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Bulletin of the World Health Organization. 1955; 22:63-83.This paper presents the results of the tuberculin-testing of over 3,600 patients in tuberculosis hospitals and of nearly 34,000 schoolchildren in widely separated areas where arrangements could be made for specially trained personnel to work uniform materials and techniques. Both patients and children were tested with an intradermal dose of 5 TU, and the children were retested with 100 TU if the reactions were less than 5 mm. The results confirm those of earlier papers, that at least two different kinds of naturally acquired tuberculin sensitivity are found in many human populations: a high-grade sensitivity, designated as specific for virulent tuberculous infection, and a low-grade kind designated as non-specific, or not specific for tuberculous infection. Specific sensitivity is the kind found in tuberculous patients and in some schoolchildren everywhere. It follows a remarkably uniform pattern wherever it is found, apparently varying only in prevalence, not in degree, from place to place. In contrast, non- specific sensitivity varies both in prevalence and in degree. It ranges from nearly universal prevalence in some localities to almost complete absence in others, from a low degree to a relatively high degree approaching that of specific sensitivity. Non-specific sensitivity is not correlated with specific sensitivity and may have different causes in different places. (excerpt)
Geneva, Switzerland, WHO, Department of Communicable Disease Surveillance and Response, 1999 Apr. 66 p. (WHO/CDS/CSR/EDC/99.1)This document has been prepared to assist medical and public health leaders to better respond to future threats of pandemic influenza. It outlines the separate but complementary roles and responsibilities for the World Health Organization (WHO) and for national authorities when an influenza pandemic appears possible or actually occurs. Specific descriptions are given of the actions to be taken by WHO as it assesses the risk posed by reported new sub-types of influenza, in advance of any epidemic spread. The responsibility for management of the risk from pandemic influenza, should it actually occur, rests primarily with national authorities. WHO strongly recommends that all countries establish multidisciplinary National Pandemic Planning Committees (NPPCs), responsible for developing strategies appropriate for their countries in advance of the next pandemic. In recognition of the individuality of countries, as well as the unpredictability of influenza, this document emphasizes the processes and issues appropriate for WHO and NPPCs, but does not provide a “model plan”. Furthermore, it is anticipated that NPPCs will confront new issues, which will call for additional international dialogue. For example, more consideration is needed about how scarce supplies of vaccines can be shared, and what might be the benefit of cancelling public gatherings to slow the spread of a pandemic virus among unvaccinated populations. (excerpt)
New York, New York, UNFPA, 2004. iv, 17 p. (E/500/2004)This report is intended for use in planning contraceptive supply, and for advocacy and resource mobilization. It contains country-specific information provided by donors on the type, quantity and total cost of contraceptives they supplied to reproductive health programmes in developing countries during 2002. The United Nations Population Fund (UNFPA) collected information for this report in 2003; as in earlier years, the UNFPA database is especially useful to illustrate commodity shortfalls and changes in funding by donor and country. The report highlights trends since 1990 and the gap between estimated needs and actual donor support, comparing UNFPA estimates of condom requirements for STI/HIV prevention, and contraceptive requirements for family planning programmes, with actual donor support. It also indicates donor support by region and product, the top ten countries supported by donors and the quantity of male and female condoms supplied. UNFPA tried to collect information on donor support for antibiotics for prevention of STIs/RTIs. In many cases, however, either donors did not record this information or the countries receiving support did not disaggregate information by commodity. UNFPA’s Commodity Management Unit will continue to discuss how to collect this information. (excerpt)
Global crises -- global solutions: managing public health emergencies of international concern through the revised International Health Regulations.
