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Your search found 19 Results

  1. 1
    327143

    Missing the Target No. 5: Improving AIDS drug access and advancing health care for all.

    International Treatment Preparedness Coalition [ITPC]

    [Bangkok, Thailand], ITPC, 2007 Dec. [114] p.

    In the first section of the report, nine country teams provide first-hand reports on central issues related to AIDS service scale-up in their countries. Each demonstrates that increasing access to AIDS treatment brings not only better life and new hope, but also shines light on challenges and effective approaches to a spectrum of health, poverty, and human rights issues. In part two of this report, 14 national teams review drug access issues, and find that global and national processes for AIDS drug registration are burdened by inefficiencies, duplications, delay, and, in some instances, corruption. In many cases key ARVs, particularly newer and second-line therapies, are not yet registered in high impact countries - an administrative roadblock that puts lifesaving care out of reach for hundreds of thousands of people. The report makes a number of concrete recommendations to the key players who are responsible for making near universal access to AIDS treatment a reality by 2010. (excerpt)
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  2. 2
    323434
    Peer Reviewed

    Reducing the impact of climate change.

    Brown H

    Bulletin of the World Health Organization. 2007 Nov; 85(11):824-825.

    The most recent report of the Intergovernmental Panel on Climate Change (IPCC) found that there is overwhelming evidence that humans are affecting climate and it highlighted the implications for human health. The World Health Organization (WHO) is helping countries respond to this challenge, primarily by encouraging them to build and reinforce public health systems as the first line of defence against climate-related health risks. (excerpt)
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  3. 3
    322966
    Peer Reviewed

    Uncertainties remain over pre-pandemic flu vaccine benefits.

    Hargreaves S

    Lancet Infectious Diseases. 2007 Nov; 7(11):705.

    An expert advisory group, convened by the European Centre for Disease Prevention and Control (ECDC), has concluded that it would be inadvisable to embark on a widespread pre-pandemic H5N1 vaccination programme in European countries at the present time. Pre-pandemic vaccines, currently being developed by several pharmaceutical companies, can be made ahead of the emergence of pandemic influenza virus, unlike "true" pandemic vaccines. However, experts have concluded that there remains too much uncertainty as to whether the H5N1 avian influenza virus, on which pre-pandemic vaccines currently under development are based, will ever be responsible for a pandemic. According to Johan Giesecke (ECDC, Stockholm, Sweden), "If there is an H5N1-based pandemic, the strategy of having stockpiled pre-pandemic H5N1 vaccines, even if the vaccines incompletely match the pandemic virus, may prevent more infections and deaths than waiting for specific "true" pandemic vaccines...however, there is no guarantee that the next human influenza pandemic will evolve from the current H5N1 avian influenza virus". (excerpt)
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  4. 4
    322946
    Peer Reviewed

    Keeping count: Births, deaths, and causes of death.

    Lopez AD; Abou Zah C; Shibuya K; Gollogly L

    Lancet. 2007 Nov 24; 370(9601):1744-1746.

    The four papers in this Series called Who Counts? describe the state of the world's vital statistics, and the fact that few countries derive these from routine compulsory measures through civil registration. However, every country in the world has the capacity to produce useful economic data. Because of its particular interest in, and requirements for, demographic and epidemiological data, the health sector should raise similar expectations of national capacity to produce vital statistics. Unrepresentative, biased, incomplete, and often out-of-date, the world's vital statistics compare poorly with the detailed information available on every country's economy. The effort and expense of gathering and interpreting data on national income and trade balances are accepted costs of monitoring economic prospects in an international market. Health is arguably as important as economics, and establishing their mutual interdependence has made a big difference to the funding and attention that health attracts.Sen proposes mortality as an indicator of economic success or failure, but many countries are still making patchy and incomplete efforts to count lives and deaths, and to document how their people die. (excerpt)
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  5. 5
    321945

    Family planning and the World Bank in Jamaica.

    King T

    In: The global family planning revolution: three decades of population policies and programs, edited by Warren C. Robinson and John A. Ross. Washington, D.C., World Bank, 2007. 155-174.

