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Response to 'WHO classification of FGM omission and failure to recognise some women's vulnerability to cosmetic vaginal surgery'
Journal of Family Planning and Reproductive Health Care. 2017 Feb 24; 1.Add to my documents.
British Journal of Nursing. 2016 Mar 24-Apr 13; 25(6):344-5.Add to my documents.
Journal of Ethnic and Migration Studies. 2014 Jun; 40(6):924-941.This article investigates the complex relationship between the practices of the United Nations High Commissioner for Refugees (UNHCR) in the field of refugee protection and the more recent political rationality of 'migration management' by drawing from governmentality studies. It is argued that the dissemination of UNHCR's own refugee protection discourse creates certain 'figures of migration' allowing for justifying the build-up and perfection of border controls, which in turn enable any attempt to 'manage' migration in the first place. Conversely, the problematisation of population movements as 'mixed migration flows' allows UNHCR to enlarge its field of activitiy despite its narrow mandate by actively participating in the promotion, planning and implementation of migration management systems. Based on ethnographic research in Turkey and Morocco, this article demonstrates, furthermore, that UNHCR's refugee protection discourse and the emerging migration management paradigm are both based on a methodological nationalism, share an authoritarian potential and yield de-politicising effects. What UNHCR's recent embracing of the migration management paradigm together with its active involvement in respective practices then brings to the fore is that UNHCR is part of a global police of populations.
Essential medicines for mothers and children: a key element of health systems. Access to medicines and public pharmaceutical policy.
Entre Nous. 2009; (68):14-15.Medicines, when used appropriately, are one of the most cost effective interventions in health care. European countries spend an important part of their health budget on medicines, from 12% on average for the EU countries to more than 30% for the Newly Independent States (NIS) countries. Whereas in EU countries the larger part of the medicines expenditures are publicly funded through taxes and/or social health insurance, in the NIS and in the south eastern European countries it is often the patients who have to pay directly for the drugs themselves. This means that many patients simply do not get the drugs they need because they cannot afford them, and also may force families to incur enormous expenses as they sell their belongings in order to pay for their drugs and their health care.
Entre Nous. 2009; (68):8-9.The availability of effective sexual and reproductive health services (SRHS) has major implications on health in the European context. Low natural growth, epidemiological challenges generated often by sexually transmitted infections, increasing cross-border movement and inequalities in quality standards and safety requirements in health services all impact the SRH of populations in the Region. Integration of health system functions is critical to efficiently address the evolving issue of SRH at national level, and to ponder system’s capacity for delivery with the fluctuating clinical demand and public expectations. In the national context, the main challenge lies in the interventions of choice and in the degree to which these are prioritized, linked and disseminated, in terms of value, resources and policies.
Entre Nous. 2009; (68):4-5.The WHO European Ministerial Conference on “Health Systems, Health and Wealth” held in Tallinn in June 2008 was a watershed event that took stock of and consolidated the recent conceptual and methodological developments, as well as, practice-based innovations in the European health arena. The upshot of the conference was that not only does health matter - we knew that already because we in Europe value health in its own right - but also good health contributes to wealth generation. The conference also argued that health systems contribute to the generation of wealth, since in almost any society, albeit at varying degrees, the health sector constitutes one of the major spheres of economic activities, producing, consuming and trading goods and services, and contributing to knowledge and technology generation through research and development.