Geneva, Switzerland, WHO, Communicable Disease Surveillance and Response, International Health Regulations Revision Project, 2002. iii, 19 p. (WHO/CDS/CSR/GAR/2002.4)One of the obvious consequences of globalization is the increased risk of international spread of infectious diseases. People and goods are crossing national borders in massive numbers unparalleled in human history. While some countries may still opt for extreme protectionism, importation of diseases is always difficult to prevent. The cross-border impact of infectious diseases is better addressed through multilateral efforts. In the past, the most concrete measures to stop importation of infectious diseases were thought to be quarantine and trade embargoes. The ultimate way to stop international spread of disease would be to stop all international trade, travel and tourism. Such drastic measures, though no longer viable in today’s globalizing world, nonetheless underline the close connection between disease control, trade and travel. The International Health Regulations (IHR) are a multilateral initiative by countries to develop an effective global surveillance tool for cross-border transmission of diseases. The IHR strive to harmonize the protection of public health with the need to avoid unnecessary disruption of trade and travel. They remain the only legally binding set of regulations, for WHO Member States, on global alert and response for infectious diseases. (excerpt)
Public Health Nutrition. 2003 Jun; 6(4):323-325.This report and the subsequent commitment to a global strategy are extremely important for those of us working in Public Health Nutrition. They provide an important opportunity to promote the benefits of an evidence-based approach to solving major public health problems and raise the profile of nutrition. I have asked Este Vorster and Tim Lang to start off a discussion about the expert report. I look forward to other comments from readers. (excerpt)
Report of an International Consultation on AIDS and Human Rights. Geneva, 26-28 July 1989. Organized by the Centre for Human Rights with the technical and financial support of the World Health Organization Global Programme on AIDS.
New York, New York, United Nations, 1991. iii, 57 p.In July 1989, ethicists, lawyers, religious leaders, and health professionals participated in an international consultation on AIDS and human rights in Geneva, Switzerland. The report addressed the public health and human rights rationale for protecting the human rights and dignity of HIV infected people, including those with AIDS. Discrimination and stigmatization only serve to force HIV infected people away from health, educational, and social services and to hinder efforts to prevent and control the spread of HIV. In addition to nondiscrimination, another fundamental human right is the right to life and AIDS threatens life. Governments and the international community are therefore obligated to do all that is necessary to protect human lives. Yet some have enacted restrictions on privacy (compulsory screening and testing), freedom of movement (preventing HIV infected persons from migrating or traveling), and liberty (prison). The participants agreed that everyone has the right to access to up-to-date information and education concerning HIV and AIDS. They did not come to consensus, however, on the need for an international mechanism by which human right abuses towards those with HIV/AIDS can be prevented and redressed. International and health law, human rights, ethics, and policy all must go into any international efforts to preserve human rights of HIV infected persons and to prevent and control the spread of AIDS. The participants requested that this report be distributed to human rights treaty organizations so they can deliberate what action is needed to protect the human rights of those at risk or infected with HIV. They also recommended that governments guarantee that measures relating to HIV/AIDS and concerning HIV infected persons conform to international human rights standards.
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.
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.
WORLD HEALTH FORUM. 1998; 19(3):298-9.During the recent Round Table on "Ethics, equity and renewal of WHO's health-for-all strategy," eminent scholars from developed countries provided a framework of thinking based on their version of the world. The contributions showed a lack of academic rigor, even in the definition of WHO terms, such as "primary health care" and "health for all"; numerous WHO publications on the subject were not examined. Contributors ignored ethical issues raised by Ivan Illich in "Limits to medicine." The presentation and discussions revolved around issues relevant to conditions in developed countries. Bryant, Khan, and Hyder spoke of inequities that should be corrected with available resources; they, with others at the presentation, ignored the considerable body of work that has been done in developing countries on the actions taken to correct inequities with available resources. This body of work can be called "another public health," which is different from the "new public health" or "new approaches to public health." "Health for all through primary health care," which was launched at Alma-Ata in 1978, was WHO's action to correct inequities in developing countries with available resources. The concept of selective primary health care appeared shortly after the Alma-Ata Declaration; it was followed by two Bellagio Conferences which unleashed many ill-fated international initiatives. The basic tenet of public health, that people, rather than the medical establishment, are the prime movers of health and health service development, has been forgotten. Community self-reliance, social control over health services, intersectoral action on health, coverage of unserved and underserved populations, integration of health services, use of traditional systems of medicine, and essential drugs came from this thinking; it was reiterated that "health for all" required action at political and social levels. Before speaking of renewing the "health for all" strategy, WHO and Round Table participants should realize that the strategy has never been completely implemented and should elicit the reasons for this.
