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  1. 1
    337896

    Position statement on condoms and the prevention of HIV, other sexually transmitted infections and unintended pregnancy.

    United Nations Population Fund [UNFPA]; World Health Organization [WHO]; Joint United Nations Programme on HIV / AIDS [UNAIDS]

    [Geneva, Switzerland], UNAIDS, 2015 Jul 7. [8] p.

    Condoms are a critical component in a comprehensive and sustainable approach to the prevention of HIV and other sexually transmitted infections (STIs) and are effective for preventing unintended pregnancies. Male and female condoms are the only devices that both reduce the transmission of HIV and other sexually transmitted infections (STIs) and prevent unintended pregnancy. Condoms have played a decisive role in HIV, STI and pregnancy prevention efforts in many countries. Condoms remain a key component of high-impact HIV prevention programmes. Quality-assured condoms must be readily available universally, either free or at low cost. Programmes promoting condoms must address stigma and gender-based and socio-cultural factors that hinder effective access and use of condoms. Adequate investment in and further scale up of condom promotion is required to sustain responses to HIV, other STIs, and unintended pregnancy. (Excerpts)
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  2. 2
    335019

    UN Commission on Life-Saving Commodities for Women and Children: Commissioners' report.

    United Nations. Commission on Life-Saving Commodities for Women and Children

    New York, New York, United Nations Commission on Life-Saving Commodities for Women and Children, 2012 Sep. [25] p.

    The United Nations Commission on Life-Saving Commodities for Women and Children presents a new plan and set of recommendations to improve the supply and access of life-saving health supplies.
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  3. 3
    328254

    A chorus of disapproval [editorial]

    Nature. 2008 Jul 31; 454(7204):551.

    The fight against AIDS is losing ground, but the current spate of mud-slinging is far from helpful. The global conversation about AIDS is beginning to sound like a high-decibel exercise in finger-pointing and blame. This dangerous trend should be on the minds of the thousands of attendees convening in Mexico City this weekend for the XVII International AIDS Conference. Thirty-three million people around the world are HIV-positive, and more than 6,800 become infected every day. Tests on microbicides and vaccines have failed, and have put some volunteers at greater risk of HIV infection. Yet critics are attacking the very programmes and people trying to solve these problems, with some even calling for an end to government spending on the search for a vaccine. This is an overreaction. As many scientists point out, the search for a malaria vaccine has seen dozens of failed trials, whereas only three AIDS vaccines have so far been tested in efficacy studies. What is needed are better vaccine candidates to test, so it makes sense that the major backers of HIV vaccine trials, including the US National Institutes of Health, are now focusing on the basic research that could help the field move forward. Meanwhile, two books published last year claim that the United Nations AIDS programme, UNAIDS, has led an ineffective, politically motivated response to the disease and has distorted statistics in an effort to garner more money. And critics such as Roger England, who runs a small think tank in Grenada, argue that spending on AIDS has distorted poor countries' priorities and weakened their health systems. England proposes that UNAIDS be shut down, and the money spent on AIDS programmes shifted to general funding for health systems. Amid the debate on these questions, the founding director of UNAIDS, Peter Piot, announced in April that he would step down at the end of this year, throwing the agency into uncertainty at a crucial time. There is no doubt that many poor countries' health systems are struggling, but it is wrong to say that AIDS aid is responsible. In fact, AIDS programmes have shown how poor countries can use new models to deliver needed care, for instance by providing antiretroviral treatments effectively, putting to rest claims that the costly drugs could not be used correctly outside resource-rich nations. It is also wrong to assume that governments will spend money effectively to fight AIDS if given funds to support health systems overall, as England suggests. Today, many strategies for delivering AIDS treatment target groups such as women, homosexuals and intravenous drug users that have been ignored by governments in the past - neglect that fuelled the spread of the disease. More money should be spent on both AIDS and strengthening health-care systems. And this will be possible if donor governments live up to their promises, such as the pledges of general and disease-specific aid to Africa that were repeated this July at the G8 meeting in Japan. On that front, it is heartening that the US House and Senate have reauthorized $48 billion for the President's Emergency Plan for AIDS Relief ($9 billion of which is for fighting malaria and tuberculosis). If President Bush signs the bill as expected, the programme will also permit the US government to reverse the shameful and embarrassing policy that bans travellers with HIV from entering the country. That might serve as an example to other governments that still sanction discrimination against those who are HIV-positive. The world is still far from achieving the goal adopted in 2000 by UN member states, which pledged to provide universal access to AIDS treatment by 2010. Three million people now receive lifesaving antiretroviral drugs, but 70% of those in low- to middle-income countries who need them don't get them. Indeed, the example of wealthy nations themselves shows what happens when they lose focus on AIDS. In the United States, for instance, reports now indicate that HIV infection rates have begun to rise in Latinos and young gay men. The activists and scientists about to meet in Mexico City must demand that leaders keep their eye on the ball. The world now has models for providing treatment and care in the places that sorely need it, and is in a position to make more tangible gains against AIDS. This is no time to backslide, and the Mexico City meeting must deliver this message loud and clear. (full-text)
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  4. 4
    303291

