Rotavirus and HPV.

Communicable Disease Control↗

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[Public health: from the past toward new frontiers].

The Authors analyse and discuss the contents of some recent international meetings devoted to Public Health, namely the 10th Congress of the WFPHA, the 12th British annual Forum of Public Health and the 12th Conference of the EUPHA. Their efforts to evaluate health services comes off enriched with new scenarios of integration and convergence. Objectives of global interest in the world cannot be faced by individual countries alone: on the contrary, the whole scientific community of public health operators must be involved. The cultural, social and economic development is the unavoidable condition to increase the health level of the populations. No health organization with the characteristics of excellence can exist without a comparable, balanced development regarding the society and its economy. With such considerations in mind, the European Commission in 1997 has began to develop the Health Monitoring Programme, with the aim to build a system for monitoring health in the UE. Within this Programme, the Study ECHI 1 (European Community Health Indicators 1) has been published, which includes 4 large groups of indicators (demographic and socioeconomic indicators, health indicators, determinants of health/disease indicators, health services indicators); such a study was performed with the cooperation of OCSE and WHO/Euro researchers. The following ECHI 2 research did not change the supporting philosophy of ECHI 1. We are trying to evaluate whether the intervention of health operators and health structures could influence - increasing or decreasing - the phenomena described and measured by the indicators, inviting the readers to start a debate with us.

Congresses as Topic↗

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