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Bethesda, Maryland, Abt Associates, Partners for Health Reform Plus, .  p. (USAID Contract No. HRN-C-00-00-00019-00)The Global Fund to Fight AIDS, TB and Malaria aims to attract, manage, and disburse resources that will make a significant and sustainable impact on the three focal diseases. The Global Fund has also stated its commitment to support programs that address the three diseases "in ways that contribute to the strengthening of health systems." The Global Fund is likely to have a variety of direct and indirect effects upon health care systems that could be positive or negative in nature. To be effective and sustainable in the long run, interventions will depend upon well-functioning health systems. This is true not only for the Global Fund, but also for other initiatives, such as the World Bank Multisectoral AIDS Program (MAP), the President's Emergency Plan for AIDS Relief, and others that aim to substantially increase the scale of response to specific diseases, particularly HIV/ AIDS. (excerpt)
Support to mainstreaming AIDS in development. UNAIDS Secretariat strategy note and action framework, 2004-2005.
Geneva, Switzerland, UNAIDS, . 10 p.Twenty years into the pandemic, there is now ample evidence for the complex linkages between AIDS and development: development gaps increase people's susceptibility to HIV transmission and their vulnerability to the impact of AIDS; inversely, the epidemic itself hampers or even reverses development progress so as to pose a major obstacle to the achievement of the Millennium Development Goals. The growing understanding of this two-way relationship between AIDS and development has led to the insight that, in addition to developing programmes that specifically address AIDS, there is a need to strengthen the way in which existing development programmes address both the causes and effects of the epidemic in each country-specific setting. The process through which to achieve this is called 'Mainstreaming AIDS'. In recognition of this, the 2001 United Nations General Assembly Special Session Declaration of Commitment on HIV/AIDS requires countries to integrate their AIDS response into the national development process, including poverty reduction strategies, budgeting instruments and sectoral programmes. (excerpt)
London, England, ActionAid International, . 27 p. (P1625/01/04)UNAIDS estimated that in Africa in 2003, more than 2.3 million people died from AIDS, 3 million were newly infected and a total of 12 million children were orphaned. Antiretroviral drugs are reaching a mere 50,000 of those with AIDS in developing countries. The HIV/AIDS pandemic is clearly a human and developmental disaster. This paper looks at the response to the HIV/AIDS crisis by the World Bank as a key member of the international donor/lending community, a leader in the international health community, and as Africa's principal development partner. In its seminal document, Intensifying Action Against HIV/AIDS, the World Bank acknowledges both its special leadership role in fighting HIV/AIDS and the need that it be held accountable for its stewardship. (excerpt)
2004 Nov-Dec; 12(6):847.The Millennium Goals were defined by the United Nations Organization in 2000 and approved by consensus during the Millennium Summit, a meeting that joined 147 heads of State. These goals reflect increasing concerns about the sustainability of the planet and about the serious problems affecting humanity. Constituted by a set of eight goals to be reached by 2015, they refer to the eradication of extreme poverty and hunger, universal access to basic education, gender equality promotion, infant mortality reduction, maternal health improvement, fight against HIV/Aids and other illnesses, guarantee of environmental sustainability and the establishment of a global partnership for development. Sustainability and development are closely linked to health and imply joint actions by States and civil society in the attempt to minimize the influence of the huge gap that exists between countries and persons. Thus, health and particularly nursing professionals' actions are paramount and can lead to local actions with regional, national and international impacts. (excerpt)
Food and Nutrition Bulletin. 2004; 25 Suppl 1:S5-S14.The rationale for developing a new international growth reference derived principally from a Working Group on infant growth established by the World Health Organization (WHO) in 1990. It recommended an approach that described how children should grow rather than describing how children grow; that an international sampling frame be used to highlight the similarity in early childhood growth among diverse ethnic groups; that modern analytical methods be exploited; and that links among anthropometric assessments and functional outcomes be included to the fullest possible extent. Upgrading international growth references to resemble standards more closely will assist in monitoring and attaining a wide variety of international goals related to health and other aspects of social equity. In addition to providing scientifically robust tools, a new reference based on a global sample of children whose health needs are met will provide a useful advocacy tool to health-care providers and others with interests in promoting child health. (author's)