    Access to drugs. UNAIDS technical update.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]; World Health Organization [WHO]. Action Programme on Essential Drugs

    Geneva, Switzerland, UNAIDS, 1998 Oct. [12] p. (UNAIDS Best Practice Collection)

    The World Health Organization (WHO) estimates that over one-third of the world's population has no guaranteed access to essential drugs. There are various reasons for this lack of access. Worldwide, the most important is affordability (drugs cost more money than is available to pay for them) but legal, infrastructural, distribution and cultural factors are also serious obstacles. The influence of each of these factors is different from country to country, just as frequencies of diseases also vary greatly. Among its activities aimed at improving drug access in developing countries (including technical services such as help in drug procurement and performance of needs estimates), WHO has drawn up a Model List of Essential Drugs, which is updated every two years. The tenth list (1997) has 308 priority drugs that provide safe, effective treatment for the infectious and chronic diseases which affect the vast majority of the world's population. The drugs are selected on the basis of cost-effectiveness within each drug class (e.g. of the dozens of penicillins only eight appear on the Essential Drugs list). With WHO's encouragement, more than 140 countries have developed their own national essential drug lists taking into account local needs, costs and available resources. (excerpt)
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  5. 5
    106870

    How to investigate drug use in health facilities. Selected drug use indicators.

    World Health Organization [WHO]. Action Programme on Essential Drugs

    Geneva, Switzerland, WHO, Action Programme on Essential Drugs, 1993. ii, 87 p. (WHO/DAP/93.1; DAP Research Series No. 7)

    The WHO Action Program on Essential Drugs has developed and field tested a core set of drug use indicators capable of describing drug use patterns and prescribing behaviors in a country, region, or individual health facility. These indicators can be used to measure the impact of interventions designed to change prescribing practices, detect performance problems, and compare the performance of providers and institutions. Three categories have been developed: 1) prescribing indicators--average number of drugs per encounter, percentage of drugs prescribed by generic name, percentage of encounters with antibiotic prescribed, percentage of encounters with injection prescribed, and percentage of drugs prescribed from essential drugs list or formulary; 2) patient care indicators--average consultation time, average dispensing time, percentage of drugs actually dispensed, percentage of drugs adequately labelled, and patients' knowledge of correct dosage; and 3) facility indicators--availability of copy of essential drugs list or formulary and availability of key drugs. All data required to measure the core indicators can be derived from medical records or direct observation. Field testing in developing countries such as Nigeria and Tanzania found these measures both feasible to obtain and informative as first-level indicators. Also presented are descriptions of key issues related to study design and sampling, field methods, analysis, and follow up.
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  6. 6
    168552
    Peer Reviewed

    UNICEF asks donors to give poorer nations longer-term commitment.

    Ahmad K

    Lancet. 2002 Jun 8; 359:2009.

    Carol Bellamy, head of UN Children's Fund (UNICEF), warned that immunization programs worldwide are threatened by the gross reduction of routine childhood- vaccines despite the fact that the risk of vaccine-preventable diseases is increasing. Although production of childhood vaccines normally requires about 2 years, countries funding such programs only commit funds for 1 year at a time. This makes it difficult for their poorer counterparts to make multiyear purchase commitments. As a consequence, UNICEF has been unable to sign long-term contracts with vaccine manufacturers. Thus UNICEF has been calling for long- term commitments from donors.
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  7. 7
    073668

    AIDS update, 1991. A report on UNFPA support in the area of HIV / AIDS prevention.

    United Nations Population Fund [UNFPA]

    New York, New York, UNFPA, [1992]. [3], 20 p.

