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  1. 1
    Peer Reviewed

    Nutrition: the new world disorder.

    Cannon G

    Asia Pacific Journal of Clinical Nutrition. 2002; 11 Suppl:S498-S509.

    Scale up 'we are what we eat' and nutrition is revealed as an aspect of world governance. The quality and nature of food systems has always tended to determine not only the health and welfare but also the fate of nations. The independence of nations depends on their development of their own human and natural resources, including food systems, which, if resilient, are indigenous, traditional, or evolved over time to climate, terrain and culture. Rapid adoption of untested or foreign food systems is hazardous not only to health, but also to security and sovereignty. Immediate gain may cause permanent loss. Dietary guidelines that recommend strange foods are liable to disrupt previous established food cultures. Since the 1960s the 'green revolution' has increased crop yield, and has also accelerated the exodus of hundreds of millions of farmers and their families from the land into lives of misery in mega-cities. This is a root cause of increased global inequity, instability and violence. 'Free trade' of food, in which value is determined by price, is imposed by dominant governments in alliance with industry when they believe they can thereby control the markets. The World Trade Organization and other agencies coordinate the work of transnational corporations that are the modern equivalents of the East India companies. Scientists should consider the wider dimensions of their work, nutrition scientists not least, because of the key place of food systems in all societies. (author's)
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  2. 2

    No product? No programme! The logistics of reproductive health supplies on conflict-affected settings.

    Crystal P; Ehrlich L

    Forced Migration Review. 2004 Jan; (19):18-19.

    The government of Angola is working with NGOs to initiate a series of aggressive HIV prevention activities and information campaigns. Twenty-five years of civil war, however, have robbed the country of its ability to procure enough contraceptives for these programmes, and even to guarantee a regular supply of essential medicines to meet other basic health needs of the Angolan population. A similar story emerges in the Democratic Republic of the Congo. Condoms are rarely available, particularly in the east, where population movements, military presence and the use of rape as a weapon of war contribute to the increased transmission of HIV. An OCHA assessment of health facilities in Kinshasa found stock-outs of many basic medicines, especially those needed for safe motherhood programmes. And although family planning supplies can be found in many pharmacies, they are too expensive for most women. (excerpt)
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  3. 3

    Global population and water: access and sustainability.

    Leete R; Donnay F; Kersemaekers S; Schoch M; Shah M

    New York, New York, United Nations Population Fund [UNFPA], 2003 Mar. xiii, 57 p. (Population and Development Strategies No. 6; E/1000/2003)

    UNFPA fully supports multi-sectoral policies and population and development programmes designed to achieve the Millennium Development Goals (MDGs). Such policies and programmes need to take into account the linkages that exist between the different goals and the critical intervening role of population factors and reproductive health. Progressing towards the MDG targets, eradicating poverty and achieving sustainable development is dependent on making progress towards the International Conference on Population and Development (ICPD) goal of achieving universal access to reproductive health services. Population growth and dynamics are often associated with environmental degradation in terms of encroachment of fragile ecosystems, rapid and unplanned urbanization, as well as water and food insecurity. Population pressures tend to be highest in countries least able to absorb large increments of people, threatening sustainable development and resulting in deterioration in the quality of life. (excerpt)
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  4. 4

    Cairo conference.

    McMichael AJ

    BMJ. British Medical Journal. 1994 Sep 3; 309(6954):554-5.

    The United Nations Conference on Population and Development in Cairo in September, 1994, will evoke criticism of the inability of governments to act quickly enough to avert demographic and environmental crises. Rapid population growth has clear implications for public health. Globally there now occur anthropogenic changes in atmospheric composition, the degradation of fertile lands and ocean fisheries, an accelerating loss of biodiversity, and the social and ecological problems of massive urbanization. In the future, per capita consumption levels will increase in burgeoning populations of developing countries, thus adding to the environmental impacts of overconsuming rich countries. By the end of the decade there will be over six billion people, of whom one half will live in cities. These demographic and environmental trends, if translated into climatic change, regional food shortages, and weakened ecosystems, would adversely affect human health. The World Health Organization is likely to concentrate only on accessible family planning and promotion of health for women and families. Continuing asymmetric child-saving aid, unaccompanied by substantial aid to help mobilize the social and economic resources needed to reduce fertility, may delay the demographic transition in poor countries and potentiate future public health disasters. As a result of recent reductions in fertility, even in Sub-Saharan Africa, average family sizes have been halved. Yet the demographic momentum will double population by 2050. The biosphere is a complex of ecosystems and, if unsustained, it could not fulfill the productive, cleansing, and protective functions on which life depends. The Cairo conference must therefore recognize that sustaining human health is a prime reason for concern about population growth and models of economic development.
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  5. 5

    World development report 1993. Investing in health.

