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  1. 1
    303410
    Peer Reviewed

    The HIV-AIDS pandemic at 25 - the global response.

    Merson MH

    New England Journal of Medicine. 2006 Jun 8; 354(23):2414-2417.

    On June 5, 1981, when the Centers for Disease Control reported five cases of Pneumocystis carinii pneumonia in young homosexual men in Los Angeles, few suspected it heralded a pandemic of AIDS. In 1983, a retrovirus (later named the human immunodeficiency virus, or HIV) was isolated from a patient with AIDS. In the 25 years since the first report, more than 65 million persons have been infected with HIV, and more than 25 million have died of AIDS. Worldwide, more than 40 percent of new infections among adults are in young people 15 to 24 years of age. Ninety-five percent of these infections and deaths have occurred in developing countries. Sub-Saharan Africa is home to almost 64 percent of the estimated 38.6 million persons living with HIV infection. In this region, women represent 60 percent of those infected and 77 percent of newly infected persons 15 to 24 years of age. AIDS is now the leading cause of premature death among people 15 to 59 years of age. In the hardest-hit countries, the foundations of society, governance, and national security are eroding, stretching safety nets to the breaking point, with social and economic repercussions that will span generations. (excerpt)
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  2. 2
    278148
    Peer Reviewed

    Called to account.

    Aldhous P

    Nature. 2004 Jul 8; 430:133.

    Next week, some 15,000 delegates will converge on Bangkok, Thailand, for the XV International AIDS Conference. It is appropriate, given the meeting's location in a fast-developing country that has done much to protect its citizens from HIV, that its theme is 'access for all'. For the poor countries hit hardest by AIDS, this is the crucial issue -- they need access to lifesaving drugs, to interventions that can limit the spread of HIV, and to the money to pay for it all. At the last international conference, in Barcelona in 2002, hopes were high that the rich world would begin to provide the cash to allow developing nations, particularly those in sub-Saharan Africa, to fight back against HIV. "Bangkok will be a time of accountability," observed Peter Piot, executive director of UNAIDS, the Joint United Nations Programme on HIV/AIDS (see Nature 418, 115;2002). Now it is time to take stock. Today's balance sheet reveals a mixed picture. On the plus side, more people than ever before are being treated with cocktails of antiretroviral drugs. According to UNAIDS, 230,000 AIDS patients in developing countries were getting these drugs at the end of 2001; two years later, this figure had risen to 400,000. Price reductions have driven this progress -- negotiations by philanthropic organizations have helped to lower costs from a minimum of US $300 per person, per year in 2002 to today's figure of $140. (excerpt)
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  3. 3
    191276
    Peer Reviewed

    Explicating donor trends for population assistance.

    Schindlmayr T

    Population Research and Policy Review. 2004 Feb; 23(1):25-54.

    Using population assistance data, this study divides donor trends for population assistance into five distinct epochs: until the mid-1960s, the population hysteria of the 1960s and 1970s, Bucharest Conference and beyond, the 1984 Mexico City conference, and the 1990s. A number of decisive events, as well as changing views of the population problem, characterise each period and have affected the sums of population assistance from donor nations. Taking a long-term view of global population assistance, the research shows that four factors account for most of the historical funding trends from primary donors: the association between population assistance and foreign aid, the role of alarmists and doomsayers in the public debate over population issues, individuals in a position of power within donor governments, and decennial international population conferences. (author's)
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  4. 4
    184562

    Challenges remain but will be different.

    Sinding S; Seims S

    In: An agenda for people: the UNFPA through three decades, edited by Nafis Sadik. New York, New York, New York University Press, 2002. 137-150.

    This volume chronicles the remarkable success -- indeed, the reproductive revolution -- that has taken place over the last thirty years, in which the United Nations Population Fund (UNFPA) has played such a major role. Our purpose in this chapter is to contrast the situation at the century's end with the one that existed at the time of UNFPA's creation thirty years ago, and to project from the current situation to the new challenges that lie ahead. In many respects, the successful completion of the fertility transition that is now so far advanced will bring an entirely new set of challenges, and these will require a fundamental rethinking about the future mandate, structure, staffing and programme of UNFPA in the twenty-first century. Our purpose here is to identify those challenges and speculate about their implications. (author's)
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  5. 5
    184556

    Thirty years of global population changes.