Forced Migration Review. 2007 Dec; (29):72.The Norwegian Refugee Council (NRC) strongly believes that the Cluster Approach holds promise for improving the international response to internal displacement. The approach represents a serious attempt by the UN, NGOs, international organisations and governments to address critical gaps in the humanitarian system. We want this reform effort to succeed and to play an active role in northern Uganda to support the work of the clusters and improve their effectiveness. (excerpt)
International Journal of Gynecology and Obstetrics. 2007 Nov; 99(2):157-161.National and international courts and tribunals are increasingly ruling that although states may aim to deter unlawful abortion by criminal penalties, they bear a parallel duty to inform physicians and patients of when abortion is lawful. The fear is that women are unjustly denied safe medical procedures to which they are legally entitled, because without such information physicians are deterred from involvement. With particular attention to the European Court of Human Rights, the UN Human Rights Committee, the Constitutional Court of Colombia, the Northern Ireland Court of Appeal, and the US Supreme Court, decisions are explained that show the responsibility of states to make rights to legal abortion transparent. Litigants are persuading judges to apply rights to reproductive health and human rights to require states' explanations of when abortion is lawful, and governments are increasingly inspired to publicize regulations or guidelines on when abortion will attract neither police nor prosecutors' scrutiny. (author's)
Danish Medical Bulletin. 2007 May; 54:150-152.In general, children and adolescents in the WHO European Region today have better nutrition, health and development than ever before. There are striking inequalities in health status across the 52 countries in the Region, however, with over ten-fold differences in infant and child mortality rates. Inequalities are also growing within countries, and several health threats are emerging. Against this background, the WHO Regional Office for Europe has developed a European strategy for child and adolescent health and development. The purpose of the Strategy, together with a tool kit for implementation, is to assist member states in formulating their own policies and programmes. (author's)
Lancet. 2007 May 26; 369(9575):1773.A recent briefing paper by the charity Save the Children UK, and an investigation by the Guardian newspaper, highlight that inappropriate activities surrounding baby-milk formula marketing and promotion cannot be resigned to the pages of history. 25 years on from the introduction of the WHO International Code of Marketing Breast Milk Substitutes, food companies persist in their dubious practices, but in a more subtle manner than in their aggressive activities of 30 years ago. Most importantly, such practices are still responsible for the deaths of thousands of children. In 1970s, an international campaign against the food giant Nestle was responsible for eliciting such collective outrage that it led to one of the biggest public boycotts in corporate history. Subsequent international pressure resulted in the WHO code, which not only covers the marketing of infant formula, but also other commodities if promoted as partial or total breastmilk replacements. (excerpt)
Lancet. 2006 Dec 9; 368(9552):2081-2094.William Harvey was born in Folkestone on April 1, 1578. He was educated at the King's School, Canterbury, Gonville, and Caius College, Cambridge, and the University of Padua, graduating as doctor of arts and medicine in 1602. He became a Fellow of the Royal College of Physicians in 1607 and was appointed to the Lumleian lectureship in 1615. In the cycles of his Lumleian lectures over the next 13 years, Harvey developed and refined his ideas about the circulation of the blood. He published his conclusions in 1628 in Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, which marks the beginning of clinical science. In it, Harvey considered the structure of the heart, arteries, and veins with their valves. By carefully devised experiments and supported by the demonstration of the unidirectional flow of the blood in the superficial veins of his own forearm, he established that the blood circulated, and did not ebb and flow as had been believed for more than 1000 years. (excerpt)
Human Reproduction. 2007 Jan; 22(1):311-312.We thank Professor Evers for his interest in our preliminary work. We agree that a positive likelihood ratio (LR+) of 1.67 will change the likelihood of disease in a clinically not very relevant way. Indeed, we have moderated our purpose saying that an LR+ of 1.67 indicated a small impact on the post-test probability of successful IVF. However, this change was statistically significant as our study showed. Thus, we believe that in the lack of other predictive tests that could be performed routinely, this new combined test is helpful to decrease the risk of fertilization failure during IVF therapy in the case of unexplained infertility. Concerning male factor, we have found an LR+ of 6.0, which indicated a better, though moderate, post-test impact, as we have said in our study and accordingly to Professor Evers' letter. However, we effectively did not include the 95% confidence interval (CI) of this LR in our study, and we agree that this could lead to misinterpretation. We thought that this CI is calculated using an approximate formula, which could not be considered as valid on such a small sample. (excerpt)