    In Jamaica, as in many countries, the pioneers of family planning were men and women who sought to improve the well-being of their impoverished women compatriots, and who perhaps were also conscious of the social threats of rapid population growth. When, eventually, population control became national policy, the relationship between the initial private programs and the national effort did not always evolve smoothly, as the Jamaican experience shows (see box 10.1 for a timeline of the main events in relation to family planning in Jamaica). A related question was whether the family planning program should be a vertical one, that is, with a staff directed toward a sole objective, or whether it should be integrated within the public health service. These issues were not unique to Jamaica, but in one respect Jamaica was distinctive: it was the setting for the World Bank's first loan for family planning activities. Family planning programs entailed public expenditures that were quite different from the infrastructure investments for which almost all Bank loans had been made, and the design and appraisal of a loan for family planning that did not violate the principles that governed Bank lending at the time required a series of decisions at the highest levels of the Bank. These decisions shaped World Bank population lending for several years and subjected the Bank to a good deal of external criticism. For that reason, this chapter focuses on the process of making this loan. (excerpt)
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  6. 6
    321970
    Peer Reviewed

    Global health governance and the World Bank.

    Ruger JP

    Lancet. 2007 Oct 27; 370(9597):1471-1474.

    With the Paul Wolfowitz era behind it and new appointee Robert Zoellick at the helm, it is time for the World Bank to better define its role in an increasingly crowded and complex global health architecture, says Jennifer Prah Ruger, health economist and former World Bank speechwriter. Just 2 years after taking office as president of the World Bank, Paul Wolfowitz resigned amid allegations of favouritism, and is now succeeded by Robert Zoellick. Many shortcomings marked Wolfowitz's presidency, not the least of which were a tumultuous battle over family planning and reproductive health policy, significant reductions in spending and staffing, and poor performance in implementing health, nutrition, and population programmes. Wolfowitz did little to advance the bank's role in the health sector. With the Wolfowitz era behind it and heightened scrutiny in the aftermath, the World Bank needs to better define its role and seize the initiative in health at both the global and country levels. Can the bank have an effect in an increasingly plural and complex global health architecture? What crucial role can the bank play in global health governance in the years ahead? (excerpt)
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  7. 7
    320993
    Peer Reviewed

    The Global Campaign for the Health MDGs: Challenges, opportunities, and the imperative of shared learning.

    Murray CJ; Frenk J; Evans T

    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)
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  8. 8
    320982
    Peer Reviewed

    Commentary: From scarcity to abundance: Pandemic vaccines and other agents for "have not" countries.

    Fedson DS; Dunnill P

    Journal of Public Health Policy. 2007; 28(3):322-340.

    The recent impasse between the Indonesian Ministry of Health and the World Health Organization (WHO) over sharing H5N1 viruses in return for access to affordable pandemic vaccines highlights slow progress in defining an antigen sparing vaccine formulation, developing licensing requirements that meet the needs of populations and obtaining government funding for vaccine trials. Currently, vaccine-producing countries would have difficulty producing enough doses for their own people and few doses would be left over for non-producing ("have not") countries. Yet within a few months of the onset of a new pandemic, several billion doses of live-attenuated and recombinant hemagglutinin H5 vaccines could be produced for "have not" countries, provided a new and disruptive system of "top down" management could be organized. In its absence, a "bottom-up" alternative that uses widely available and inexpensive generic agents like statins must be considered. The "have not" countries must continue to put pressure on WHO and leading countries to ensure that they will have access to the interventions they will need. (author's)
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  9. 9
    320669

    AIDS is not a business: A study in global corporate responsibility -- securing access to low-cost HIV medications.

    Flanagan W; Whiteman G

    Journal of Business Ethics. 2007 Jun; 73(1):65-75.