    Caldwell JC

    In: An agenda for people: the UNFPA through three decades, edited by Nafis Sadik. New York, New York, New York University Press, 2002. 2-23.

    In demographic terms, the last thirty years have been quite distinct from the period that preceded it, or, indeed, from any other period in history. The global fertility level had been almost stable for at least twenty years prior to 1965-1969, with a total fertility rate just under 5 children per woman, and this stability did not hide countervailing forces in different parts of the world. The developed countries, whether they had participated or not in the post-World War II “baby boom,” showed no strong trends in fertility, with a total fertility rate remaining around 2.7. The same lack of change characterized the developing countries, but there the total fertility rate was well over 6, as it may well have been for millennia. (excerpt)
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  6. 6
    031138

    WHO Programme in Maternal and Child Health and Family Planning. Report of the second meeting of the WHO Programme Advisory Committee in Maternal and Child Health, Geneva, 21-25 November 1983.

    World Health Organization [WHO]. Division of Family Health. Maternal and Child Health Unit

    [Unpublished] 1984. 95 p. (MCH/84.5)

    The objectives of the 2nd meeting of the Program Advisory Committee (PAC) for the World Health Organization's (WHO's) Program in Maternal and Child Health, including Family Planning (MCH/FP) were to 1) assess the MCH/FP program's achievements since the 1st PAC meeting in June, 1982, 2) determine the level of scientific and financial resources available for the program, and 3) to examine the role of traditional birth attendants (TBAs) in the delivery of MCH/FP services. The committee reviewed the activities and targets of the program's 4 major areas (pregnancy and perinatal care, child health, growth, and development, adolescent health, and family planning and infertility), and developed a series of recommendations for each of these areas. Specific recommendations were also made for each of the major program areas in reference to the analysis and dessimination of information and to the development and use of appropriate health technologies. Upon reviewing the role of TBAs in the delivery of MCH/FP services, PAC recommended that all barriers to TBA utilization be removed and that training for TBAs should be improved and expanded. PAC's examination of financial support for MCH/FP activities revealed that for a sample of 26 countries, the average annual amount allocated to MCH activities was less than US$3/child or woman. This low level of funding must be taken into account when setting program targets. International funding agencies did indicate their willingness to increase funding levels for MCH programs. The appendices included 1) a list of participants, 2) an annotated agenda, 3) detailed information on the proposed activities of the program's headquarters for 1986-87, and 4) a description of the the function, organizational structure, and technical management of the MCH/FP program. Also included in the appendices was an overview of the current status of MCH and a series of tables providing information on infant, child, and maternal health indicators. Specifically, the tables provided information by region and by country on maternal, child, and infant mortality; causes of child deaths; maternal health care coverage; contraceptive prevalence; infant and child malnutrition; the number of low weight births; adolescent health; teenage births; breast feeding prevalence and duration; and the proportion of women and children in the population.
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  7. 7
    019447

    Haiti. Project paper. Family planning outreach.

    United States. Agency for International Development [USAID]. International Development Cooperation Agency

    [Unpublished] 1981 Aug 28. 222 p. (AID/LAC/P-085)

    The background, goals, projected activities and beneficiaries, financial requirements, and implementation plans for a Family Planning Outreach Project in Haiti are detailed. The project is intended to assist the Government of Haiti to establish a cost-effective national family planning program. Population growth continues to accelerate in Haiti, despite high infant and child mortality, significant emigration, and declining fertility. The government does not have an articulated population policy. Although family planning and maternal and child health services have been in existence since 1971, there is no effective access to these services. This project is viewed as a means of achieving a substantial and sustained reduction in family size and improving health status. It is also a means of strengthening the Haitian family so it can participate more directly in the national development process. The purpose of the project will be accomplished through the following activities: 1) improvement of the organization and management of the national family planning program; 2) improvement of the quality and quantity of maternal and child health and family planning services; 3) expansion of the participation of private and voluntary organizations, other governmental, and local community groups in service provision; 4) increase in the availability of contraceptives at reasonable prices through rural and urban commercial channels; and 5) formulation of appropriate population and family planning policies. By the end of the project, all government health facilities and 75% of private facilities will actively counsel and provide family planning services; integrated models of community health and family planning services will have been developed to serve 60% of the population; basic drugs and contraceptives will be available at reasonable subsidized prices throughout the country; and 25% of women ages 15-45 at risk of pregnancy will be continuing users of effective contraceptive methods. The project will be implemented by the existing infrastructure of private and public organizations, primarily by the Department of Public Health and Population and its Division of Family Hygiene. The US Agency for International Development (USAID) is providing US$9.615 million (54%) toward the estimated US$17.980 million cost of the 5-year project. An additional US$6.555 million (36%) will be provided by the Government of Haiti.
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  8. 8
    167590

