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NEW YORK TIMES. 1992 Jun 4; A1, B10.The international AIDS Center at the Harvard School of Public Health led a coalition of AIDS research from around the world in an analysis of more than 100 AIDS programs and discovered that the HIV/AIDS pandemic is more serious than WHO claims. Its findings are in the book called AIDS in the World 1992. AIDS programs do not implement efforts that are known to prevent the spread of HIV. For example, clinicians in developing countries continue to transfuse unscreened blood to many patients, even though HIV serodiagnostic test have existed since 1985. Further, programs do not evaluate what works in other programs. As long as people debate whether or not to distribute condoms, exchange needles, or offer sex education and whether people with AIDS deserve care, the fight against HIV/AIDS is hindered. The report recommends that leader come up with a new strategy to address the AIDS pandemic. WHO claims to have done just that at its May 1992 meeting. An obstacle for WHO is political pressure from member nations. On the other hand, the private Swiss foundation, Association Francois-Xavier Bagnoud, finances the Harvard-based AIDS program, allowing members more freedom to speak out. The head of the Harvard program believes the major impact of AIDS has not yet arrived. Contributing to the continual spread of HIV is the considerable difference of funding for AIDS prevention and control activities between developed and developing countries (e.g., $2.70 per person in the US and $1.18 in Europe vs. $.07 in sub-Saharan Africa and $.03 in Latin America). Even though developed countries provide about $780 million for AIDS prevention and care in developing countries, they do not enter in bilateral agreements with developing countries. 57 countries limit travel and immigration of people with HIV/AIDS. Further, efforts to drop these laws have stopped. Densely populated nations impose travel constraints to prevent an explosive spread of HIV.
Geneva, Switzerland, WHO, 1991. vii, 72 p.Members of WHO's Technical Working Group on Essential Obstetric Functions at First Referral Level have prepared a book geared towards district, provincial, regional, national, and international decision makers, particularly those in developing countries, whose areas of expertise include planning, financing, and organization and management of obstetric services. The guidelines should allow them to improve referral services' standards at the district level. They should also help them decide how far and by what means they may possibly expand some of these services to more peripheral levels, e.g., renovating facilities and improving staff. When developing these guidelines, WHO took in consideration that many countries confront serious economic obstacles. The book's introduction briefly discusses maternal morbidity and mortality in developing countries and maternity care in district health systems. The second chapter, which makes up the bulk of the book, addresses primary components of obstetric care related to causes of maternal death. This chapter's section on surgical obstetrics examines cesarean section and repair of high vaginal and cervical tears among others. Its other sections include anesthesia, medical treatment, blood replacement, manual procedures and monitoring labor, family planning support, management of women at high risk, and neonatal special care. The third section provides guidelines for implementation of these services, including cost and financial considerations. It emphasizes the need at the first referral level to have the least trained personnel perform as many health care procedures as possible, as long as they can do so safely and effectively. Other implementation issues are facilities, equipment, supplies, drugs, supervision, evaluation, and research. Annexes list the required surgical and delivery equipment, materials for side ward laboratory tests and blood transfusions, essential drugs, and maternity center facilities and equipment.