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Journal of Adolescent Health. 2003 Oct; 33(4):240-251.The contemporary health problems of young people occur within the context of the physical, social, cultural, economic, and political realities within which they live. There are commonalities and differences in this context among developed and developing countries, thus differing effects on the individual’s personal as well as national development. Internationally, the origins and evolution of health care for adolescents can be viewed as an unfolding saga taking place particularly over the past 30 years. It is a story of advocacy and subsequent achievement in all corners of the world. This paper reviews the important developments in the international arena, recognizes major pioneers and milestones, and explores some of the current and future issues facing the field. The authors draw heavily on their experiences with the major nongovernmental adolescent health organizations. The special roles of the World Health Organization, Pan American Health Organization, and United Nations Children’s Fund (UNICEF) are highlighted, and special consideration is given to the challenge of inclusion through youth participation. (author's)
POPULI. 1995 Jan; 22(12):4-5.According to speakers from 45 countries, at a UN General Assembly debate (November 17-18), "a major mobilization of resources and effective monitoring of follow-up actions are needed" in order to implement the Programme of Action of the International Conference on Population and Development (ICPD). Algeria spoke for developing countries in the Group of 77 (G77) and China; commended the Programme's recognition of the key role played by population policies in development and its new approach that centered on people rather than numbers; called for concerted international mobilization to meet ICPD goals for maternal, infant, and child mortality, and access to education; and, since G77 had agreed at the Cairo Conference that developing countries should pay two-thirds of the implementation costs of the Programme, asked industrialized countries to provide the remaining third from new resources, rather than by diversion of existing development aid. It was reported that G77 is preparing a draft resolution which will address distribution of ICPD follow-up responsibilities. Germany spoke for the European Union; commended the shift of focus from demographics and population control to sustainable development, patterns of consumption, women's rights, and reproductive health; and suggested that the World Summit on Social Development and the Fourth World Conference on Women, which will be held in 1995, could carry on the Cairo agenda (a point underscored by Thailand). It was reported that several Western European countries had already pledged substantial increases in population assistance. Indonesia and South Korea addressed increasing South-South cooperation in population and development. Nigeria and the Holy See noted the emphasis on national sovereignty in regard to law, religion, and cultural values. Many called for a global conference on international migration. To ensure a common strategy for ICPD follow-up within the UN system, UN Secretary General Boutros Boutros-Ghali has asked UNFPA Executive Director Nafis Sadik to chair an inter-agency task force. All UN agencies and organizations have been asked to review how they will promote implementation of the Programme of Action.
In: Change: threat or opportunity for human progress? Volume II. Economic change, edited by Uner Kirdar. New York, New York, United Nations, 1992. 21-31.The world may no longer be seen as divided along North-South and East-West lines of economic development and political institutions. Characteristics of the South are developing in pockets of the North, and parts of the South are assuming characteristics of the North. The former East-West political dichotomy has collapsed and the outmoded concept of national markets has been replaced by the themes of internationalization and globalization. It is hoped that this new perspective will lead to less absolute poverty and fewer developing countries by the turn of the century. A global development agenda for the 1990s may include the integration of environment and development; the integration of Eastern European countries into the international community in such a way that the position of developing countries will be strengthened; the discussion of trade and investment policies beyond the Uruguay Round; the coordination of international policies and programs for alternative, renewable, and safe energy; the development of international policies on migration which target the root causes; demilitarization; democratization; putting the domestic policies of industrialized countries on the agenda so that they pursue frugal and sustainable economic growth while restructuring industry and agriculture to increase the market access of developing countries; human development; the development of new approaches to increase the transfer of resource and reverse the current South-North net flow; and the reform of the United Nations.