    [AIDS and poverty: breaking the vicious circle] Sida et pauvrete: rompre le cercle vicieux.

    Tesson-Millet MC

    Equilibres et Populations. 2001 May; (68):3.

    Poverty facilitates the development of disease, but at the same time, by attacking developing countries’ active populations, disease frustrates countries’ capacity to organize and produce. AIDS’ devastating effects upon poor countries threatens the development process. On the heels of the UN Conference on Underdeveloped Countries, UNFPA and IPPF dedicated a day to explore the links between AIDS and poverty. Following the notion that AIDS should lie at the core of all development aid policies, a new global fund against AIDS and infectious diseases has been developed. It will be administered by an independent council comprised of representatives from donor and recipient countries, the UN, nongovernmental organizations, and the private sector. The fund’s resources will be used to implement recipient country strategies, based upon needs in the field and already existing capacities. The private sector and the pharmaceutical industry have very important, yet still undefined roles. Efforts must certainly be made to enable developing countries to develop or build, together with their healthcare system infrastructure, pharmaceutical supply policies together with the World Health Organization, major industry groups, and international partners. Prior to mobilizing fund resources, agreements will have to be worked out with the pharmaceutical industry, while diversifying product demand concerns and implementing a differential pricing system.
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  9. 9
    168253

    To cure poverty, heal the poor. WHO study finds investments in health pay big development dividends.

    Africa Recovery. 2002 Apr; 16(1):22-3.

    Research conducted by the Commission on Macroeconomics and Health, established by the WHO and headed by Harvard University economist Jeffrey Sachs, found that the economic impact of ill health on individuals and societies is far greater than previous estimates. Providing basic health care to the world's poor, the commission asserted, is both technically feasible and cost effective. However, the price tag is high, with the annual spending on health care in the least developed countries and other low-income states increased from US$53.5 billion to US$93 billion by 2007, and to US$119 billion per year by 2015. These amounts are intended to finance essential services required to meet the minimum health goals adopted by world leaders at the September 2000 UN Millennium Assembly. These objectives can be achieved by forging a new global partnership between developed and developing countries for the delivery of health care. Moreover, donor countries and multilateral agencies would have to increase their overall support for health programs in all developing countries.
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  10. 10
    154855

    Grants, not loans, for the developing world [editorial]

    Lancet. 2001 Jan 6; 357(9249):1.

    The year 2000 marked a turning point in public perception of globalization and its effects on poorer nations. A key force behind this awareness-raising process was Jubilee 2000, an international movement advocating a debt-free start to the millennium for a billion people. In response, the World Bank and International Monetary Fund announced during the closing days of 2000 that debt relief for 22 countries had been approved. However, there is clearly still a long way to go, especially where the links between indebtedness and poor health are concerned. Although these efforts at debt relief that could improve public health for the most highly indebted developing countries are a step in the right direction, the countries concerned will still be paying on average 0.5 times more on remaining debt service than on health. Critics argue that access to such relief demands continued adherence to the structural adjustment model, which, since its inception in the early 1980s, has been undermining HIV/AIDS control. It is noted that the shift to export-oriented economics was leading to social changes such as increased mobility, migration, urbanization, and dislocation of family units, favoring HIV spread in the developing world. The solution, critics contend, is ending loans and channeling international assistance into grants for the poorest nations.
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  11. 11
    146980

    U.S. and industrialized world asked to show compassion and pragmatism to support population programs. Dr. Nafis Sadik speaks at the U.S. Congressional Women's Caucus.