BMJ. British Medical Journal. 1995 Oct 7; 311(7010):891-2.Over the past 30 years a wide range of developing countries have successfully developed a model of primary health care promoted by the World Health Organization (WHO). It differs fundamentally from the primary care system in the United Kingdom, which relies more on technical and curative care than the community-oriented approach. In the 1950s and 1960s many developing countries faced a daunting task. A different model of care emerged, which recognized that the health of populations was determined by factors other than medical care and that these factors could be controlled by communities themselves, through collaboration with agriculture, water sanitation, and education in a spirit of self reliance. By the 1970s WHO had formulated this model and declared at Alma Ata that Health for All was achievable through primary health care by 2000. The West's reaction to this model was to support it in developing countries by giving aid but to reject it for the West's own countries. The medical model was powerful, and its proponents argued that populations would become healthier with more doctors and hospitals. The West's second reaction was political. Socialist countries such as China, Cuba, and Tanzania had fully adopted primary health care and the concepts of community participation. Such reforms resulted in dramatic improvements in health status in many countries. After the introduction of barefoot doctors, for example, in China mortality among children under five fell from more than 175 per 1000 live births to under 49. With the end of the Cold War, the receding threat of socialist expansionism, British and other Western governments are now discovering the wider determinants of health and the strength of community involvement. Some of the WHO's initiatives that have been so successful in developing countries, such as Health for All, use of health targets, and community empowerment, are now being pursued in Britain.
New York, New York, Oxford University Press, 1993. xii, 329 p.The World Bank's 16th annual World Development Report focuses on the interrelationship between human health, health policy, and economic development. WHO provided much of the data on health and helped the World Bank on the assessment of the global burden of disease found in appendix B. Following an overview, the report has 7 chapters covering health in developing countries: successes and challenges; households and health; the roles of the government and the market in health; public health; clinical services; health inputs; and an agenda for action. Appendix a lists and discusses population and health data. The report concludes with the World Development Indicators for 127 low, lower middle, upper middle, and high income countries in tabular form. All developed and developing countries have experienced considerable improvements in health. But developing countries, particularly their poor, still experience many diseases, many of which can be prevented or cured. They are starting to encounter the problems of increasing health system costs already experienced by developed countries. The World Bank proposes a 3-part approach to government policies for improving health in developing countries. Governments must promote an economic growth that empowers households to improve their own health. Growth policies must secure increased income for the poor and expand investment in education, particularly for girls. Government spending on health must address cost effective programs that help the poor, such as control and treatment of infectious diseases and of malnutrition. Governments must encourage greater diversity and competition in the financing and delivery of health services. Donors can finance transitional costs of change in low income countries.
Editor's introduction [to the proceedings of the Second International Conference on Health Law and Ethics, London, July 16-21, 1989].
LAW, MEDICINE AND HEALTH CARE. 1990 Spring-Summer; 18(1-2):11-4.The editor introduces selected proceedings from the 2nd International Conference on Health Law and Ethics. Over 600 participants from more than 60 international cooperating organizations and the World Health Organization (WHO) were in attendance. Papers considered to be among the finest from the conference are included in the proceedings, and represent a widely-diverging range of cultures and approaches. While this introduction points repeatedly to the United States' health system for contrast and comparison with other systems, the conference paid special attention to global dimensions, wealth and poverty, and innovative ways of approaching health law and ethics in other nations and regions. The publication introduced by the editor considers 6 main topics, the 1st being AIDS medicine, law, and public health in industrialized and 3rd world countries. In light of the ethical challenges in international research, resource distribution, prevention, and blood supply protection, and drug and vaccine availability, steps by WHO's Global Program on AIDS and the Council for International Organizations of Medical Sciences to develop international ethical guidelines for research and development of therapeutic agents are discussed. Comparative treatments of euthanasia, medical malpractice, resource allocation and service inequity, abortion and family planning, and the state's role in medical coercion are explored.