Human Reproduction. 2007 Jan; 22(1):311.I have read with great interest the article by Sifer et al. (2005) on the combination of a newly developed sperm-zona pellucida-binding assay and WHO grade 'a' sperm motility to predict sperm fertilizing ability in IVF. The authors have to be commended for developing a--theoretically very appealing--new sperm function test, and it is easy to understand how they could get carried away by their enthusiasm about the clinical applicability of this new test. In fact, the authors are so positive about the results of their combination test that they consider it 'an excellent predictor of sperm fertilizing potential in cases of mild male-factor infertility', and they recommend that it 'should be incorporated as a functional test to direct patients to IVF or ICSI at their first attempt'. They continue by stating that 'the positive LR of 1.67 (95% CI 1.07-2.59) allowed us to use this test in these cases' (i.e. in patients with unexplained infertility). (excerpt)
BMJ. British Medical Journal. 2006 Aug 26; 333(7565):410.A group of Czech Roma women who said that they were forcibly sterilised have, on 17 August, outlined their stories in person to a United Nations committee in New York. They hope this will exert pressure on the Czech government to apologise. On the same day, many Roma women staged a protest outside a hospital in the east of the Czech Republic to raise awareness for their cause. About 30 women carrying banners stating "we want children" and "sterilise gherkins not women" protested outside the municipal hospital in Ostrava in an attempt to get a public apology from the government. A report by the Czech ombudsman released several months ago found that at least 50 women had been unlawfully sterilised as recently as 2003. Eighty women had lodged complaints with the ombudsman, alleging they underwent operations to be sterilised against their will. (excerpt)
Choices. 2001 Dec; 18-19.I don't have any used syringes. Somebody has stolen all, Anka was almost begging. In a worn-out black T-shirt and torn jeans, she looked helpless and desperate, standing in the middle of a vacant square, squeezed between Warsaw's main railway station and a Holiday Inn hotel. "I really don't have any," she repeated. "You know it's an exchange. Go and find some," Grzegorz Kalata said, patiently but firmly. Kalata comes to the square -- a meeting point for local drug users -- almost every evening. He is a streetworker from Monar, Poland's leading chain of non-profit detoxification centres. Under a harm reduction programme, partly sponsored by the United Nations Development Programme (UNDP), Kalata gives disposable syringes and needles, bandages, condoms and antiseptics to drug addicts who meet at the square. In return, he collects used syringes and needles in a plastic container, usually full by the end of his visit. After scouring the grass at the site, Anka came back with four used needles. Kalata gave her seven new ones and a package of bandages. On average, Kalata gives out some 200 needles and 150 syringes during an evening. (excerpt)
Lancet Infectious Diseases. 2006 Jun; 6(6):328.Ukraine plans to restructure a key HIV/ AIDS and tuberculosis control project to help ensure disbursement of a US$60 million loan recently suspended by the World Bank. Alla Shcherbinska (Ukrainian Centre to Combat HIV/AIDS) told journalists that it will take the government only a few weeks to "reconstruct" the project. However, Shiyan Chao, a senior health economist at the World Bank cautioned that: "resumption of the funds will hinge on the government's concrete actions to improve earlier shortcomings related to policy issues on tuberculosis control, procurement, fiduciary controls, and other important aspects of project management". The World Bank suspended the loan, complaining of poor implementation by the Ukrainian ministry of health. "At the time of suspension, which came after the first 3 years of implementation, only 2% of funds available for this project had been disbursed by the Ukrainian ministry of health", Merrell Tuck, a spokesperson of the Bank said. The Bank says "there is also concern about the government's full commitment to both condom use and harm reduction for injecting drug users [IDUs]". (excerpt)
BMJ. British Medical Journal. 2006 Jul 1; 333(7557):8.Hundreds of thousands of women in developing countries suffer the devastating injury during child bearing of obstetric fistula. But the agency behind a global campaign to eradicate the condition says it is simple to prevent and easy to treat. The global campaign, led by the international development agency the United Nations Population Fund, has launched a month long advertising drive in the United Kingdom to raise awareness of a condition that is believed to affect between 50 000 and 100 000 women each year. Obstetric fistula is usually caused by several days of obstructed labour without prompt medical intervention and leaves the woman with agonising, long term pain, chronic incontinence, and--in most cases--a stillborn baby. (excerpt)
WHO healthy cities and the US family support movements: a marriage made in heaven or estranged bed fellows?