    This 1991 report reviews UNFPA efforts to strengthen HIV/AIDS prevention activities throughout the globe. The most recent estimate places the number of HIV infections at 10-12 million people, a figure that is expected to more than triple by the year 2000. Following an introductory section, section II of the report discusses UNFPA country-level support for AIDS prevention. UNFPA support is divided into the following categories: 1) general information and communication activities; 2) in-school and out-of-school AIDS education activities; 3) the supply and distribution of condoms; and 4) training in AIDS prevention. Currently, UNFPA is supporting a wide range of information, education, and communication (IEC) activities in 31 countries. In-school and out-of-school AIDS prevention modules have been initiated in 41 countries. UNFPA is supporting condom distribution program in 30 countries, as well as training in AIDS prevention in 38 countries. Section III briefly reviews regional and interregional AIDS prevention activities, while section IV identifies 4 priority areas in AIDS prevention. The latter include: 1) strengthening collaboration with national AIDS control programs; 2) accelerating and focusing on research and development activities; 3) combating complacency and denial, which threaten to undermine current AIDS preventing activities; and 4) reinforcing efforts in the area of human rights.
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  8. 8
    068475

    Condom services to prevent HIV transmission: are they workable? [editorial]

    Friel P

    AIDS HEALTH PROMOTION EXCHANGE. 1989; (3):1-2.

    This editorial argues that in order to increase the use of condoms in the fight against AIDS, WHO's Global Program on AIDS (GPA) must address the problems of weak condom distribution and promotion systems. The available data indicates that condom use can protect against HIV transmission. Studies in Zaire, Denmark, Germany, and Australia reveal that seropositivity among prostitutes who use condoms is much lower than among prostitutes who do not use condoms. However, the use of condoms largely depends on whether services are available to the people who practice risk behavior, and whether such people can be motivated to adopt safe sex practices -- including proper and consistent condom use. In order to bring about this desired behavior change, it is essential to have a strongly managed integrated program that combines condom services and health promotion, as well as specific plans and budgets to distribute and promote condoms. In supporting national AIDS programs, GPA's current strategy for condom services includes the following: 1) the provision of high-quality, low-cost condoms; 2) assistance in developing comprehensive program management and technical support plans and budgets for incorporation into subsequent funding cycles; and 3) support for research and development of new methods for preventing the sexual transmission of HIV -- including barrier methods that can be controlled by women.
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  9. 9
    050840

    Distribution and logistics.

    Fabricant S

    In: ICORT II proceedings. Second International Conference on Oral Rehydration Therapy, December 10-13, 1985, Washington, D.C., [edited by] Linda Ladislaus-Sanei and Patricia E. Scully. Washington, D.C., Creative Associates, 1986 Dec. 83-5.

    At a recent international conference on Oral Rehydration Therapy (ORT) there were discussions on policy issues. Advances in oral rehydration solution (ORS) local production, and the use of private sector and public sector distribution. It was agreed that the roles of ORS packets and home solutions must be carefully thought through and the be the basis of the program. If ORS is going to be available at the household level then the use of the private sector should be considered. The policy to use informal distribution channels and traditional healers has shown to increase public access to ORS. Also, donor support of ORS commodities may not lead to self sufficiency. Governments should plan for self sufficiency in advance and should manage donor support. Advances in local ORS production include factors that promote low cost production such as efficient personnel, economical procurement of materials, appropriate choice of equipment, minimizing duties, and using existing production facilities. The adoption of a citrate ORS formula allows the use of cheaper packaging material. The private sector can and should be used to make ORS available on a wide scale. Product pricing is a highly complex problem and the mothers ability to pay must be balanced against the profit incentives in the distribution system. Subsidies have been necessary to encourage the private sector and mass media campaigns have proven to be a useful subsidy. The key factor in gaining wide coverage is the person who contacts the mother. Competition can be useful in gaining greater effective usage but there are tradeoffs. The high costs of import licenses and hard currency have been stumbling blocks for the private sector production in some countries. It was found that it is inadvisable to set up a separate distribution system for ORS and it should not be given priority over other child survival interventions. Also a policy of cost recovery can make a program more viable in the absence of donor assistance and has increased confidence in the product and therapy.
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  10. 10
    051976

    The use of essential drugs. Third report of the WHO Expert Committee.

    World Health Organization [WHO]. Expert Committee on the Use of Essential Drugs

    WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1988; (770):1-63.