    At the end of the 1990s, Brazil was faced with a potentially explosive HIV/AIDS epidemic. Through an innovative and multifaceted campaign, and despite initial resistance from multinational pharmaceutical companies, the government of Brazil was able to negotiate price reductions for HIV medications and develop local production capacity, thereby averting a public health disaster. Using interview data and document analysis, the authors show that the exercise of corporate social responsibility can be viewed in practice as a dynamic negotiation and an interaction between multiple actors. Action undertaken in terms of voluntary CSR alone may be insufficient. This finding highlights the importance of a strong role for national governments and international organizations to pressure companies to perform better. (author's)
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  10. 10
    320248

    State of anarchy. Rebellion and abuses against civilians.

    Bouckaert P; Bercault O

    New York, New York, Human Rights Watch, 2007 Sep. 108 p. (Human Rights Watch Vol 19, No. 14(A))

    Since mid-2005, hundreds of civilians have been killed, more than 10 thousand houses burned, and approximately 212,000 persons have fled their homes in terror to live in desperate conditions deep in the bush in northern Central African Republic (CAR). Bordering eastern Chad and war-ravaged Darfur in Sudan, this area has been destabilized by at least two major rebellions against the government of President Francois Bozize. The vast majority of summary executions and unlawful killings, and almost all village burnings, have been carried out by government forces, often in reprisal for rebel attacks. While both main rebel groups have been responsible for widespread looting and the forced taxation of the civilian population in areas they control - and rebels in the northeast have committed killings, beatings, and rape - their abuses pale in comparison to those of the Central African Armed Forces (Forces armees Centrafricaines, FACA) and the elite Presidential Guard (Garde presidentielle, GP). As the International Criminal Court (ICC) begins investigations into atrocities committed during the 2002-2003 rebellion against former President Patasse, it should also investigate possible war crimes under its jurisdiction committed in the current round of fighting. (excerpt)
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  11. 11
    320246

    Keep your head down: Unprotected migrants in South Africa.

    Kriger N

    New York, New York, Human Rights Watch, 2007 Feb. 111 p. (Human Rights Watch Vol 19, No. 3(A))

    South Africa's vibrant and diverse economy is a powerful draw for Africans from other countries migrating in search of work. But the chance of earning a wage can come with a price: If undocumented, foreign migrants are liable to be arrested, detained, and deported in circumstances and under conditions that flout South Africa's own laws. And as highlighted by the situation in Limpopo and Mpumalanga provinces, both documented and undocumented foreign farm workers may have their rights under South Africa's basic employment law protections violated by employers in ways ranging from wage exploitation to uncompensated workplace injury, and from appalling housing conditions to workplace violence. Human Rights Watch has conducted research on the situation and experiences of migrant workers around the globe. Its research demonstrates that migrant workers, whether documented or undocumented, are particularly vulnerable to human rights abuses. Such abuses can be the result of many different factors includinginadequate legal protections, illegal actions of unscrupulous employers or state officials, and lack of state capacity or political will to enforce legal protections and to hold abusive employers and officials to account. The focus of this report is principally the situation of Zimbabweans and Mozambicans in South Africa's Limpopo and Mpumalanga provinces. (excerpt)
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  12. 12
    313696
    Peer Reviewed

    The evolving cost of HIV in South Africa: Changes in health care cost with duration on antiretroviral therapy for public sector patients.

    Harling G; Wood R

    Journal of Acquired Immune Deficiency Syndromes. 2007 Jul; 45(3):348-354.

    A retrospective costing study of 212 patients enrolled in a nongovernmental organization-supported public sector antiretroviral treatment (ART) program near Cape Town, South Africa was performed from a health care system perspective. t-Regression was used to analyze total costs in 3 periods: Pre-ART (median length = 30 days), first 48 weeks on ART (Year One), and 49 to 112 weeks on ART (Year Two). Average cost per patient Pre-ART was $404. Average cost per patient-year of observation was $2502 in Year One and $1372 in Year Two. The proportion of costs attributable to hospital care fell from 70% Pre-ART to 24% by Year Two; the proportion attributable to ART rose from 31% in Year One to 55% in Year Two. In multivariate analysis, Pre-ART and Year One costs were significantly lower for asymptomatic patients compared with those with AIDS. Costs were significantly higher for those who died Pre-ART or in Year One. In Year Two, only week 48 CD4 cell count and being male were significantly associated with lower costs. This analysis suggests that the total cost of treatment for patients on ART falls by almost half after 1 year, largely attributable to a reduction in hospital costs. (author's)
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  13. 13
    318335
    Peer Reviewed

    Midwifery education and maternal and neonatal health issues: Challenges in Pakistan.

