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No product? No programme! The logistics of reproductive health supplies on conflict-affected settings.
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)
HEALTH FOR THE MILLIONS. 1994 Jun; 2(3):4-7.The International Conference on Population and Development (ICPD) is set for September 1994. Arms control and control of military interests are as crucial as population control. The expenditure on the military and arms should go to social measures and true socioeconomic development. Women are leading the movement against war and towards peace. Women make up 70% of current refugees of ethnic conflicts. The conquest of free trade with little or no restriction and globalization trends forces developing countries to accept nonessential luxury items which tend to be irrational, hazardous consumer articles and technologies from industrialized countries. The privileged elite in developing countries and the industrialized countries overconsume, while the basic needs of the poor majority are not being met. The rich view the poor as a global threat and a threat for environmental degradation. They believe that free trade will solve all problems, yet it only marginalizes the poor and the vulnerable. The pattern of overconsumption is the threat. The poor are characterized as demons responsible for the population explosion. Women are angry that population control policies are attempts to control women's fertility. Specifically, most contraceptive technologies and most family planning programs target women. Male responsibility is ignored. Religious fundamentalists tell women not to become pregnant, not to use contraception, and not to seek abortion, yet they allow male sex behavior, e.g., sexual violence. This attitude leaves women vulnerable to unwanted pregnancies, sexually transmitted diseases, and AIDS. Developing countries should be concerned about chapter III on Population, Environment, and Development in the ICPD text. Most countries, including India, have formed a consensus on this chapter. The Vatican and some Latin American countries have objections, however. The meeting in Cairo will likely continue to promote the view that the fertility of women in developing countries and of women of color must be controlled.
Providence, Rhode Island, Brown University, Alan Shawn Feinstein World Hunger Program, 1990 Jun. x, 87 p. (HR-90-1)The Hunger Profile differentiates among food shortages, poverty, and deprivation. Food shortage is further reflected in the amounts needed to fulfill nutritional requirements of an entire country's population, to maintain current levels of food consumption, and to prevent starvation or famine. Views are also expressed in terms of a global food shortage food-short countries, food-poor households, and food-deprived individuals. 2% of the world are affected by food shortage and 9-20% are affected by food poverty. 16% of the world's infants are food deprived. 31% of children are underweight/age. 4% are iodine deficient, 13% are deficient in iron, and 15% suffer from vitamin A deficiency. The authors present their views on the state of hunger in 1990, hunger as a weapon of war, food aid and hunger, refugees and hunger, breast-feeding trends, and reducing hunger by 50%. The text of the Bellagio Declaration on Overcoming Hunger in the 1990s is included. Hunger was being used in 1990 as a weapon in Afghanistan, Cambodia, Sri Lanka, and the Philippines in Asia; in Angola, Mozambique, Ethiopia, Sudan, Somalia, and Mauritania in Africa; in Nicaragua, El Salvador, and Guatemala in Latin America; and in Armenia and Romania in Eastern Europe. 15% of imports to low-income, food-deficit countries and 44% of imports in developing in developing countries come in the form of food aid. Food aid has decreased 16% since 1985-86. Most food aid comes from the US (57%), the European Economic Community and member countries (20%), and Canada (10%). There is a longterm need to shift from direct food aid to programs that increase access to food for the most vulnerable populations. There has been an increase in cereal food aid since 1973-74; aid is dependent on cereal prices. There must be a balance between longterm and shortterm aid. Food aid is distributed as emergencies (20%), project food aid for maternal and child health programs (25%), and program aid. 5% is directed to target groups. Refugees are a growing population vulnerable to hunger. The most basic rations are given to refugees on an inconsistent basis due to inadequate and hoarded supplies and logistics. Refugee populations are reported by host country for 1989. Breast feeding is declining in general. Commitment, organization, and evaluation are necessary to halve hunger in the 1990s.