    ASIAN FORUM NEWSLETTER. 1999 Jun-Aug; 10-1.

    Dr. Nafis Sadik, Executive Director of the UN Population Fund, spoke at the Congressional Women's Caucus on July 20th in Washington, DC. In her speech, she asked for the compassion and pragmatism of the US and the industrialized world to support the population programs of developing countries. She stated that although the ICPD+5 Review confirmed the success of the Programme of Action, which has provided remarkable changes throughout the world, there are still many continuing problems and constraints. Some of these include high maternal mortality rate, high HIV/AIDS infection rates, the poor status of the youth, and prevalence of gender inequality issues. In addition, she emphasized the problem of funding, which is the major obstacle to the implementation of the Programme of Action. A total of $17 billion is needed to implement such program by the year 2000. Much is still needed for the execution and realization of the goals of the Programme of Action.
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  12. 12
    138398
    Peer Reviewed

    Achievements on population issues counted since Cairo.

    Palmer J

    Lancet. 1998 Jul 18; 352(9123):210.

    Marking World Population Day, the International Planned Parenthood Federation (IPPF) held a seminar in London on July 11, during which participants reviewed achievements made since the 1994 International Conference on Population and Development (ICPD) held in Cairo, Egypt. The seminar was part of a program of Cairo+5 events which will end in a special session of the UN General Assembly in June 1999, to review and assess the implementation of the ICPD Program of Action. The 20-year Program of Action aims to give all couples and individuals the right to freely and responsibly decide the number, spacing, and timing of their children, and to have the information and means to do so. Women's education and equality are at the program's core. Since the ICPD, the provision of family planning services has increased by 33.6%, and family planning associations reached about 9.4 million people in 1997. Lack of funding by developed nations is the main obstacle to the implementation of the Program of Action.
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  13. 13
    140295

    Speeding the reproductive revolution.

    Robey B; Upadhyay U

    PEOPLE AND THE PLANET. 1999; 8(1):18-9.

    In 1994, at the International Conference on Population and Development (ICPD) held in Cairo, the international community set the goal of ensuring universal access to reproductive health care by 2015 and agreed to finance its costs. Few governments and donor countries, however, have made good on commitments made at the ICPD. Reproductive health is not improving and may actually be getting worse. Specific goals to be reached by 2015 include meeting all unmet need for family planning, reducing maternal mortality by 75% compared with 1990 levels, and reducing infant mortality to lower than 35 deaths/1000 births. Reaching these and the related reproductive health goals of the ICPD was calculated to cost about US$17 billion/year until 2000, then to increase to $22 billion/year by 2015 (in constant 1993 US dollars). Developing countries agreed to pay 66% of the cost, while donor countries paid the remainder. Immediately after the ICPD, reproductive health funding increased substantially, then declined again, with most donor countries failing to meet their funding commitments. Failure to deliver on the promised financial support for the ICPD goals will result in higher levels of unintended pregnancies, induced abortions, cases of maternal mortality, and infant deaths. Governments need to be convinced that paying for reproductive health programs is an urgent priority and that developing countries, donor countries, and multilateral institutions all have much to gain from reaching the ICPD goals.
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  14. 14
    133659
    Peer Reviewed

    UK pledges money for WHO malaria initiative.

    Saldanha V; O'Sullivan T

    Lancet. 1998 May 23; 351(9115):1561.

    Leaders of the world's 8 major government powers who met at the Group of Eight (G8) Summit in Birmingham, UK, during May 15-17, endorsed an international initiative to control malaria and other parasitic diseases. The leaders agreed to improve mutual cooperation on infectious and parasitic diseases, and offered support for the new World Health Organization (WHO) initiative "Roll Back Malaria" to reduce levels of malaria-related mortality by 2010. UK Prime Minister Tony Blair was, however, the only leader to pledge new funding, in the amount of US$100 million, for the initiative. The other G8 countries fought the inclusion of specific targets in the final joint G8 document and made no new commitment to fund the malaria initiative. The Japanese government's report on global parasite control for the 21st century outlined 4 strategies for controlling malaria, soil-transmitted nematode infections, schistosomiasis, filariasis, and other parasitic infections. The strategies include international cooperation for implementing parasite control and research to provide a scientific basis for such control. Roll Back Malaria will begin in Africa. G8 support was less enthusiastic for France's Therapeutic Solidarity Initiative to establish a fund for HIV treatment regimens which are appropriate to conditions in the developing world.
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  15. 15
    128616

    On course for the 21st century? [Interview with Nafis Sadik].