Ottawa, Ontario, Canada, International Development Research Centre, 1990. 40 p. (Searching Series No. 1)There are many global problems. North and South are both worried about thinning of the ozone layer and global warming. This report begins with problems created by the North and the South. The next part shows how scientists in 3rd World countries can help solve these problems. The developing countries are seen as a laboratory where solutions to global problems are being found. Greenhouse gases are heating the earth's climate. This global warming will be bad for millions of people. The carbon dioxide build-up could double between now and the 2nd half of the 21st century. The earth's average surface temperature will rise by 2 degrees centigrade by the year 2030. This could raise sea levels. Scientists from different climates will have to get together on researching this problem. More than 1/2 of the genes of plants used by the West to improve agricultural species of develop medicines are in developing countries. Gene banks should be established. It is too late to stop global warming. Methane gets into the air from many sources. Nitrous oxide is another main greenhouse gas, as is carbon dioxide. The chlorofluorocarbon (CFC) gases also contribute to the greenhouse effect. Ozone is destroyed when chlorine from CFCs and bromine from halons are in the upper atmosphere. Acquired immunodeficiency syndrome is a new global health threat; as are travelling influenzas. The population will grow to about 6.2 billion by the year 2000; 9 out of 10 new births will take place in the 3rd World. The total debt of developing countries right now is more than US $1.3 trillion. This has doubled since 1980. Illegal production of narcotics is significant to various economies. There are many military threats to security. There are many scientists in the South and much health and biological research is undertaken there. In 1997, Brazil will manufacture alcohol-powered vehicles. Canada maintains many ties with developing countries. The North and South must cooperate on scientific research, including the international research centers that have been established in 3rd World countries.
EPI NEWSLETTER. 1987 Oct; 9(5):3-5.This article sets forth data on vaccination coverage rates in children under 1 year of age in the individual countries of Latin America and the Caribbean in 1986. In the Region of the Americas as a whole, the 1986 coverage rate was 80% for oral poliovaccine, 54% for DPT, 55% for measles, and 63% for BCG. Vaccination coverage rates increased over 1985 levels for all but measles, which showed a 5% decline due to decreases in Brazil and Mexico. In the Caribbean subregion, the majority of country coverage rates for DPT and oral poliovirus vaccine are equal to or above 80%, while measles coverage rates are generally below 50%. In Central America, vaccine coverage rates with all antigens except BCG showed significant increases between 1985 and 1986. In Central America, coverage ranged from above 80% for oral poliovirus vaccine and DPT in Belize, Costa Rica, and Nicaragua, to below 40% in Guatemala. In general, countries in the region are improving vaccination performance as a result of establishment of vaccination days or campaigns and acceleration of the Expanded Program on Immunization. However, much work remains to be done if the goal of 100% immunization of children and women of childbearing age by 1990 is to be met.
[Vaccination, the right of each child, World Day of Health 1987] Vacunacion: derecho de cada nino, Dia Mundial de la Salud 1987.