    This booklet incorporates both guidelines and criteria for establishing national programs for essential drugs, and a suggested list of approximately 250 essential drugs. It is important to emphasize that it is up to each country to decide whether to implement an essential drug policy, and how to adapt the list to their own changing needs. Guidelines for a national program include accepting recommendations by a local committee; using generic names and providing a cross index; providing a drug information sheet to accompany the list; regulation or constant testing of quality of the drugs; deciding on the level of expertise needed to prescribe each drug; administration of supply, storage and distribution. Choice of drugs is based on quality, bioavailability, safety, price and availability. Criteria for selection of drugs for primary health care involves evaluation of existing medical care systems, the national health infrastructure, trained personnel and available supplies, and the pattern of endemic disease. Each agent is listed by its international nonproprietary name (INN), is accompanied by substitutions and complementary drugs, and is described by its route of administration, dosage form and strength. Listings are by category and alphabetically.
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  11. 11
    044481

    Quantities of Noristerat (doses) [and] Depo Provera (doses) supplied by IPPF 1982-1986.

    International Planned Parenthood Federation [IPPF]

    [Unpublished] [1986]. [12] p.

    Tabulated data show amounts of Noristerat and Depo-Provera supplied by IPPF (International Planned Parenthood Federation) by years from 1982-1986, in doses, listed by country. Each set of data is preceded by a summary sheet showing total numbers of doses shipped to geographical regions. Amounts of Noristerat rose from 4600 doses in 1982 to 97,000 doses in 1986. Depo-Provera rose from 471,000 to 558,000 doses yearly.
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  12. 12
    032447

    Oral rehydration salts: an analysis of AID's options.

    Elliott V

    [Columbia Maryland], Westinghouse Electric Corporation, Public Applied Systems, 1984 Sep. 26, [13] p. (Contract No. PDC-1406-I-02-4062-00, W.0.2; Project No. 936-5939-12)

    Westinghouse Health Systems, under a US Agency for International Development (USAID) contract, ass ssed the global supply and demand of oral rehydration salts (ORS) and developed a set of recommendations concerning USAID's future role as a supplier of ORS. 1.5 billion ORS packets (assuming each packet is equivalent to 1 liter of ORS solution) would be required to treat all ORS treatable cases of diarrhea which occur annually among the world's children under 5 years of age. Currently, about 200 million packets are manufactured/year. In 1983, international sources supplied slightly less than 37 million packets, and the remaining packets were produced by local or in-country manufacturers. UN Children's Fund (UNICEF), which currently provides 81% of the international supply, contracts with private firms to manufacture ORS and then distributes the packets to developing countries, either at cost or free of charge. UNICEF purchases the packets for about US$.04-US$.05. USAID provides about 12.3% of the international supply. Prior to 1981, USAID distributed UNICEF packets. Since 1981, USAID has distributed ORS packets manufactured by the US firm of Jianas Brothers. USAID must pay a relatively high price for the packets (US$.08-US$.09) since the manufacturer is required to produce the packets on an as needed basis. Other international suppliers of ORS include the International Dispensary Association, the Swedish International Development Authority, the International Red Cross, and the World Health Organization. Currently, 38 developing countries manufacture and distrubute their own ORS products. These findings indicate that there is a need to increase the supply of ORS; however, the supply and demand in the future is unpredictable. Factors which may alter the supply and demand in the future include 1) the development of superior alternative formulations and different type of ORS products, 2) a reduction in the incidence of diarrhea due to improved environmental conditions or the development of a vaccine for diarrhea, 3) increased production of ORS in developing countries, 4) increased commercial sector involvement in the production and sale of ORS products, and 5) the use of more effective marketing techniques and more efficient distribution systems for ORS products. USAID options as a future supplier of ORS include 1) purchasing and distributing UNICEF packets; 2) contracting with a US firm to develop a central procurement system, similar to USAID's current contraceptive procurement system; 3) contracting with the a US firm to establish a ORS stockpile of a specified amount; 4) promoting private and public sector production of ORS within developing countries; 5) including ORS as 1 of the commodities available to all USAID assisted countries. The investigators recommended that USAID should contribute toward increasing the global supply of ORS; however, given the unpredictability of the ORS demand and supply, USAID should adopt a short-term and flexible strategy. This strategy precludes the establishment of a central procurement system; instead, USAID should contract a private firm to establish an ORS stockpile and to fill orders from the stockpile. Consideration should be given to altering the ORS packets size and to alternative ORS presentations. USAID should also promote the production of quality ORS products within developing countries and continue to support research on other diarrhea intervention strategies. This report also discusses some of the problems involved in manufacturing and packaging ORS. The appendices contain 1) a WHO and UNICEF statement on the ORS formulation made with citrate instead of bicarbonate, 2) a list of developing countries which manufacture ORS, and 3) statistical information on distribution of ORS by international sources.
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