    Rowley J

    PEOPLE AND THE PLANET. 1997; 6(1):10-1.

    Dr. Nafis Sadik, Executive Director of the UN Population Fund, notes that in the wake of the 1994 International Conference on Population and Development (ICPD), governments have been persuaded to abandon demographic targets and instead set specific social goals such as reductions in maternal, child, and infant mortality, and improvements in education, especially for girls. Progress is being made with regard to health and education, with all countries having set target dates for the enrollment of all children in school. The meaning of basic health services for all remains unclear. Progress is also being made against female genital mutilation and sexual violence, and improving women's status and the delivery of reproductive health care. Most countries could, however, do a lot more, and greater public support and resources are needed for programs. India, Brazil, Egypt, and Peru are cited as examples of countries which have begun to change policy following the ICPD. Developing countries and donors, with the exception of the US in 1996, have made efforts to increase their levels of spending on reproductive health services; the US has reduced its aid budget by 35%.
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  16. 16
    129379

    Turning a vision into reality.

    FAMILY PLANNING NEWS. 1996; 12(2):2.

    This article is based on a speech presented at an International Planned Parenthood Federation (IPPF) seminar to volunteers and staff. The speech was given by the secretary general of the IPPF, Mrs. Ingar Brueggemann. She stressed that complacency was not appropriate. The concepts of sexual and reproductive health need to be implemented. IPPF must act as the conscience of the people and the voice for the underprivileged. IPPF must ensure that governments understand the concept of reproductive health and its importance. IPPF's "Vision 2000" published in 1992 emphasizes the empowerment of women, a focus on youth needs, reductions in unsafe abortion, prevention of sexually transmitted diseases, greater attention to safe motherhood, and increased programs in sexual and reproductive health. All women must have the basic right to make free and informed choices regarding their sexual and reproductive health and the satisfaction of unmet need for quality family planning services and sexual and reproductive health services, particularly for the disadvantaged groups in society. Africa has the greatest needs. Estimated maternal mortality is over 600 maternal deaths per 100,000 live births. The maternal death rate in some countries may be close to 1200 per 100,000 live births. Africa also practices female genital mutilation, and the practice is widespread. Average life expectancy is around 50 years of age. The average African modern contraceptive use rate is about 10%. Botswana, Kenya, and Zimbabwe have recently made progress in rapidly increasing the modern contraceptive use rates. Africa may also have about 66% of the world's HIV/AIDS cases. Funding will be needed to advance programs in sexual and reproductive health. However, the shift of funds from supporting one soldier would pay for the education of 100 children. The cost of one jet fighter would pay for equipping 50,000 village pharmacies.
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  17. 17
    117376

    International funding of the global AIDS strategy: official development assistance.

    Laws M

    In: AIDS in the world II: global dimensions, social roots, and responses. The Global AIDS Policy Coalition, edited by Jonathan M. Mann and Daniel J.M. Tarantola. New York, New York, Oxford University Press, 1996. 375-89.

    This book chapter reports on the current state of international funding for AIDS programs in developing countries. The chapter opens by discussing the development assistance provided by the developed countries which are members of the Organization for Economic Cooperation and Development and notes that development assistance is declining and that no published summaries on development assistance provide detailed information on the allocation of funds to HIV/AIDS programs. The data for this chapter, therefore, were drawn from an international financing survey conducted for this publication. The nature of the survey and complications involved in this type of data collection are then reviewed. Adequate survey responses were received from Australia, Canada, Denmark, France, Germany, Japan, Luxembourg, the Netherlands, Norway, Sweden, the UK, and the US. The data are tabulated to display bilateral, multilateral, combined multi- and bilateral, and total funding. To reveal the trends exhibited by the major donors and to track funds donated to developing countries, tables present 1) total contributions to the Global AIDS Strategy for 1986-93 according to these funding channels, 2) multilateral contributions by country for 1987-93, 3) multi- and bilateral contributions by country for 1987-93, and 4) bilateral contributions for 1986-93. Pie charts show donor contributions by country and recipient countries. The increase in World Bank loans for HIV/AIDS prevention and care is covered as is the reduced supply of donors, increasing demand for development assistance, and evidence of donor fatigue. It is concluded that it will be critical for the UN AIDS Program to improve the financial accountability of both donor and recipient countries so that HIV/AIDS resources can be evaluated. Unless this occurs, such resources will likely continue to decline in proportion to needs.
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  18. 18
    105171