BOLETIN DE LA OFICINA SANITARIA PANAMERICANA. 1987 Mar; 102(3):263-80.In the 10 years since the Panamerican Health Organization (PAHO) and the World Health Organization initiated the Extended Immunization Program in the Americas (PAI), coverage has increased from less than 1/3 to over 1/2 of children immunized in their first year against 6 major childhood diseases. Due mainly to the PAI, the incidence of measles, tetanus, and diptheria has been reduced by 1/2, that of whooping cough by 75%, and that of tuberculosis by about 5% annually. About 75% of children are immunized against polio, which has 1/10 as many victims today as 10 years ago. PAHO and several other organizations have targeted 1990 for eradication of polio from the South American continent. Since the PAI was established in 1977, more than 15,000 health workers have been trained, cold chains have been established to preserve vaccines, and more than 250 technicians have been trained to maintain and repair the needed equipment. The cost of the campaign to eradicate polio is estimated at US $ 24 million per year for the entire region--a low total compared to the costs of hospitalization and rehabilitation of the victims in the absence of such a program. The goal of immunizing all the world's children by 1990 proposed by the World Health Assembly in 1977 is achievable, but much remains to be done. The number of children immunized in the largest Third World countries ranges from 20-90% owing in part to national immunization days but also to assumption by local communities of the goal of universal immunization by 1990. All deaths produced by these 6 killer diseases are not registered, but the World Health Organization estimates that measles takes 2.1 million lives annually, neonatal tetanus 800,000, and whooping cough 600,000. Governmental and nongovernmental international organizations have made financial help available to countries needing it for their immunization programs. Most developing countries are expected to achieve the goal of universal immunization by 1990, but the 10 poorst countries of Africa and the Eastern Mediterranean may not be able to do so. At the worldwide level, 41% of the 118 million children who survive their first year have been vaccinated against measles and 46% against tuberculosis. 47% have received the full course of vaccine against diptheria, whooping cough, tetanus, and polio. The cost of these immunization is $5-15 per child and 80% is assumed by local countries. The World Health Organization recommends that all children, even the undernourished or slightly ill, be vaccinated, and that all health services vaccinate. Parents should be urged to return for the 2nd and 3rd doses of polio and DPT vaccines. Vaccination programs should pay more attention to impoverished urban populations. Several countries of the region have added innovations such as vaccination against other illnesses, house to house searches for unvaccinated children, or use of mass media to publicize national vaccination programs.
WORLD HEALTH FORUM. 1986; 7(2):131-4.Although WHOHs work is directed mostly to developing countries, the aim of WHO is to help bring about the highest possible level of health among all peoples. This article discusses ways in which developed countries also benefit from WHO's activities. In the area of international services, WHO provides worldwide epidemiological surveillance, the international drug monitoring system, the international program on chemical safety, the establishment of standards, biological and chemical standardization, statistics and the international classification of diseases, and publications. WHO also combats problems that are particularly serious in developed countries: cardiovascular disease, respiratory ailments, cancer, mental health and drug abuse. Other direct benefits include organization of public health systems, medical research and further training of health staff. WHO's activities also have indirect benefits. For instance, any improvement in health in developing countries is good for developed countries; this is particularly true in the area of communicable diseases. The reports of expert committees and of working groups, other publications including the WHO monographs and public health papers, and the input of collaborating centers add up to an incomparable guide to national health services. Finally, the application of the primary health care concept in developing countries has lead to reflection on adjustments that might be made in health care systems of developed countries.
Assignment Children. 1985; 69/72:397-414.The recent immunization campaign in El Salvador has been a success despite the civil war. Both the government and the guerrillas agreed that the goal of immunizing children was an ideal transcending all differences, and that immunization should be taken to all parts of the country and all Salvadorian children. The campaign had the personal support of the head of state, the church, UNICEF, PAHO/WHO, ICRC and other organizations who worked with the parties to implement the campaign. The 3 national immunization days, held on February 3, March 3, and April 21, 1985 were transformed into days of tranquillity. This article describes how the campaign was organized and presents an assessment of its achievements. An executive committee was created and both UNICEF and PAHO/WHO took part in its meetings. Specific commissions handled channeling, training, supplies, the cold chain, information and evaluation, and promotion and education. The plan of action proposed that all branches of government and the private sector support the immunization campaign and a national support council was establish for this purpose. The original goal was to immunize 400,000 children under 3 years of age against diphtheria, pertussis, tetanus, polio, and measles. The goal was extended to cover children under 5 years of age. Funding was provided from both public and private organizations. Reasons the campaign was a success despite war conditions include: the campaign was backed by political commitment; the mechanisms created to implement the campaign functioned smoothly; mobilizing the media generated a change in opinion and attitude. The campaign rested on solid technical and political foundations. It reached 87% of children under 5 in the area.
