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New York, New York, United Nations Commission on Life-Saving Commodities for Women and Children, 2012 Sep.  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.
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.
In: Mectizan (Ivermectin) and the Control of Onchocerciasis: Strengthening the Global Impact. A symposium sponsored by Merck and Co., Inc. marking the fifth anniversary of the donation of Mectizan for the treatment of onchocerciasis and held with the technical cooperation of the World Health Organization at the Hudson Theater in New York on September 23, 1992. Summary proceedings of the symposium. Rahway, New Jersey, Merck and Company, 1992. 57.Christoffel-Blindenmission (CBM) is an interdenominational Christian service organization for blind and disabled persons in many of the world's poorest developing countries. It supports more than 300 eye care programs in approximately 70 countries at an annual cost of US $15-16 million. Funded by many individual donors, fund raising activities are conducted in Europe, North America, and Australia. CBM operates through 8 regional offices: 3 in Asia, 3 in Africa, and 2 in Latin America. Program development and evaluation are the responsibility of regional representatives, each of whom uses the services of a medical consultant. CBM's program support is usually long term, based on a recipient's annual budget application and evaluation. Since 1988, CBM has been distributing 200,000 tablets of Mectizan each year to voluntary hospitals in 14 African countries to treat patients with onchocerciasis. CBM also supports community-based treatment programs in Ecuador and Zaire, and, in collaboration with OCP, in Sierra Leone. Plans for 1993 include establishing a program for 600,000 people in the Central African Republic (CAR) in collaboration with the CAR Ministry of Health and the River Blindness Foundation. As an organization, CBM identifies 5 specific barriers to be overcome in developing and sustaining programs of treatment with Mectizan: 1) Poor communication systems in the endemic areas, which require development of an appropriate infrastructure. 2) Lack of health knowledge, which requires a community awareness action. 3) Limited availability of financial resources in the worst-affected countries, requiring a mobilization of funds for long-term commitment. 4) Inadequately-trained personnel, requiring staff training as an integral part of all programs. 5) Affected communities have so many health problems that integration of distribution of Mectizan with already existing or developing primary health care activities is becoming increasingly important.
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.
SCIENCE. 1991 Mar 15; 251:1312-3.AIDS scientists met in February 1991 to discuss international trials of AIDS vaccines because of the urgency in conducting such trials since the US Food and Drug Administration approved 6 vaccines for trails. Major problems discussed were how to insure access to potential AIDS vaccines to developing countries, where to conduct future tests of vaccine efficacy, and which of the leading institutions should coordinate such an effort. The most difficult issue centered around who assumes the risks and who benefits. Many researchers considered conducting AIDS vaccine trials in developing countries since they have a large population varied in age and gender at high risk of HIV infection. Assuming an HIV vaccine is effective, additional questions must be addressed: How can a developing country afford a vaccine at free market prices? If that country does get the vaccine should not other developing countries also get it? Who will pay for it and distribute it? WHO has already contacted ministries of health about AIDS trials. Other organizations, e.g., the US Centers for Disease Control and the US National Institutes of Health, also already involved in international AIDS vaccine research do not want to be kept out of the Phase III trials. Some recommended that WHO be the international umbrella, others suggested that no organization control all the research. Nevertheless the vaccine will be produced in a rich country, and if left to the free market, it will be too expensive. 1 suggestions is a 2-tiered pricing plan in which rich countries pay higher prices thereby subsidizing the price in poor countries. Another is a patent exchange where the vaccine developers donate the vaccine patent to an international organization and they in turn can get an extension on an existing patent. Another alternative includes removing AIDS vaccines from the private sector altogether.
JOURNAL OF TROPICAL MEDICINE AND HYGIENE. 1989 Aug; 92(4):229-41.This general discussion on health economics provides an historical overview as well as a discussion of some of the developments and deficiencies in health economics in developing countries, broadly focused on expenditure and financing studies, cost benefit and cost effectiveness, local costing studies and health planning. In 1963, it was found that as GDP rose so did health expenditures, that countries with similar per capita income spent different percentages of GDp on health services, that the private sector involvement was greater than the public, and that hospitals received most of the money. Countries were encouraged to conduct further studies. The World Bank has successfully stimulated discussion. However, lacking the expenditure studies, cost benefits are hampered by the availability of epidemiological data and poor cost information, and geared toward studies on how to cut costs for immediate goals, or specific diseases, rather than on practical advice to governments. 1 such study helped identify that most cost effective allocation of resources. The limited local cost studies are particular to understanding specific costs of immunization versus antenatal visits; however, the usefulness of such preliminary information reveals wide variability between countries. The Health for All initiatives and the limited resources in developing countries have placed health planning in a central position with Ministries of Health. Due to prior mistakes in planning an excess number of trained medical staff are underutilized and present needs have been defined as developing local PHC support staff. The WHO expectation of 5% of GNP for health service was unfulfilled because larger donor aid and local resources have not been sufficient even with strong posturing, and over ambitious plans were made unrealistically. Since 1987, WHO has provided economic strategies but the economic crises changed the needs. Many questions remain and consultants are too few, improperly trained, or unavailable for the appropriate time period: unacceptable solutions, coupled with a confusing World bank prospectus for action when more research is needed. Intersectorial collaboration has not provided answers to priorities or addressed the interactions among nutrition and agricultural policy, education and lifestyle, water and sanitation and the economy. The research agenda should include: the identification of the determinants of health, key elements of primary health care (PHC), cost of delivering PHC, hospital efficiency, health manpower mix, adequate procurement and distribution, appropriate technology, user charges for financing, health insurance, and community financing.
FORUM. 1988 Apr; 4(1):14-5.PROFAMIL, the Haitian family planning association affiliated with the IPPF, has embarked on employment-based education and distribution by trained nurse-visitors. A typical nurse visits 17 workplaces monthly, dispensing pills and condoms, and referring those interested in an IUD or injectable to the clinic. PROFAMIL was established in 1986. It opened a clinic in Port-au-Prince, and has begun working with physicians, private voluntary organizations, as well as the media. Haiti, the poorest country in the Western Hemisphere, has a per capita income of $350, an average fertility of 5 children per woman, a population growth rate that is still growing and virtual desertification in rural areas. Only 6% of couples use a modern method of contraception. PROFAMIL's work is viewed with mistrust by many leaders and voodoo priests, who suspect that it is a form of foreign domination.