    Global population assistance report, 1992.

    United Nations Population Fund [UNFPA]

    New York, New York, United Nations Population Fund [UNFPA], 1994. 56 p.

    This is the sixth edition of a report on global population assistance first published by the UN Population Fund (UNFPA) in 1988. It provides information on the levels, trends, and nature of international population assistance for the period 1983-92, focusing upon the flow of funds in the form of grants or loans from developed countries to developing countries. In 1992, primary funds for international population assistance reached $926 million, $1033 million including World Bank loans. In 1983 dollars, however, total primary funds in 1992, not including those of the World Bank, were $657 million. Primary funds from 17 developed countries in 1992 totalled $766 million of which 50% came from the US and Japan, and 80% from the US, Japan, Germany, Sweden, Norway, and the UK. As a percentage of official development assistance, population assistance from each donor country was 1.37% on average in 1992. Final expenditures in 1992 were $211 million in Asia and the Pacific, $172 million in Africa, $97 million in Latin America and the Caribbean, $42 million in the Middle East and North America, and $6 million in Europe. In 1992, 69% of the final expenditures for population assistance were for family planning programs. Most data in the report were obtained through a questionnaire mailed in June 1993 to 392 countries and organizations involved in population activities. Survey respondents included donor countries, multilateral organizations and agencies, major private foundations, and other nongovernmental organizations (NGO). Responses were obtained from all donor countries and multilateral organizations and agencies, although only 113 of the 366 NGOs contacted responded. Survey data were supplemented by other sources, such as annual reports, UN specialized agencies' records, published secondary sources, and telephone interviews. The report notes the practical difficulty of defining population programs and of apportioning the population component of integrated projects.
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  19. 19
    098622

    Donors promise increased support for population, reproductive health.

    ICPD 94. 1994 Aug; (18):3.

    Increased support is needed from the international community to implement the actions proposed in the 1994 International Conference on Population and Development (ICPD) program of action. Some countries have already indicated their willingness and plans to provide additional funds for population-related programs. For example, the Group of Seven major industrial nations strongly endorsed the ICPD at their July 8-9 summit in Naples. The group called on the World Bank and regional development banks to reinforce private capital flows to developing countries while providing growing resources for health, education, family policies, and environmental protection. The summit in 1995 will focus specifically upon the challenge of providing sustainable development and prosperity for the world's peoples and nations. Most striking, however, is the European Union pledge to increase by fifteen-fold the amount of aid it already gives for population-related development activities in developing countries. Its contribution will total a pledged $347 million/year by the year 2000, with an increased percentage going to sub-Saharan Africa.
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  20. 20
    079669

    African debt crisis and the IMF adjustment programmes: the experiences of Ghana, Nigeria and Zambia.

    Adefulu RA

    In: Development perspectives for the 1990s, edited by Renee Prendergast and H.W. Singer. Basingstoke, England, Macmillan, 1991. 37-57.