Washington, D.C., PAHO, Pan American Sanitary Bureau/Regional Office of the World Health Organization, 1985. xix, 265 p. (Official Document No. 201)Efforts to meet the goal of health for all by the year 2000 have been hampered by the internal and external problems faced by many countries of the Americas. The pressures of external debt have been accompanied by a reduction in the resources allocated to social sector programs, including health programs. In addition, the conflict in Central America has constrained solutions to subregional problems. The health sector suffers from uncoordinated services, lack of trained personnel, and waste. Thus 30-40% of the population do not have access to basic health services. In 1984, the governments in the region, together with the Pan American Health Organization (PAHO), undertook projects in 5 action areas: new approaches and technology, development, intra- and intersectoral linkages, joint activities by groups of countries, mobilization of national resources and external financing, and preparation of PAHO to meet the needs of these processes. New approaches include the expansion of epidemiological capabilities and practices, the use of low-cost infant survival strategies, the improvement of rural water supplies, and the development of domestic technology. Interorganizational linkages are aimed at eliminating duplication and filling in gaps. Ministers of health and directors of social security programs are working together to rationalize the health sector and extend coverage of services. Similarly, countries have grouped to deal with common problems and offer coordinated solutions. The mobilization of national resources involves shifting resources into the health field and increasing their efficiency and effectiveness by setting priorities. External resources are recommended if they supplement national efforts and are short-term in nature. In order to enhance these strategies, PAHO has increased the managerial and operating capacity of its central and field offices. This has required consolidating programs, retraining staff, and instituting information systems to monitor activities and budgets. The report summarizes health indicators and activities by country, for all nations under PAHO.
World Health Forum. 1984; 5(1):60-3.The great improvement in public health in developed countries, culminating in the 1950s, was the direct result of the widespread application of application of principles and techniques derived from research. Since 1950 a 2nd cycle of health research, primarily government sponsored, has helped to bring about an understanding of biology, of microbes, and of viruses. Yet, infectious disease remains the principal health problem of the developing countries and hence of most of the world's population. Most recent health research has held little relevance for the least developed countries, whose main problem, despite considerable progress, may be considered as the application of knowledge already well established in the 1950s. Thus there has been some skepticism about the role of research in the World Health Organization's (WHO's) program. Medical research definitely has a role in efficiently adapting existing knowledge to the needs of individual countries and cultures, in dealing with those diseases that are particularly prevalent in the least developed countries (notably parasitic diseases), and particularly in exploring opportunities now opened up by modern molecular biology. Despite efforts to express the relationship between science and health in quantitative terms, it is difficult to realize more than an approximate idea of it. The question that arises is what part of the medical knowledge scientifically accumulated since 1950 has been of critical importance in world public health. The basic principles of vaccination were established long ago, but a practical means of producing vaccines for viral afflictions had to await the advances in cell and tissue culture made during the 1950s. It was not until the work of Indian researchers in 1959 that it was learned that the cholera toxin is essentially harmless when injected, for its main effect on the body is to stimulate secretion of water into the gut. Yet, the resultant diarrhea may be so malignant as to turn the blood into a dehydrated sluggish paste. Most cases of cholera can now be treated by simple rehydration with water plus salt and sugar. Thus sophisticated research has led to simple and practical measures that have saved thousands of lives in cholera epidemics. Oral and injectable contraceptives, based on the most advanced chemical and endocrinological principles, have been important to the scattered successes in the effort to fight the threat of population explosion. The gradually improving health and living standards of the developing countries are bringing them closer to the problems and opportunities of the developed nations. There will be an increasing emphasis in research on their growing problems of heart disease and cancer as well as psychiatric illness and viral infections.