    World Bank

    New York, New York, Oxford University Press, 1993. xii, 329 p.

    The World Bank's 16th annual World Development Report focuses on the interrelationship between human health, health policy, and economic development. WHO provided much of the data on health and helped the World Bank on the assessment of the global burden of disease found in appendix B. Following an overview, the report has 7 chapters covering health in developing countries: successes and challenges; households and health; the roles of the government and the market in health; public health; clinical services; health inputs; and an agenda for action. Appendix a lists and discusses population and health data. The report concludes with the World Development Indicators for 127 low, lower middle, upper middle, and high income countries in tabular form. All developed and developing countries have experienced considerable improvements in health. But developing countries, particularly their poor, still experience many diseases, many of which can be prevented or cured. They are starting to encounter the problems of increasing health system costs already experienced by developed countries. The World Bank proposes a 3-part approach to government policies for improving health in developing countries. Governments must promote an economic growth that empowers households to improve their own health. Growth policies must secure increased income for the poor and expand investment in education, particularly for girls. Government spending on health must address cost effective programs that help the poor, such as control and treatment of infectious diseases and of malnutrition. Governments must encourage greater diversity and competition in the financing and delivery of health services. Donors can finance transitional costs of change in low income countries.
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  6. 6

    Population growth and policies in mega-cities: Mexico City.

    United Nations. Department of International Economic and Social Affairs. Population Division

    New York, New York, United Nations, 1991. vi, 34 p. (Population Policy Paper No. 32; ST/ESA/SER.R/105)

    This review of elements affecting the population policy of Mexico City, the largest city in the world, is part of a series on formulation, implementation and evaluation of population policies of mega-cities as they follow the World Population Plan of Action of the UN World Population Conference, 1984. The main sections of the report are demographic factors and projections, economy, strategies of decentralization, issues and sectors, and resources and management. Mexico city is expected to have 27 million in 2000. Growth by migration accounts for doubling every 20 years, as natural increase declines. While Mexico City's economy has in recent decades grown because of industrial development, in the future increasing proportions of people will work in the informal sector. Air pollution, the worst documented in the world, due to photochemical smog, and traffic congestion are the city's most serious issues. These are being addressed by a contemplated retro-fit of automobiles with pollution control devices, state bus lines and a metro system. Decentralization has been approached by the National Urban Plan of 1978 and the National Development Plan of 1983-1988 among other efforts, but lack of a central authority, and the failure of the government to respond to the 1985 earthquake by relocating housing cost doubt of the likelihood of results. Counteracting systems such as subsidies for water, food electricity and diesel fuel for urban residents, and inadequate tax incentives for companies moving elsewhere are also in effect. Land speculation combined with illegal settlement of communal lands have hampered planning, but the earthquake cleared extensive areas for parks and low income apartments. Water supply is another major problem, with per capita usage equal to U.S. levels because of losses from the aging system. Health care and other services are allotted mainly on income lines because of political factors. Resources and regulation are in a pitched battle between the Federal District (the City) and Mexico State which soon will make up the majority of the population, but receives poorer services at greater expense relative to the City.
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  7. 7
    Peer Reviewed

    Health is a sustainable state.

    King M

    Lancet. 1990 Sep 15; 336(8716):664-7.