    Sub-Saharan African countries suffer from rapidly growing external debt and the concomitant burden of its service; debt service in 1987 accounted for 40.6% of exports. Liberal and neo-Marxist rationales exist to explain the development and existence of the African debt crisis. The former view, however, drives the market-oriented development approach of the IMF and World Bank and has resulted in the development and imposition of structural adjustment programs (SAP). Main components of SAP are exchange rate reforms or currency devaluation; trade liberalization; export promotion; rationalization of public expenditure, capital, investment, and employment in the public sector; privatization and commercialization of public enterprises; producer price adjustment; wage restraints; withdrawal/reduction of subsidies; tax structure reform; and financial/administrative reforms. SAP, however, ignores that the narrow production base of post-colonial African states encourages unpredictable export earnings which in turn make it hard for countries to concurrently service debt and pay for imports to cushion the effects of SAP. Internally, programs also ignore the inflationary effect of devaluation while underestimating the social cost of domestic tightening on living standards. While national leaders are willing to take steps towards much-needed structural reform, they object to SAP policies which exacerbate Africa's dependence upon external financial flow. The African Alternative Framework to Structural Adjustment Programmes for Socio-Economic Recovery and Transformation therefore proffers that the IMF modify its policy to allow African states to strengthen and diversify production capacities. Recommendations are largely reflationary and would require substantial internal and external funding. In sum, donor and recipient states must recognize that both internal and external factors caused the present situation and that interested parties must continue to explore viable options for action; African nations need structural reform but with out paralyzing their productive bases; and that the social costs of SAP must be evenly distributed in order to be politically acceptable. The structural adjustment experience of Ghana, Nigeria, and Zambia are presented as examples of these realities and conclusions.
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  21. 21
    077777

    Major impact: a global population policy can advance human development in the 21st century.

    McNamara RS

    INTEGRATION. 1992 Dec; (34):8-17.

    In Tokyo, Japan, former president of the World Bank, Robert McNamara, addressed the Global Industrial and Social Progress Research Institute Symposium in April 1992. He reiterated a statement he made during his first presentation as president of the World Bank in September 1968--rapid population growth is the leading obstacle to economic growth and social well-being for people living in developing countries. He called for both developed and developing countries to individually and collectively take immediate action to reduce population growth rates, otherwise coercive action will be needed. Rapid population growth prevents countries from achieving sustainable development and jeopardizes our physical environment. It also exacerbates poverty, does not improve the role and status of women, adversely affects the health of children, and does not allow children a chance at a quality life. Even if developing countries were to quickly adopt replacement level fertility rates, high birth rates in the recent past prevent them from reducing fast population growth for decades. For example, with more than 60% of females in Kenya being at least 19 years old (in Sweden they represent just 23%), the population would continue to grow rapidly for 70 years if immediate reduction to replacement level fertility occurred. Mr. McNamara emphasized than any population program must center on initiating or strengthening extensive family planning programs and increasing the rate of economic and social progress. Successful family planning programs require diverse enough family planning services and methods to meet the needs of various unique populations, stressing of family planning derived health benefits to women and children, participation of both the public and private sectors, and political commitment. McNamara calculated that a global family planning program for the year 2000 would cost about US$8 billion. He added that Japan should increase its share of funds to population growth reduction efforts.
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  22. 22
    075379

    Economic aid and the environment.

    Repetto R

    EPA JOURNAL. 1990 Jul-Aug; 16(4):20-2.

    Approximately 1/3 of the signatories of the Montreal Protocol on ozone depletion were developing countries lacking the resources to pay for its implementation. Germany announced at 25% reduction of carbon dioxide emissions by 2005, the Netherlands, the UK, and Japan promised similar steps. The southern hemisphere has to reduce emissions with improved technology from the northern hemisphere, as 45% of greenhouse gases are generated there. There is need to finance such initiatives: $20-50 billion a year is required by 2000 to help these countries. The world Resources Institute proposed a green investment fund for the environment or Ecovest. It was first proposed in eastern Europe by the Nordic Environmental Finance Corporation (NEFCO) in 1990 with an initial capital of $47 million. The US Overseas Private Investment Corporation set up a $100 million for-profit Environmental Investment Fund for eastern Europe and the developing world for sustainable agriculture, forest management, eco-tourism, renewable energy, and pollution prevention. Debt-for-nature swaps between nongovernmental agencies and governments to purchase debt at discount have been paid in bonds for nature conservation in Bolivia, Ecuador, Costa Rica, the Philippines, Zambia, and Madagascar. $69 million of Costa Rica's debt was converted in 2 years to save parks, protected areas, and finance reforestation. The debts of some African countries have been written off by donor countries. The Bush Administration proposed to write off parts of Latin America's $7 billion debt. The Global Environment Fund of the World Bank proposed to lend $300-400 million a year for environmental projects in developing countries and in eastern Europe. The main goals are to protect the ozone layer, prevent deforestation and desertification, and clean up pollution. Some companies finance reforestation in Guatemala to offset their own emissions.
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  23. 23
    075769

    International cooperation in the area of population.