FOCUS. 1993; 3(2):43, 47-50.Rebuttal is made to a theory that developed countries should not provide famine relief to countries whose population size has exceeded their carrying capacity and that developing countries must also accept contraceptives and encourage vasectomies to receive development aid. This view is based on assumptions and arguments that more than 10 years of research, analysis, and informed debate have made anachronistic. 20% of the world's population who live in developed countries consume 80% of the Earth's resources. At present levels of consumption and waste, the 57 million people born in developed countries in the 1990s. Japan has few natural resources and limited agricultural capacity and, thus, has already exceed its carrying capacity. Still it has one of the world's highest standards of living and a high degree of ecological stability. Japan has displaced its resources and environment costs to less wealthy and less powerful countries. Japan's demand for tropical woods, for example, is responsible for rapid deforestation in Thailand, Indonesia, the Philippines, Malaysia, Myanmar, Cambodia, and Laos. It exports its industrial pollution to developing countries, largely by relocating pollution intensive heavy and chemical industries to other Asian countries. Population growth is not the leading reason for the famines in the Sahel. Global climactic change, conflict between the superpowers in the Horn of Africa, and export agriculture (e.g. during the 1984-1985 famine, Ethiopia exported green beans to England) contributed greatly to these famines. To reduce fertility rates, society must work to raise living standards, cultivate equality, and people's control over their lives, and improve women's status. Sri Lanka, China, and the Indian state of Kerala are examples of how political commitment to social welfare, including a commitment to increasing women's status, contributed to sizable reductions in population growth despite only moderate levels of per capita income.
Washington, D.C., Island Press, 1992. xxi, 291 p.The only person to serve on all 5 independent international commissions on global issues (e.g., the Brundtland Commission on Environment and Development) analyzes and compares scientific research to reveal the nature and magnitude of human excesses and their inherent dangers. He proposes recommended solutions from other international organizations. He urges us to achieve these solutions during a new era of enlightened change beginning with an Earth Charter at the June 1992 Conference on Environment and Development. This era depends on political will and the will of the people to accept and adopt long-term programs to protect the planet and to secure equitable access to its resources (i.e., a revolution in human consciousness). Sustainable development is based on needs, particularly those of the Earth's poor, and environmental limits. The rich tend to live in the industrialized countries of the North and account for 25% of the world's population, yet they consume 80% of commercial energy (i.e., burning of fossil fuels). In 1991, the world's worst polluter, the US, did not commit to stabilizing or reducing carbon dioxide output coming from consumption of fossil fuels. Since this consumption is almost entirely responsible for global pollution, the North must curb energy consumption. The author also petitions the North to help the South defeat poverty--the world's worst polluter, because the environment and world development are interconnected. He proposes a multilateral program comparable to the Marshall Plan implemented after World War II. The example of clearing tropical forests for timber exports and farming illustrates how poverty contributes to environmental pollution (e.g., it contributes to the build up of carbon dioxide, thereby threatening our atmosphere).
CHRISTIAN SCIENCE MONITOR. 1992 Oct 21; 9-10, 12.Discussion of world food supply identifies the reasons for shortages, based on the opinions of various food experts, as maldistribution of wealth and income, population growth, limits to production, shortage of usable land, global warming, air pollution, and civil war. In 1992, farmers produced enough food to feed the world's 5.3 billion population, but starvation and hunger occur because people cannot afford to buy enough or because of armed conflict. To meet the growing demands of expected population increases, productivity must increase by 3 times within 50 years to feed 9-12 billion people. Although Dennis Avery from the Hudson Institute is optimistic, the Population Crisis Committee's International Human Suffering Index shows Mozambique as suffering the most with a population growth of 2.7% while Denmark with zero growth suffers the least. 786 million still go hungry today. The agronomists' solution is to lesson the political conditions that lead to conflicts, to make agriculture sustainable, to enhance farm productivity with modern techniques, and encourage economic development. The political challenges are exemplified in the case of Tenneco West's investment in mechanized agriculture in northern Sudan which doubled agricultural productivity but civil war disrupted activities. Famine in Africa is due to war, i.e., Somalia in the present context. 11% of the earth's land surface is cultivated (3.7 billion acres). Lester Brown of the Worldwatch Institute pessimistically points out that the farmland base stopped growing in 1980, air pollution can reduce crop yields by 10%, and part of the world's food output is not sustainable. Avery states that a billion acres of African wetlands and another billion of savanna could be changed over to agriculture, that African farmers could triple corn production using high yield varieties, but Africa will have a "slow, desperately difficult struggle." Dr. Harwood at Michigan State says that global warming might increase yields as well as contribute to flooding. Dennis Leopold from the Leopold Center for Sustainable Agriculture at Iowa State University suggests that a balance must be reached between the farmer and the community, and large farms may not be the best. World trade is low compared with production and consumption, yet countries like Indonesia clear 1.5 million acres of jungle for crop production regardless of the environmental degradation.