    Rukanuddin RJ; Ali TS; McManis B

    Journal of Midwifery and Women's Health. 2007 Jul-Aug; 52(4):398-405.

    Although numerous health care interventions have been implemented in Pakistan, the high maternal and neonatal mortality rates still remain a challenge. Developed countries have reduced maternal and neonatal mortality rates by improving the skill and knowledge levels of nurse-midwives. This paper reviews maternal and neonatal health issues, challenges in current midwifery education, and the role of government and international agencies in Pakistan. The exact maternal and neonatal mortality rates in Pakistan are unknown; a census has not occurred since 1998, and data provided in more recent studies were presented in summary format. A number of factors that contribute to the high mortality rate could easily be controlled by using competent nurse-midwives throughout all levels of the Pakistani health care system. A reduction in the maternal mortality rate is likely to occur if the Pakistan government and international agencies work together to implement specific recommendations in maternal and neonatal health. These recommendations include: 1) holding an invitational conference; 2) strengthening the existing midwifery and Lady Health Visitor curricula; 3) pilot testing an expanded midwifery program; and 4) advocating for and obtaining political commitments and resources for midwifery education. (author's)
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  14. 14
    318069
    Peer Reviewed

    Inadequate, but not quite hopeless.

    Lancet Infectious Diseases. 2007 Jul; 7(7):439.

    The 2007 Group of Eight (G8) summit, which took place in Heiligendamm, Germany, on June 6-8, has been described by John Kirton (G8 Research Group, University of Toronto, Canada) as an "emerging centre of democratic global governance". Like many self-appointed elites, the G8 is an idiosyncratic club. The eight started as six in 1975 with a meeting in Rambouillet, France, of the heads of government of France, West Germany, Italy, Japan, the UK, and the USA-the most economically powerful democratic nations. This annual forum for discussion of matters of mutual interest was joined by Canada in 1976, by the European Union in 1977, and by Russia in 1997. Although the G8 nations account for nearly two-thirds of world economic output, the Russian economy is not among the world's top eight, whereas China with the fourth largest economy remains outside the G8 club. (excerpt)
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  15. 15
    317324
    Peer Reviewed

    The UN global compact and substantive equality for women: Revealing a "well hidden" mandate.

    Kilgour MA

    Third World Quarterly. 2007 Jun; 28(4):751-773.

    The achievement of women's equality is an elusive goal, especially in developing economies, where states have been unable or unwilling to protect and promote women's human rights and gender equality. Many argue that globalisation has heightened gender inequality. One response to this crisis is the United Nations corporate citizenship initiative: the Global Compact. This paper argues that the Global Compact has a strong gender equality mandate, which has not been fulfilled. The paper advances a number of reasons why this may be the case, including the lack of women's participation at many levels, the pervasive nature of women's inequality and the fact it may not be in the interests of Global Compact signatories to address this inequality. Despite the limitations of this voluntary initiative, it does have some potential to effect positive change. However, unless the pervasive and continued violation of women's human rights is addressed by the Global Compact, the claim that it is a viable new form ofglobal governance for addressing major social and economic problems is severely weakened. (author's)
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  16. 16
    317068
    Peer Reviewed

    Beyond and below the nation state: Challenges for population data collection and analysis.

    Hull TH

    Asia-Pacific Population Journal. 2007 Apr; 22(1):3-7.