PAKISTAN DEVELOPMENT REVIEW. 1991 Winter; 30(4 Pt 1):497-501.Papanek's responses to the Gamani Corea paper on UN strategy for the 1990s in international development are presented. Corea's paper is considered as an evolution of thinking about development economies. Over 40 years, some issues have faded and others have taken prominence, and some issues have been ignored even though of considerable importance to development. 4 areas are identified for discussion: 1) the changing role of planning, and the market, poverty, and the environment; 2) north/south issues; 3) major changes in the world economic system; and 4) the world economic environment and the role of domestic policies. The greatest change has occurred in the emphasis on environmental consequences of development in contrast to past concerns with achieving a high rate of growth with some attention to land tenure issues. There is also an emphasis on the private sector and foreign private investment. Planning has taken a recessive role. Income distribution and poverty alleviation is also of concern. Although government intervention is no longer fashionable, it is not clear what provisions there are in the market for assuring that the poor have a reasonable share of the growth. The north/south issues are discussed in terms of the limited bargaining power of developing countries. Contributing factors are the multiplicity of objectives desired simultaneously. The UN resolutions on development strategy do not always reflect developing country's objectives. Suggestions are made to bargain 1) on objectives crucial to many developing countries, 2) on objectives that generate the least resistance among the industrialized countries, and 3) on those objectives where there is reasonable consensus on what needs to be done. Major changes in the world economic system that are not included in UN strategy but will affect policy are: 1) US leadership has declined as the principal supplier of capital; 2) US absorption of world exports is shrinking; 3) the peace dividend will insure stability if not an increase in transfers; 4) increased competition for markets and private investment will come from Eastern Europe and the Soviet Union; and 5) a response needs to be made to technology changes in the US, Japan, an Europe in order to stay competitive. There is recognition that countries shape their own destiny and can be successful with the appropriate policy mix.
Washington, D.C., PAHO, 1988 Jul. v, 117 p. (Official Document No. 221)The global economy continued to adversely affect member countries' health programs and activities in 1987. For example, Latin American and Caribbean countries lost >$US28 billion in 1987 and from 1982-1987 they lost $US130 billion. At the same time, the percentage of adolescents and elderly in the total population increased tremendously, the numbers of people experiencing chronic and disabling diseases also increased while infectious and parasitic diseases still posed challenges for the health community, and the number of urban poor continued to grow. In 1987, to help member countries deal with the everchanging health needs of their populations, PAHO focused on population groups and geographic regions and within these defined areas concentrated on specific diseases. For example, PAHO worked with member governments to formulate, implement, and evaluate policies and programs on the health of adults. Specifically, diseases and conditions emphasized in adult health included cardiovascular diseases, cancer, diabetes mellitus, accident prevention, and the prevention, treatment, and rehabilitation of alcoholism and drug abuse. Other emphases were maternal and child health and family planning and those diseases and conditions associated with the population. Additionally, PAHO continued with special programs and initiatives to maximize its role as a catalyst and to mobilize national and international resources in support of activities aimed at selected health priorities. Some of these initiatives included the Expanded Program on Immunization, the Emergency Preparedness and Disaster Relief Coordination, and the Caribbean Cooperation in Health. In addition, each country's PAHO activities have been summarized.
WORLD HEALTH STATISTICS QUARTERLY. RAPPORT TRIMESTRIEL DE STATISTIQUES SANITAIRES MONDIALES. 1988; 41(3-4):267-73.Because declining mortality from infectious diseases is accompanied by increasing mortality from noncommunicable diseases in both developed and developing countries, the World Health Organization (WHO) has initiated the Integrated Program for Community Health in Noncommunicable Diseases (Interhealth). Interhealth is based on the concepts that 1) noncommunicable diseases are related to a set of risk factors some of which can be controlled; 2) the entire community must be involved; 3) health promotion intervention strategies, such as population control, risk identification, screening and prevention strategies, must be integrated; 4) different categories of intervention (e.g., lifestyle changes, health care reorganization) must be coordinated; 5) social and environmental changes will be necessary; and 6) noncommunicable disease prevention and control strategies will be implemented through existing primary health care systems. The core program of Interhealth addresses heart diseases, stroke, diabetes, cancer, and respiratory diseases from the point of view of their common risk factors: diet, tobacco, physical activity, environment, oral hygiene, blood pressure, lipids, and glucose. The Interhealth program is being developed as a dynamic system, consisting of 4 main activities: experimental testing by means of demonstration projects (of which there are currently 18 in 15 countries); mathematical modeling of disease/risk factor interrelations; training; and research activities. These activities will be supported by organizational, financial and information activities at WHO headquarters and in the WHO Regional Offices.
ASSIGNMENT CHILDREN. 1987; (3):3-84.Recent findings from xerophthalmia studies in Indonesia have served as a catalytic force within the international health and nutrition community. These analyses conclude that, in Indonesia, there is a direct and significant relationship between vitamin A deficiency and child mortality. Further research is under way to determine the degree to which these findings are replicable in other countries and contexts. At the same time, representatives from international, bilateral, national and private organizations are critically examining their programs in vitamin A deficiency and xerophthalmia control for future planning. At UNICEF, there has been a special concern for vitamin A issues because of the possible implications in child survival. This is noted in the 1986 State of the World's Children Report. UNICEF recruited a consultant in January 1986 to examine its existing vitamin A programs, review scientific findings and meet with specialists to prepare policy options for consideration in future UNICEF involvement in the area of vitamin A. A brief background is given on the absorption, utilization, and metabolism of vitamin A, and its role in vision, growth, reproduction, maintenance of epithelial cells, immune properties, and daily recommended allowances. Topics cover xerophthalmia studies, treatment and prevention, prevalence, morbidity and mortality, program implications and directions, and procurement of vitamin A. Target regions include Asia, the Americas and the Carribean.