    This commentary by Maurice King questions the viability of current public health strategies. He advocates for an ecological approach that seeks to improve the health of the entire planet. He discusses the concept of the demographic trap. Being demographically trapped refers to a population being stuck in an "unsustainable state with a high birth rate and death rate, with an ever increasing pressure on its resources, and with a rapidly deteriorating environment". King points out that the possible outcomes are limited for a population that becomes trapped. Some of the possible outcomes include dying from starvation and disease; fleeing as ecological refugees; being destroyed by war or genocide; or being supported by food and other resources from elsewhere, first as emergency relief and then perhaps indefinitely. King believes that ecological collapse has already taken place in parts of Ethiopia and the process may have begun on a wider scale elsewhere. According to King, this ecological predicament can be found in both rural and urban areas in the developing world. This article also discusses the problem of high fertility. King believes that the widely held belief that the necessary and sufficient condition for reducing the birth rate is to reduce the child death rate is erroneous. He states that a causal relationship between the 2 rates is untenable, instead, it is more reasonable to say that both rates respond to other common factors. The author suggests that a fall in the birth rate requires the harnessing of social and economic gains to reduce poverty and promote socio-economic development. He also believes that the continued growth in the size of the world's population is due to declining efforts in family planning and declining child mortality not having its alleged effects on fertility. King also brings forth an ethical dilemma. He asks, "are there some programs which, although they are technically feasible, should not be initiated because of there long-term population-increasing consequences?" He suggests that other factors such as ecological deterioration, integrity of the ecosystem, and the welfare of future communities need to be taken into consideration. King presents a new global strategy based on the concept of "sustainability". He says that "sustainability should be the maintenance of the capacity of the ecosystem to support life in quantity and variety". Specifically, he advocates for consumption control in the industrial North with intensive energy conservation and recycling. In the South, he calls for renewed vigor in family planning efforts. Public health measures need to be understood in terms of their demographic and ecological implications. If measures are found to be desustaining, King says that complementary ecologically sustaining measures should be introduced with them. He also believes that desustaining measures, such as oral rehydration, should not be introduced on a public health scale if no adequately sustaining complementary measures are possible. He asserts that desustaining measures, without complementary interventions, can ultimately increase the man-years of human misery.
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  8. 8

    Europe's ageing population: trends and challenges to 2025.

    de Jouvenel H

    Guildford, England, Butterworths, 1989. 54 p.

    This report examines the trends of demographic ageing in Europe up to 2025. By that date one European in four could be aged 65 or over. With trends continuing towards the contraction of working life, severe imbalances may occur in individual life cycles, in the structure of the workforce, and in socioeconomic provision for an ageing population. The report further considers the potential impacts of these emerging imbalances on living conditions, consumption patterns, and socio-medical/health care provision for the old. Finally, a range of responses are outlined to the challenges of possible intergenerational conflict surrounding the nexus of issues related to demographic ageing.
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  9. 9
    Peer Reviewed

    Assessment and implementation of health care priorities in developing countries: incompatible paradigms and competing social systems.

    Makhoul N

    Social Science and Medicine. 1984; 19(4):373-84.

    This paper addresses conceptual issues underlying the assessment and implementation of health care priorities in developing countries as practiced by foreign development agencies coping with a potentially destabilizing unmet social demand. As such, these agencies mediate the gap between existing health care structures patterned around the narrow needs of the ruling classes and the magnitude of public ill-health which mass movements strive to eradicate with implications for capitalism at large. It is in this context that foreign agencies are shown to intervene for the reassessment and implementation of health care priorities in developing countires with the objective of defending capitalism against the delegitimizing effects of its own development, specifically the persistence of mass disease. Constrained by this objective, the interpretations they offer of the miserable state of health prevailing in developing countries and how it could be improved remains ideological: it ranges between "stage theory" and modern consumption-production Malthusiansim. Developing countries are entering into a new pattern of public health which derives from their unique location in the development of capitalism, more specifically in the new international division of labor. Their present position affects not only the pattern and magnitude of disease formation but also the effective alleviation of mass disease without an alteration in the mode of production itself. In the context of underdevelopment, increased productivity is at the necessary cost of public health. Public health improvement is basically incompatible with production-consumption Malthusianism from which the leading "Basic Needs" orientation in the assessment and implementation of health care priorities derives. Marx said that "countries of developing capitalism suffer not only from its development but also from its underdevelopment." (author's modified)
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  10. 10

    [Cuba, statistical profile, 1982] Cuba en cifras 1982.

    Cuba. Comite Estatal de Estadisticas

    [Havana], Cuba, Comite Estatal de Estadisticas, [1983]. 126 p.

    This edition of "Cuba in Figures" contains selected indicators for different sectors which characterize the development of the national economy over the past few years. The statistical indicators for 1982-82 should be considered preliminary. The 16 sections provide data on the territory and climate; population, including resident population by sex and age group, the working age population by sex, the resident population by sex for provinces and municipalities and by rural or urban residence, annual growth rate, sex ratio, population distribution by social groups, and demographic rates; total production and indicators of sectoral production; labor force distribution and average salary levels; industrial production and basic indicators for the sugar, fishing, and other industries and energy consumption; contruction and housing; investment by components and provinces; agriculture and animal husbandry, including production, growth, land use patterns, irrigation, and activity indicators; transport and communications including total income, passenger and cargo totals, and structure and indicators of communications activity; internal commerce; external commerce; communal and personal services; education; culture and art; public health, including facilities, manpower resources, consultations, immunizations, and morbidity rates for reportable illnesses; tourism; and sports.
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