    Baldwin CS

    POPULATION BULLETIN OF THE UNITED NATIONS. 1991; (31-32):89-103.

    International cooperation in population activities (69 of 73 countries reporting) is still needed according to the 6th UN Population Inquiry among Governments, 1988. There is a decline in need for consultants and priority requests for computer equipment and training. Difficulties have arisen due to funding decreases and slow implementation. The responding sample population involved 108 (79 developing and 29 developed) of 170 member and observer states. Questions pertained to attainment of policy goals, future needs and priorities, and government policies and programs. The questionnaire and response rate were similar to the 5th Survey conducted in 1983. Comparability to developing countries is uncertain since the response was only 60% of 132 developing countries. The population of the developing countries responding was 3.5 billion or 60% of the world's 5.1 billion. The results of the data aggregation are presented in terms of sources of past technical support, relative contribution of technical cooperation, need for technical cooperation on population issues, and statements of governments. The conclusions reached were that all had received support for population programs from international sources. 36 countries reported having 4-6 sources of support, of which 66% were in the UN system. In the Economic Commission for Africa (ECA) 80% of the countries assigned technical cooperation as the most important contribution to population progress. Slightly fewer countries from the Economic Commission for Asia and the Pacific (ESCAP) and the Economic Commission for Latin America and the Caribbean (ECLAC) reported similar impacts. However, >50% also experienced difficulties with technical cooperation. ECA countries had difficulties with reduced funding and slowness in implementation, and minor complaints about poor donor agency coordination, differences in priorities between the government and donors, and too narrow a technical focus. Compared with the last inquiry, family planning was now a priority. Computer equipment and training programs were ranked the highest in technical support. There was some regional variation. Only 8 expressed a negative response to technical cooperation.
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  24. 24
    065936

    The United Nations Population Fund and support for national population policies.

    Rao SL

    In: International transmission of population policy experience. Proceedings of the Expert Group Meeting on the International Transmission of Population Policy Experience, New York City, 27-30 June 1988, compiled by United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1990. 159-66. (ST/ESA/SER.R/108)

    Patterns of development affect population trends and are themselves affected by population factors. This cycle between socio-economic development and population is common knowledge, yet the functioning of the cycle can vary widely from country to country. UNFPA support for national population policies has so far achieved formal institutional arrangements established in many developing countries, large numbers of national level staff trained to undertake project activities, awareness in a large number of countries, more descriptive policy research studies have been conducted in a large number of countries, a formulation of population policy and its incorporation into a national development plan in only a few countries. Between 1961-81 over $31 billion was available for population programs in developing countries. However between 1981-85 there has been mixed data about the trend in spending for population programs. Between 75-85% of the money comes from the Development Assistance Committee which consists of 17 countries including 14 European countries, Japan, Canada and the US.
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  25. 25
    061007

    The position of women and changing multilateral policies.

    Joekes S

    Development. 1989; (4):77-82.

    Contemporary multilateral loan agreements to developing nations, unlike previous project and program aid, have often been contingent upon the effective implementation of structural adjustment programs of market liberalization and macroeconomic policy redirection. These programs herald such reform as necessary steps on the road to economic growth and development. Price decontrol and policy change may also, however, generate the more immediate and undesirable effects of exacerbated urban sector bias and plummeting income and quality of life in the general population. This paper considers the resultant changes expected in the political arena, product and input pricing, small business promotion and formation, export crop production, interest rate policy reform and financial market deregulation, exchange rate and public sector expenditure, and the labor market, and their effect upon women's economic position. The author notes, however, that women are not affected uniformly by these changes and sectoral disruptions, but that some women will suffer more than others. To develop policy to effectively meet the needs of these target groups, more subpopulation specificity is required. Approaches useful in identifying vulnerable women in particular societies are explored. Once identified, these women, especially those who head poor households, should be afforded protection against the turbulence and short- to medium-term economic decline associated with adjustment.
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