Health Promotion International. 1996; 11(2):137-142.The family support movement in the US emerged at about the same time that the WHO Healthy Cities project was gaining momentum in Europe, and the underlying principles and ecologic frameworks of the two have much in common. However, while many 'Healthy Cities' in Europe have included activities that benefit families, this has not been made a major focus. There seems to be little awareness of experience gained in the US in terms of establishing programs with limited or no government funding, using volunteers, and developing social marketing and advocacy strategies sustain long term viability. Similarly, cities and states in the US are struggling to develop networks of family support programs and they appear to be doing this without the benefit of experience gained in Healthy Cities projects on how to engage political leadership, develop public policies, establish intersectoral councils, fund a coordinator position, mobilize neighborhoods, and evaluate community wide health promotion programs. The purpose of this paper is to examine how these two movements might join forces and learn from each other. (author's)
All rights for all children. UNICEF in Central and Eastern Europe and the Commonwealth of Independent States.
Geneva, Switzerland, UNICEF, Regional Office for Central and Eastern Europe and the Commonwealth of Independent States, 2005. 48 p.All children have the right to survive, to be educated, to be healthy, to have a name and nationality. All children have the right to participate in decisions that affect them. And all children have the right to be protected from harm. UNICEF, the United Nations Children's Fund, speaks out for the rights of all children in Central and Eastern Europe and the Commonwealth of Independent States. The region faces unique challenges. No other region has been through so dramatic a transformation in so short a time and the scale of the changes has had a serious impact on children. Rising poverty and unemployment and falling social spending have excluded vast numbers of children from the economic progress that has been made in recent years. Millions of families are under pressure: the systems that once guided their lives have vanished and they must find their way in a new and unfamiliar landscape, confronting new dangers such as HIV/AIDS and the trafficking of drugs and human beings. (excerpt)
Lancet. 2005 Nov 5; 366(9497):1586.Next week, on Nov 8, an important deadline for ratifying the WHO Framework Convention on Tobacco Control (FCTC) approaches. Any country that has not ratified the convention by then will not become a full party to its governing body, which will meet for the first time at the Conference of the Parties in Geneva, Feb 6–17, next year. At that meeting parties will take decisions on technical, procedural, and financial issues relating to the implementation of the convention. The FCTC has been rightly hailed as a milestone for the promotion of public health worldwide and WHO can be proud of its achievement. So far, 94 countries have ratified the FCTC, 41 of these in 2005, with China, Rwanda, Nigeria, Cyprus, and the Democratic Republic of the Congo becoming the latest nations to do so this October. China, with the world’s largest cigarette market and with an estimated 350 million smokers, is a particularly important signatory. By ratifying the FCTC, China has taken an important and welcome step to protect its people’s health. Rapid economic changes make China’s large population especially vulnerable to a future epidemic of chronic diseases. (excerpt)
Habitat Debate. 2000; 6(3): p..Large-scale corruption in developed and developing countries is closely connected to contracting-out, concessions, and privatization. The encouragement of privatization of public services and infrastructure by the World Bank and others has multiplied the potential scale of this business. At the same time it has multiplied the incentives for multinational companies active in these sectors to offer bribes in order to secure concessions and contracts. One of the sectors most at risk is water and sanitation. The concessions invariably involve long-term monopoly supply of an essential service, with considerable potential profit. Often, major construction works are involved, which are themselves a source of profit. (excerpt)
BMJ. British Medical Journal. 2005 Jul 2; 331:46-47.I want to congratulate you, Prime Minister Blair, on the hard work that you and your team have put into the Commission for Africa’s report. It is an honest document, probing gently but fearlessly into the reasons why so many endeavours in this great continent have failed. You emphasise the responsibility of African leaders to drive development from within Africa but at the same time make clear the responsibility of the richer countries to commit to serious partnership in the process, with the aim being Africa’s development rather than their own. I am sure you don’t need reminding that these principles will be difficult to put into practice, but I am hopeful that the report will be a template for action. When I heard about the commission last year I tried to contact you, requesting that at least one of the commissioners be involved in health care. Maybe you were overwhelmed by advice, as my letters went unanswered. However, your report has touched on matters of health, with sections on HIV and AIDS, tuberculosis, and malaria. These diseases are of enormous importance and are already being tackled by many groups in Africa. I am not involved in HIV treatment myself, but many of my patients are infected by the virus and my wife is working in a palliative care project for dying children, most of whom have HIV or AIDS, so I know first hand of the misery and hopelessness in so many lives. (excerpt)
Protecting choice means making choices. Legislators worldwide must choose to preserve the Cairo consensus.
