Abstract Given that the last notified case of poliomyelitis due to wild poliovirus type 2 was in 1999, in 2012, the Strategic Advisory Group of Experts on Immunization (SAGE) of the World Health Organization (WHO) recommended the withdrawal of the type 2 component of oral polio vaccine (OPV) and the introduction of a bivalent OPV (bOPV) in all countries by 2016. WHO recommended also that the withdrawal should be preceded by the introduction of at least one dose of inactivated poliovirus vaccine (IPV) in routine immunization schedules. The introduction of IPV prior to the change of the bOPV in 2016 to trivalent OPV (tOPV) was based on the concept of ensuring that a substantial proportion of the population would be protected against type 2 polio after the removal of the type 2 OPV. However, the world's two producers of IPV (Bilthoven Biologicals and Sanofi) have faced problems in the production of this vaccine and therefore reported a reduction of the global supply of IPV. In response to the potential shortage of IPV, at a meeting held on March 10 2017, the SAGE and Technical Advisory Group (TAG) of the Pan American Health Organization (PAHO) urged the countries in the Latin American region to replace the routine administration of the full doses of inactivated polio vaccine (IPV-C) in the immunization schedule (administered by intramuscular route), administering a fraction of the full dose in two intradermal shots (IPV-f). The possibility of this strategy was analyzed by opinion leaders convened by the Paraguayan Society of Pediatrics with the support of the Latin American Society of Pediatric Infectious Diseases (SLIPE) and Latin American Association of Pediatrics (ALAPE). This document presents the results of the discussion.

As last notified case of poliomyelitis due to wild poliovirus type 2 was 1999, in 2012, the Strategic Advisory Group of Experts on Immunization (SAGE) of the World Health Organization (WHO) recommended the withdrawal of the type 2 component of oral polio vaccine (OPV) and the introduction of bivalent OPV (bOPV) in all countries by 2016. WHO recommended also that the withdrawal should be preceded by the introduction of at least one dose of inactivated poliovirus vaccine (IPV) in routine immunization schedules. The introduction of IPV prior to the change of the bOPV in 2016 to trivalent OPV (tOPV) was based on the concept of ensuring that a substantial proportion of the population would be protected against type 2 polio after the removal of the type 2 OPV. However, the world's two producers of IPV (Bilthoven Biologicals and Sanofi) have faced problems in the production of this vaccine and therefore reported reduction in IPV global supply. In response to the possible shortage of IPV, the SAGE and Technical Adviser Group (TAG) of the Pan American Health Organization (PAHO), in the meeting of March 10, 2017, has urged that countries in the Latinamerican region should replace the routine administration of the full doses of polio inactivated vaccine (IPV-C) in the immunization schedule (administered by intramuscular route) by the administration of a fraction of the full dose in two shots by intradermal route (IPV-f). The possibility of this strategy was analyzed by leaders of opinions gathered by the call of the Paraguayan Pediatric Society with the support of the Latin American Society of Pediatric Infectious Diseases (SLIPE) and Latin American Association of Pediatrics (ALAPE). The results of the discussion are presented in this document.

Abstract Sustainable development is based on ethical principles such as respect for and harmony with nature, political values such as participative democracy and social equity, and moral norms such as environmental rationality. Sustainable development is egalitarian, neutral, and self-managed, able to satisfy the basic needs of people, respecting cultural diversity, and improving the quality of life. The concepts of agriculture and sustainable development refer to the need of minimizing degradation of fertile land, while working to increase production. They include agricultural activities such as soil and water management, crop management, and the conservation of biodiversity, taking into account the provision of food and raw materials. Sustainability of agricultural production systems refers to the capacity of the system to maintain its productivity in spite of economic and natural, external or internal limitations. Sustainability is a function of the natural features of a system and the pressures and interventions it experiences, as well as social, economic, and technical interventions that are carried out in order to fight negative pressures, highlighting the resiliency of the system.

Se analizan las complejas relaciones entre la producción agrícola, la salud humana, la alimentación y el ambiente. El propósito es criticar al modelo dominante de agricultura moderna que usa semillas mejoradas, agroquímicos y maquinaria de alta capacidad operativa que conlleva a una alta degradación de los recursos naturales, siendo necesario aceptar y aplicar la concepción agroecológica, como alternativa de una dieta sana y nutritiva, pero también socialmente justa. Sin embargo, las políticas neoliberales de ajuste estructural promovidas por los organismos financieros multilaterales como el Fondo Monetario Internacional (FMI), el Banco Mundial (BM) y la liberalización del comercio agropecuario dentro de la Organización Mundial del Comercio (OMC) consolidaron el poder transnacional sobre el sistema alimentario nacional y debilitaron la intervención de los estados nacionales en la agricultura y reorientaron las políticas agrícolas, para privilegiar los intereses del mercado, en detrimento de las necesidades de la población nacional, fomentando los cultivos de agroexportación y sacrificando las políticas de apoyo a la producción de granos básicos que aseguran la autosuficiencia alimentaria.

The purpose of this paper is to analyze the complex relationship between agriculture production, human health, nutrition and environment, considering the actual prevalent agriculture model that is using improved seeds, agrochemicals and modern technology, which is destroying the natural resources. It makes necessary to accept and apply agro-ecological techniques as a good alternate to obtain healthy food, and additionally it is more reasonable for societies. However multilateral financial organisms such as the International Monetary Fund (IMF), the World Bank (WB), and the World Trade Organization (WTO), working together, consolidated the multinational power, promoting new polices that don’t benefit national and agriculture systems because they are promoting agro-exportation products, without considered and supporting national agriculture policies for basic farmers therefore affecting food production, food access and food security.