Economic Development and Cultural Change. 1986 Jan; 34(2):245-62.The authors analyze aspects of Palestinian demographic change in the West Bank and the Gaza Strip during the years 1922-1982. "The research is initiated in Section II with a brief historical overview of demographic change in the territories, including comparison of fertility, natality, and mortality during periods of Jordanian and Israeli administration. Section III focuses on composition, destination, and local demographic impacts of Palestinian migration. In Section IV, econometric evaluation of migratory determinants is undertaken." Data are from official Jordanian, Kuwaiti, Israeli, and Palestinian sources and from other published literature. The significance of migration in explaining demographic trends in the region is noted. Migratory movements in the wake of the 1948 and 1967 wars are shown to be similar in magnitude to those observed during periods of relative political stability. The authors also suggest that "consumption patterns, housing development, and indices of employment opportunity in local and foreign labor markets are highly significant in an explanation of Palestinian emigration over the post-1967 period." Population growth forecasts and policy implications are briefly considered. (EXCERPT)
[Hunger and disease in less developed countries and en route to development (the Third World). Proposal for solutions] Hambre y enfermedades en los paises menos adelantados y en vias de desarrollo (Tercer Mundo). Propuesta de soluciones.
Anales de la Real Academia Nacional de Medicina. 1984; 101(1):39-96.The extent, causes, and possible solutions to problems of hunger, inequality, and disease in developing countries are discussed in this essay. Various frameworks and indicators have been proposed for identifying the poorest of nations; currently, 21 African, 9 Asian, and 1 American nation are regarded as the poorest of the poor. The 31 least developed countries, the 89 developing countries, and the 37 developed countries respectively have populations of 283 million, 3 billion; infant mortality rates of 160, 94, and 19/1000 live births; life expectancies of 45, 60, and 72 years; literacy rates of 28, 55, and 98%; per capita gross national products of $170, and $520, and $6230; and per capita public health expenditures of $1.70, $6.50, and $244. Developing countries in the year 2000 are expected to have 4.87 billion of the world's 6.2 billion inhabitants. The 3rd world contains 70% of the world's population but receives only 17% of world income. 40 million persons die of hunger or its consequences each year. Economic and social development is the only solution to problems of poverty and underdevelopment, and will require mobilization of all present and future human and material resources to achieve maximum possible wellbeing for each human being. Among principal causes of underdevelopment in the 3rd World are drought, illness, exile, socioeconomic disorder, war, and arms expenditures. Current food production and a long list of possible new technologies would be adequate to feed the world's population, but poor distribution condemns the world's people to hunger. Numerous UN agencies, organizations, and programs are dedicated to solving the problems of hunger, underdevelopment, and disease. In 1982, 600 billion dollars were spent in armanents, of $112 for each of the world's inhabitants; diversion of these resources to development goals would go a long way toward solving the problem of underdevelopment. The main problem is not lack of resources, but the need to establish a new and more just economic and distributive order along with genuine solidarity in the struggle against underdevelopment. Several steps should be taken: agricultural production should be increased with the full participation of the developng nations; the industrialized or petroleum-producing nations should aid the poor states with at least .7% and up to 5% of their gross national products for the struggle against drought, disease, illiteracy, and for the green revolution and new agropastoral technologies; prices paid to poor countries for raw materials should be fair; responsible parenthood, education, women's rights, clean drinking water, environmental sanitation and primary health care should be promoted; the arms race should be halted, and the North-South dialogue should be pursued in a spirit of goodwill and cooperation.