[Population and the new international economic order] La poblacion y el neuvo orden economico internacional.
Medicina y Desarrollo. 1977 May; 13-16.The problem of population received little attention in the meetings on the New International Economic Order. Historically, governments have equated population increases with prosperity. Recently, governments have accepted the necessity to reduce population for the succcess of social and economic programs. This article points out the advances made by several countries in the areas of health, nutrition, education, contraception, legal aspects, planning, and research methods since 1972. The collaboration of different governments with UNFPA and their solicitation of help from this organization are regarded as further evidence of the advances made. Difficulties for the acceptance of family planning in developing countries such as social sanctions, lack of demographic data, and the role of UNFPA in the amelioration of these problems are discussed. Since population politics are seen as long-term strategical weapons, an intensification of persuasive methods in all countries and an increase in aid to underdeveloped countries are recommended.
International consultation of NGOs on population issues in preparation of the 1984 United Nations International Conference on Population: report of the consultation.
[Unpublished] . 83 p.196 individuals from 44 countries, representing national and international non-governmental organizations, bilateral agencies and intergovernmental organizations attended the consultation. The purposes of the consultation were: 1) to provide an overview of the contributions of non-governmental organizations to the implementation of the World Population Plan of Action through a wide range of population and population related programs carried out since the Plan was adopted in 1974; 2) to explore what non-governmental organizations believe needs to be done in the world population field during the balance of the century; 3) to prepare for participation in the January 1984 Conference Preparatory Committee meeting and in the Conference itself to be held in August 1984; and 4) to provide suggestions for activities of national affiliates relative to the 1984 Conference. This report provides a synopsis of the plenary sessions and their recommendations. Addresses by numerous individuals covered the following topics: the creative role of non-governmental organizations (NGOs) in the population field; vital contributions of NGO's to the implementation of the world population plan of action; the family; population distribution and migration; population, resources, environment and international economic crisis; mortality and health; and NGO prospects for the implementation of the world population plan of action.
Who Chronicle. 1973 Oct; 27(10):410-7.In recent years the epidemiological pattern of venereal disease and endemic treponematoses has undergone important changes in both developing and developed countries. This discussion outlines the present situation and indicates the role that the World Health Organization (WHO) is playing in efforts to combat these infections. About 15-20 years ago 2 contrasting epidemiological situations confronted health authorities around the world. The developed countries were experiencing the lowest recorded incidence of venereal diseases since World War 2. At the same time in developing countries nonvenereal endemic treponematoses were becoming a major health problem because of their widespread endemicity and their disabling effect on the sufferers, which was causing a serious reduction in manpower resources. By the mid 1950s reports from several countries showed an increase in the incidence of early syphilis and gonorrhea and during the subsequent years the rising trend continued and began to affect most countries of the world. Simultaneously, the prevalence of endemic treponematoses dropped markedly in several developing nations as a result of WHO/UN International Children's Emergency Fund (UNICEF) assisted mass treatment campaigns. There can be little question that the introduction of penicillin for the treatment of venereal diseases and treponematoses made a major contribution to the developments outlined. The marked treponemicidal effect of this drug, its ease of administration, and the low incidence of side effects made it almost ideal for the safe, short-term, ambulatory treatment of both venereal and nonvenereal treponematoses as well as of gonorrhea. The immediate result of intensive antivenereal campaigns in the developed countries at the end of World War 2 as well as of the mass treatment campaigns against endemic treponematoses was excellent. Yet, it led some to believe that these infections could be completely eliminated by treatment alone. Subsequent experience has shown this opinion to be unjustified, because the transmission of venereal diseases and treponematoses is closely dependent upon the socioeconomic structure of the society concerned. It is clear at this time that a new approach is required in the field of endemic treponematoses. The era of mass treatment is most likely nearing its end. The endemic treponematoses will remain a longterm public health problem until the hygiene and socioeconomic conditions of the populations concerned are improved so as to eliminate low level transmission of the disease. In regard to the increase of early syphilis and gonorrhea reported from most countries since 1955-57, it should be noted that national statistics are unreliable. Underreporting is general and the statistics are variously estimated to represent between 10% and 50% of the true number of cases.
