Abstract

PIP: Since 1960, the Cholera Research Laboratory (CRL) and its successor, the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), has been the leading international, non-profit, health research and training institute addressing diarrheal diseases and problems of nutrition and fertility. CRL developed the oral rehydration solution (ORS). The CRL became ICDDR,B in 1978. During 1968-70 researchers from US-funded institutions in Dhaka and Calcutta successfully used oral rehydration solutions for adult cholera patients in clinical trials. CRL/ICDDR,B effectively used ORS in children with cholera, and adults and children with non-cholera diarrheal diseases. In 1975 UNICEF and the World Health Organization agreed to a single formula rehydration solution (ORS) and to distribution of standard ORS packets. In 1977 studies at ICDDR,B in Dhaka and Costa Rica provided definitive proof that rotavirus could be effectively treated with ORS. In 1978 an international systematic attack was mounted on diarrheal diseases leading to multidonor efforts to create the World Health Organization Program for Control of Diarrheal Disease (WHO/CDD). In 1979 the Bangladesh Rural Advancement Committee (BRAC) launched a campaign to introduce ORT and home-made ORS to every home in Bangladesh. In 1981 ICDDR,B successfully treated patients with cereal-based ORS. During 1980-85 USAID funded pilot ORS programs to promote home ORS use in Egypt, Honduras, and The Gambia. In 1992 global access to ORS was estimated at 73%. ORS was utilized in 35% of all diarrhea cases. In 1993 a new strain of cholera, V cholerae 0139, emerged that also infects people normally immune to cholera, underlining the need for continuing efforts to strengthen training and surveillance. ICDDR,B leads-the work to identify, type, and prepare antisera for the new organism. By 1994 international efforts over the previous 10 years had reduced dehydration-induced child deaths from 4 million each year to less than 3 million.