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Washington, D.C., The National Academies Press, 2008 Dec 15.  p.At this historic moment, the incoming Obama administration and leaders of the U.S. Congress have the opportunity to advance the welfare and prosperity of people within and beyond the borders of the United States through intensified and sustained attention to better health. The United States can improve the lives of millions around the world, while reflecting America's values and protecting and promoting the nation's interests. The Institute of Medicine-with the support of four U.S. government agencies and five private foundations-formed an independent committee to examine the United States' commitment to global health and to articulate a vision for future U.S. investments and activities in this area.
The Global Campaign for the Health MDGs: Challenges, opportunities, and the imperative of shared learning.
Lancet. 2007 Sep 22; 370(9592):1018-1020.On Sept 5, the International Health Partnership (IHP) was launched by the UK, and on Sept 26, Women and Children First: the Global Business Plan for Maternal, Newborn and Child Health will be launched by Norway. These two new efforts, along with the Canadian Catalytic Initiative to Save a Million Lives, have been packaged as part of a broader Global Campaign for the Health Millennium Goals (MDGs). Such an explosion of proposals, which is meant to accelerate action for achieving MDGs 4, 5, and 6, should be welcomed by the world's health community. The proposals are further recognition of the continued commitment by high-income countries to address key health challenges in low-income and middle-income countries. Building on a decade of expanding work in global health, we can hope that these high-profile initiatives will sustain interest and address major obstacles to improving the health of the poorest people in the magnitude and time-frame demanded by the MDGs. Nevertheless, as is often the case with new policy efforts, the main operative aspects of the proposals and their likely consequences can be difficult to identify. We frame questions on five key issues that these announcements highlight. (excerpt)
Lancet. 1995 Jul 29; 346(8970):301.The World Bank, in "India's Welfare Programme: Towards a Reproductive and Child Health Approach," a review done with the Ministry of Health and Family Welfare, makes the following recommendations: 1) eliminate method-specific contraceptive targets and incentives, and replace them with broad reproductive and child health goals and measures; 2) increase the emphasis on male contraceptive methods (which account currently for only 6% of contraceptive use); 3) improve access to reproductive and child health services; 4) increase the role of the private sector by revitalizing the social marketing program; and 5) encourage experimentation with an expanded role for the private sector in implementing publicly funded programs. Since the launch of the family planning program in 1951, mortality has fallen by two-thirds, and life expectancy at birth has almost doubled. However, the population has almost doubled since 1961. By 2025, it is expected to be 1.5-1.9 billion. By 1992, India had achieved 60% of its goal for replacement fertility (2.1 births per woman), decreasing from 6 births per woman in 1951-1961 to 3-4 births per woman. Meeting India's unmet need for family planning would allow the replacement fertility goal to be reached. Female education and employment would add to the demand for smaller families and assure continuing declines in fertility and population growth rate. The report also highlights problems in implementation of the program, including program accessibility and quality of care. The report cites National Family Health Survey data which shows that only 35% of children under 2 received all six vaccines in the program, while 30% received none. The bank's "1993 World Development Report" recommended spending $5.40 per head for maternal and child health and family welfare programs; India spends $0.60. Massive borrowing will be required.
HEALTH FOR THE MILLIONS. 1991 Aug; 17(4):20-3.Until recently, the only sustained AIDS activity in India has been alarmist media attention complemented by occasional messages calling for comfort and dignity. Public perception of the AIDS epidemic in India has been effectively shaped by mass media. Press reports have, however, bolstered awareness of the problem among literate elements of urban populations. In the absence of sustained guidance in the campaign against AIDS, responsibility has fallen to voluntary health activists who have become catalysts for community awareness and participation. This voluntary initiative, in effect, seems to be the only immediate avenue for constructive public action, and signals the gradual development of an AIDS network in India. Proceedings from a seminar in Ahmedabad are discussed, and include plans for an information and education program targeting sex workers, health and communication programs for 150 commercial blood donors and their agents, surveillance and awareness programs for safer blood and blood products, and dialogue with the business community and trade unions. Despite the lack of coordination among volunteers and activists, every major city in India now has an AIDS group. A controversial bill on AIDS has ben circulating through government ministries and committees since mid-1989, a national AIDS committee exists with the Secretary of Health as its director, and a 3-year medium-term national plan exists for the reduction of AIDS and HIV infection and morbidity. UNICEF programs target mothers and children for AIDS awareness, and blood testing facilities are expected to be expanded. The article considers the present chaos effectively productive in forcing the Indian population to face up to previously taboo issued of sexuality, sex education, and sexually transmitted disease.
Studies in Family Planning. 1984 Nov-Dec; 15(6/1):296-302.The international Conference on Population, held in Mexico City in August 1984, met to review past developments and to make recommendations for future implementation of the World Population Plan of Action. Despite the several ifferences of opinion, the degree of controversy was minor for an intergovernmental meeting of this size. The 147 government delegations at the Conference reached overall agreement on recommendations for future international commitment to expanding population efforts in the future. This review examines the recommendations of the Mexico Conference with regard to health, family planning, women in development, research, and realted issues. The total 88 recommendations wre intended to reaffirm and refine the World Population Plan of Action adopted in Bucharest in 1974, and to strengthen the Plan for the next decade. Substantial improvement in development was noted including fertility and mortality declines, improvements in school enrollement and literacy rates, as well as access to health services. Economic trends, however, were much less encouraging. While the global rate of population growth has declined slightly since 1974, world population has increased by 770 million during the decade, with 90% of that increase in the developing countries. Part of the controversy at the Conference focused on the remarkable change of position by the US delegation, which largely reversed the policies expressed at Bucharest. The US delegation stated that population was a neutral issue in development, that development is the primary requirement in achieving fertility decline. Several recommendations emphasized the need to integrate population and development planning, and called for increased national and international efforts toward the eradication of mass hunger, illiteracy, and unemployment; achievement of adaquate health and nutrition levels; and improvement in women's status. The need for futher development of management, training, information, education and communication was recognized. A clear call to strenghten global efforts in population policies and programs emerged.