Countdown 2015: Sexual and Reproductive Health and Rights for All. 2004; (Spec No):48-50.At the ten year mark of the ICPD Programme of Action, never HAS a woman’s right to decide freely the number and spacing of her children been so widely recognised and exercised—yet paradoxically challenged. These challenges are both old and new, and they call upon us as European parliamentarians to make a number of fundamental policy, diplomatic and budgetary choices. In 1994, the adoption of the ICPD Programme of Action by 179 countries marked a major shift towards placing the individual at the centre of development and abandoning demographic targets. The Millennium Development Goals further enshrined women’s right to make their own decisions as a global development objective. Despite this explicit political will and the great strides forward of the past decade, trends have emerged that force us to reassess our long-held strategies. The first is the HIV/AIDS pandemic. In 2004, the worst-case scenarios of the early 1990s are becoming reality. The developed world watches as entire generations suffer in less developed countries from a disease that is both preventable and treatable—one that has been controlled in donor countries. Yet rather than coming together to fight a common enemy, the HIV/AIDS community and sexual and reproductive health and rights (SRHR) advocates have seemed to drift apart. (excerpt)
Journal of Gender, Social Policy and the Law. 2004; 12(1):197-231.Sexual violence against women during conflict and war has always had a place in history. However, protection against such genderbased violence found a place in international criminal statutes only after World War II. The Nuremberg Charter of the International Military Tribunal at Nuremberg (“IMT”) did not criminalize rape but created the category of crimes against humanity, which today encompasses gender-based crimes such as rape. Nearly a year later, the International Military Tribunal for the Far East at Tokyo (“IMTFE”) included rape as a violation of war in the Tokyo Charter. While the significance of such prosecutable crimes in the Nuremberg and Tokyo Charters is arguable, the inclusion of rape as a war crime served as the foundation for the wide acknowledgment of genderbased crimes and crimes specifically targeting women. Consequently, an increased awareness of gender-based crimes is evident in the Rome Statute of the International Criminal Court. This Comment analyzes the Rome Statute and the degree to which the International Criminal Court (“ICC”) protects women from gender-based violence. Part I discusses the history of international criminal courts and the path leading up to the need for the ICC. It also explores discussions at the Rome Diplomatic Conference that placed gender-based crimes under the ICC’s jurisdiction. Part II addresses the protection that women receive under the ICC as regulated by the Rome Statute, specifically Articles 7 and 8 (“the Articles”), which lend greatest protection to women. Part III applies the Rome Statute’s Articles 7 and 8 to two regions: the Democratic Republic of Congo (“DRC”) and Kosovo. (excerpt)
Annan addresses European Parliament on migration and accepts Andrei Sakharov prize for freedom of thought.
Population 2005. 2004 Jun; 6(2):10-11.I am deeply touched that you have honored my friend and colleague, Sergio Vieira de Mello, and the many other U.N. staff who have lost their lives in working for peace in the world. I am proud to accept the Andrei Sakharov Prize in memory of them. This Prize for Freedom of Thought is not only a worthy recognition of the ultimate sacrifice that they made in the cause of peace. It is also a welcome acknowledge of the kinds of people they were. The brave men and women we lost in Baghdad on 19 August – U.N. staff and others – were free spirits and free thinkers and also soldiers of humanity and of peace. Earlier, President Cox and I met some of the survivors of the attack, and family members of those who were killed or injured, and, as you know, they are with us in the Chamber now. I thank them for joining us today, and I accept this Prize in their name too. (excerpt)