On p 1682 Kovats et al discuss the likely effects of climate change in Europe. Given this fact, the authors recommend improving disease surveillance systems and introducing vaccination programmes for vector borne diseases that are likely to spread, such as tick borne encephalitis. The combination of sudden wealth, access to cars, and a flood of new drivers had disastrous effects on the safety of East Germans particularly young adults after the reunification of Germany. On p 1647 Winston et al show how the death rate for occupants of cars was affected after East Germans were suddenly able to buy cars because of the abrupt revaluation of the East German mark and access to Western markets. These data have implications for countries where wealth and car ownership are increasing greatly but over a period of years.
Opportunities exist to institute measures to prevent avoidable death among car occupants.
Model shows that incidence of HIV infection in children can be reduced Despite results showing that low cost antiretroviral treatments were effective in reducing vertical transmission of HIV in Thailand and Africa, many developing countries are reluctant to introduce such programmes because of the high costs of the drugs. Low cost antiretroviral interventions seem to offer good value for money in most settings with moderate and high prevalence of HIV infection. Recommendations to avoid breast feeding, however, seem appropriate only where there are reasonably high rates of infant survival. Universal antenatal HIV screening is cost effective in areas of high prevalence Universal voluntary antenatal HIV screening has been recommended in London as a way of reducing vertical transmission. On p 1656 Postma et al present a cost effectiveness analysis of such a policy in England.