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DEVELOPMENT FORUM. 1987 Mar; 15(2):1, 6.The author presents arguments to refute what he considers alarmist, unsupported generalizations about the origin and soread of AIDS (acquired immune deficiency syndrome) in Africa. The first myth is that AIDS originated in Africa, after a green monkey bit a man. There is no concrete evidence to support this theory. Moreover, if it were true, AIDS would have been known for years; there would be effective herbal remedies and folk traditions about the danger of green monkey bites. The syndrome is so distinctive, for example the oral candidiasis and striking wasting disease, called "slim" disease, that it would have been recognized long ago. Finally, numbers of cases have peaked in America first, a few years ago, and are now beginning to surge in some areas of Africa. A second myth is that countries are not reporting cases out of embarrassment. The author claims that reports to the WHO show far more cases of AIDS in the U.S. and Europe, and even if the 1000 cases in Africa as of 1986 were 1000-fold underestimated, they would be nowhere near the 5 or 10 million often printed. The third myth, that AIDS is out of control in Africa, is unsupported when the efforts of countries like Uganda are considered. Uganda has an extensive media campaign, significant funds relegated to fighting AIDS, foreign experts called in, blood testing equipment on order and in use in 2 hospitals. AIDS is only a problem in a few urban areas.
Alternative approaches to meeting basic health needs in developing countries: a joint UNICEF/WHO study.
Geneva, World Health Organization, 1975. 116 p.Based on the failure of conventional health services and approaches to make any appreciable impact on the health problems of developing populations, this study examined successful or promising systems of delivery of primary health care to identify the key factors in their success and the effect of some of these factors in the development of primary health care within various political, economic, and administrative frameworks. In the selection of new approaches for detailed study, emphasis was placed on actual programs that are potentially applicable in different sociopolitical settings and on programs explicitly recognizing the influence of other social and economic sectors such as agriculture and education on health. Information was gathered from a wide range of sources; including members, meeting reports, and publications of international organizations and agencies, gathered country representatives, and field staff. The 1st section, world poverty and health, focuses on the underprivileged, the glaring contrasts in health, and the obstacles to be overcome--problems of broad choices and approaches, resources, general structure of health services, and technical weasknesses. The main purpose of the case studies described in the 2nd part was to single out, describe, and discuss their most interesting characteristics. The cases comprised 2 major categories: programs adopted nationally in China, Cuba, Tanzania, and, to a certain extent, Venezuela, and schemes covering limited areas in Bangladesh, India, Niger, and Yugoslavia. Successful national programs are characterized by a strong political will that has transformed a practicable methodology into a national endeavor. In all countries where this has happened, health has been given a high priority in the government's general development program. Enterprise and leadership are also found in the 2nd group of more limited schemes. Valuable lessons, both technical and operational, can be derived from this type of effort. In all cases, the leading role of a dedicated individual can be clearly identified. There is also evidence that community leaders and organizations have given considerable support to these projects. External aid has played a part and apparently been well used. Every effort should be made to determine the driving forces behind promising progams and help harness them to national plans.