    While the science of demography addresses the whole of the human population, substantive demographic research is most often focused on populations with common characteristics. For the last six decades the nation state has been the social unit that has dominated demographic research. The reasons for this focus make perfect sense. Nations define their populations in terms of citizenship and define the ways in which people will be identified in any effort to count the numbers. They have the authority, the interest and the resources to carry out collections of information about members of these defined populations. As members of the United Nations they collaborate with other nations to develop the methodological and technical tools used to analyse national population numbers in ways that are relevant to state policies and actions. In short, the nation is the foundation unit for understanding human population composition and growth. Global population numbers are estimated by compiling the information collected by nations. Interest in populations of units smaller than the nation also relies on national statistical collections and national definitions of component populations, but for most users of data the focus is on the nation, and not the units beyond or below that political entity. (excerpt)
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  17. 17
    315611
    Peer Reviewed

    Old dilemmas or new challenges? The politics of gender and reconstruction in Afghanistan.

    Kandiyoti D

    Development and Change. 2007 Mar; 38(2):169-199.

    This article situates the politics of gender in Afghanistan in the nexus of global and local influences that shape the policy agenda of post-Taliban reconstruction. Three sets of factors that define the parameters of current efforts at securing gender justice are analysed: a troubled history of state-society relations; the profound social transformations brought about by years of prolonged conflict; and the process of institution-building under way since the Bonn Agreement in 2001. This evolving institutional framework opens up a new field of contestation between the agenda of international donor agencies, an aid-dependent government and diverse political factions, some with conservative Islamist platforms. At the grassroots, the dynamics of gendered disadvantage, the erosion of local livelihoods, the criminalization of the economy and insecurity at the hands of armed groups combine seamlessly to produce extreme forms of female vulnerability. The ways in which these contradictory influences play out in the context of a fluid process of political settlement will be decisive in determining prospects for the future. (author's)
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  18. 18
    312909
    Peer Reviewed

    Making G8 leaders deliver: an analysis of compliance and health commitments, 1996 -- 2006.

    Kirton JJ; Roudev N; Sunderland L

    Bulletin of the World Health Organization. 2007 Mar; 85(3):192-199.

    International health policy-makers now have a variety of institutional instruments with which to pursue their global and national health goals. These instruments range from the established formal multilateral organizations of the United Nations to the newer restricted-membership institutions of the Group of Eight (G8). To decide where best to deploy scarce resources, we must systematically examine the G8's contributions to global health governance. This assessment explores the contributions made by multilateral institutions such as the World Health Organization, and whether Member States comply with their commitments. We assessed whether G8 health governance assists its member governments in managing domestic politics and policy, in defining dominant normative directions, in developing and complying with collective commitments and in developing new G8-centred institutions. We found that the G8's performance improved substantially during the past decade. The G8 Member States function equally well, and each is able to combat diseases. Compliance varied among G8 Member States with respect to their health commitments, and there is scope for improvement. G8 leaders should better define their health commitments and set a one-year deadline for their delivery. In addition, Member States must seek WHO's support and set up an institution for G8 health ministers. (author's)
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  19. 19
    312212
    Peer Reviewed

    Responding to the global HIV / AIDS crisis: A peace corps for health.

    Mullan F

    JAMA. 2007 Feb 21; 29(7):744-746.

    HIV disease is essentially the black death of the 21st century, killing on a massive scale and threatening to cripple economies and topple governments. However, the continued spread of the HIV epidemic and the new availability of lifesaving antiretroviral drugs have triggered an extraordinary response by governments, international organizations, philanthropies, pharmaceutical companies, religious organizations, and individuals. Campaigning against HIV/AIDS has no precedent in the history of medicine. Smallpox was eliminated by a globally coordinated strategy that required a single patient encounter to deliver the vaccine. In contrast, the directly observed therapy strategy at the core of modern tuberculosis treatment necessitates daily patient contact over much of the treatment course and, therefore, a much larger health workforce. Treating AIDS requires the daily delivery of medications as well as the clinical management of patients-- for the rest of their lives. Antiretroviral medications can help control disease, but do not cure it. More problematic yet, stopping treatment once started promotes the emergence of resistant strains of the virus, making halfway programs hazardous to public health. The sheer volume of health workers needed to tackle HIV disease--and the health systems to support their work--is off the scale of any previous public health campaign. (excerpt)
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