Population Review. 1980 Jan-Dec; 24(1-2):5-8.The medical system perfectd in India--"Knowledge of the Span of Life"--in many ways foreshadowed the World Health Organization's (WHOs) own definition of health as a "state of complete physical, mental and social wellbeing." The goal of "health for all by the year 2000" envisages strengthening of public health programs of developing countries, where most diseases are concomitants of economic backwardness. Yet, it should not be assumed that developed countries are without health problems. They are experiencing the tensions, mental and physical, to which residents of densely populated cities succumb. Once it is recognized that better health is not simply an offshoot of overall economic development, and that major improvements in health are possible in the absence of industrialization, it follows that the patterns of public health and health administration of advanced countries are not necessarily appropriate for developing nations. What must be stressed is the need for a health revolution in developing countries, to wipe out diseases and to make available specialized treatment as well as to provide basic health care and to take preventive measures. Education from the earliest stages needs to include certain elementary information about health, sanitation, cleanliness, the avoidance of contagious diseases, and the preservation of the environment which is closely linked to these. There is a need at this time for a global campaign for eradication of leprosy, prevention of blindness, and greater research to produce an ideal contraceptive. Family planning programs are awaiting a big breakthrough. Without a safe, preferably oral, drug which women and men can take, no amount of government commitment and political determination will bring success.
Evaluation of UNFPA assistance to the family planning programme of the Dominican Republic, 1978-1982/3.
New York, New York, United Nations Fund for Population Activities [UNFPA], 1983 Aug. xii, 48,  p. (DOM/73/P01)This evaluation was carried out by an independent mission coordinated by the United Nations Fund for Population Activities (UNFPA) Evaluation Branch. The program's long-term objectives are to reduce the birth rate to 29/1000, reduce mortality rates, achieve a sustained reduction in fertility rates and to devise and implement a specific population policy. Immediate objectives are to acheive the functional integration and financial self-sufficiency to carry out family planning programs, offer family planning services to the entire population and increase the demand for them, to offer new methods, especially female sterilization, and alter the distribution of users by method; increase active users to 22% of the country's women and to increase the availability of health personnel. In general, the Evaluation Mission found that the project documents describing the objectives to be achieved, strategy, activities and inputs do not elaborate sufficiently on the relationship between objectives and activities and the inputs required and do not give details about the strategy for achieving objectives. The birth rate was estimated at 34.5/1000 in 1982. Infant mortality seems to be declining particularly fast in areas with active rural health promotors. No specific population policy has been enuciated. The program has, to a large extent, achieved the immediate objectives set for it, except that of financial self-sufficiency. The program's strongest elements are the considerable expansion of the physical and health personnel infrastructre; political and institutional willingness to carry out integrated maternal and child health and family planning programs; and the great demand for family planning services by the population. Week elements which have hindered the program's progress are the abence of a tradition of public health and preventive medicine in the country, which has resulted in inadequate training of medical personnel and a lack of motivation, and the extreme centralization of the health system and the consequent lack of delegation of authority and resources which limits the initiative and action of personnel at supposedly operational levels. Other weaknesses are the cultural models which favor authoritarianism and paternalism; the stressing of a clinic-based service delivery system as opposed to the Primary Health Care approach; the lack of direct information education and communication (IEC) action in the communities; the lack of a strategy to gather the knowledge existing in such communities to incorporate it in the joint planning of services, and deficiencies in supervision and evaluation which are aimed at measuring goals and results but not at identifying and analyzing problems.