Ann Arbor, Michigan, University Microfilms International, 1984.  p.One form of international authority proposed by David Mitrany was that of an advisory and coordinating one where both the performance of a task and the means for its accomplishment remain mainly under national control. Mitrany's theoretical framework and its organizational analogue within the UN and national political arenas account for the emergence of a new UN population policy to cope with the rapid global population growth between 1960 and 1974. The most prestigious outcome of this policy was the United Nations Fund for Population Activities (UNFPA), whose centralized contributions came primarily from the US, Japanese, Swedish, and some other west European governments. Its aim is to assist governments in the development of national family planning programs and in related demographic and family planning training and research programs. UNFPA grants went to UN-system agencies, governments, and private organizations. Recipients include India, Pakistan, Egypt, Malaysia, Kenya, Nigeria and Mexico. A mew ideology emerged to support the concept of an interventionist policy to lower the birth rate. That ideology include the responsibility of each government for its own population; an emphasis on social framework for parental choices about family size; and a legitimate role for international assistance. How the UNFPA came into existence is a political process involving government delegations and officials, UN Secretarist staff, and representatives of selected religious and population transnational organizations. It is also a Laswellian social process model of 7 decision-outcomes marking the significant population events and interactions underlying the creation of UNFPA. 6 UN resolutions and 2 decisions by the Secretary-General denominate these decision outcomes. 2 analytic approaches account for these decision outcomes--the Parsonian concept of organized levels (institutional, managerial, and technical) in conjunction with the Laswellian concepts of centralization/decentralization and concentration/decontration, and the concept of coalitions, (legislative and programming). This expanded UN population policy process reveals the interconnectedness of elites and groups in a global network centered at UFPA. (author's modified)
[Unpublished] 1982. Paper prepared for Conference on Vasectomy, Colombo, Sri Lanka, Oct. 4-7, 1982. 21 p.Discusses the factors responsible for the decline of male acceptance of vasectomy over the past decade. The Association for Voluntary Sterilization (AVS) is a nonprofit organization working in the United States which helps funding of similar programs in other developed and developing countries. Reasons for the decline of vasectomy acceptance include the lack of attention paid to male sterilization in countries with family planning programs, the introduction of new technology for female sterilization, the introduction of new effective methods of contraception, and the exaggerated sexual role of the male and the need to protect his virility. The author reviews successful vasectomy programs and finds that, to be successful, a program should have strong leadership, a focussed design, clinic hours that would not interfere with patients' working schedules, and should pay attention to the needs of men, e.g., emphasizing that vasectomy does not cause impotency. The program should also have a community-based orientation, since all the services are not hospital-based and can be brought to the client's home, thereby emphasizing the minor nature of the surgery. AVS believes that vasectomy as a means of family planning can be effective. It is safe, inexpensive, simple, and deliverable. A special fund was allocated in 1983 to stimulate the development of several pilot and demonstration projects in a variety of countries.
In: Bannerman RH, Burton J, Ch'en Wen-Chieh. Traditional medicine and health care coverage: a reader for health administrators and practitioners. Geneva, Switzerland, World Health Organization, 1983. 194-206.There is a genuine interest now being taken in phytotherapy and medicinal plants throughout the world. In industrialized countries there is a trend of going back to nature or wanting to combat the chemical pollution of the body provoked by inopportune chemotherapy or by the misuse of convenience drugs of chemical origin; third world countries are primarily concerned with providing their peoples with adequate coverage of their essential drug needs. A new type phytotherapy is proposed, to produce phytotherapeutic preparations for use in modern medical practice from the resources of traditional medication. In view of difficulties experienced by developing countries in meeting their needs for essential drugs, 4 measures might be taken to encourage utilization for primary health care of their vast local resources: 1) a real health policy option at national and regional level; 2) determination of priorities regarding health problems and definition of possible solutions; 3) goal-oriented applied scientific research on medicinal plants, incorporating properly planned programs; 4) effective implementation of these programs with regard to technical and financial resources and appropriate personnel. Cooperation among developing countries, with the industrialized countries and with organizations of the United Nations system is recommended. A table illustrates integrated overall organization.