[New York, New York], UNIFEM, 2004.  p.At the Millennium Summit held in September in September 2000, the leaders of the majority of the countries in the world adopted the UN Millennium Declaration where the promotion of gender equality was determined as one of eight goals. The XXIII Special Session of the UN General Assembly "Women in 2000: Equality Between Men and Women. Development and Peace in XXI century" was dedicated to this issue (June 2000). The Session recommended representatives of the Governments of the participating countries to take measures to ensure women equal access and full participation in all spheres and at all levels of life. The Concept of Gender Policy (hereinafter called the Concept) determines the basic principles, priorities and tasks for gender policy in Kazakhstan. The basic principles of the gender policy are based on the equal rights and freedom for women and men that are guaranteed in the Constitution of the Republic of Kazakhstan. The gender policy should deal with he following tasks: the achievement of equal participation of women and men in decision-making structures: the realisation of equal opportunities for economic independence, the development of business and career promotion; conditions for equal realization of rights and responsibilities for the family; and freedom from gender based violence. The Concept is based on the Constitution of the Republic of Kazakhstan, the Development Strategy of Kazakhstan to 2030, the National Action Plan on Improvement of Women's Status Kazakhstan, the United Nations Conventions on the Elimination of all Forms of Discrimination Against Women, United Nations Recommendations for its implementation in Kazakhstan and other ratified international agreements. The Concept of Gender Policy in Kazakhstan is designed both for the contemporary period of stabilization of the socio-economic situation with sustainable growth of the national economy (up to 2010) as well as for the long-term perspective (up to 2030). ( excerpt)
New York, New York, UNDP, Bureau for Development Policy, HIV / AIDS Group, 2004. 32 p.HIV/AIDS multi-sectoral strategic planning has been promoted and successfully undertaken in a number of countries. In most cases, the planning process results in the design and completion of national strategic frameworks (NSF) or plans. While such frameworks continue to provide valuable strategic orientation, they have often not served the intended purpose of guiding successful and well-coordinated implementation at national, provincial, regional, district, constituency and community levels. To date, the transformation of strategic frameworks into effective and coordinated action remains a major concern for most governments and their partners. The broad diversity of actors, the numerous sectors involved and the variety of components of the response illustrate the complexity of implementation and coordination. To achieve a strategic multi-sectoral response, it is important to develop a strategic framework and management approach consistent with national policies, priorities and local experiences. (excerpt)
Kyiv, Ukraine, UNDP, . 15 p.Ukraine is at a critical point in its response to the HIV/AIDS epidemic. The country has the highest rate of HIV infection prevalence in Europe and the CIS, about one per cent of the adult population. At the heart of generating an effective national response on HIV/AIDS are committed, mobilized leaders who are speaking out and taking action in their respective spheres of influence. Analysis of successful responses around the globe has highlighted leadership as a key ingredient for overcoming stigma and effective action in both prevention and care. Leaders for an effective national response must come from all levels of society -- national, regional and local Government; NGOs; media; schools; youth organizations; and the household. In modern, democratic Ukraine, citizens enjoy unprecedented freedoms and choices. Each leads his or her own life in a very personal way. Faced with the present onslaught of HIV/AIDS such individuals need basic information and support for their safe behaviour choices to avoid infection, for their compassion for those living with the virus and for their inclusion in the nationwide response. (excerpt)
Perspectives on Global Development and Technology. 2004; 3(1-2):131-152.This paper considers influences of globalization on three relevant health policy issues in South Africa, namely, private health sector growth, health professional migration, and pharmaceutical policy. It considers the relative role of key domestic and global actors in health policy development around these issues. While South Africa has not been subject to the overt health policy pressure from international organizations experienced by governments in many other low- and middle-income countries, global influence on South Africa's macroeconomic policy has had a profound, albeit indirect, effect on our health policies. Ultimately, this has constrained South Africa's ability to achieve its national health goals. (author's)
Multinational corporations and health care in the United States and Latin America: strategies, actions, and effects. [Corporaciones multinacionales y atención de la salud en Estados Unidos y América Latina: estrategias, acciones y efectos]
Journal of Health and Social Behavior. 2004; 45 Suppl:136-157.In this article we analyze the corporate dominance of health care in the United States and the dynamics that have motivated the international expansion of multinational health care corporations, especially to Latin America. We identify the strategies, actions, and effects of multinational corporations in health care delivery and public health policies. Our methods have included systematic bibliographical research and in-depth interviews in the United States, Mexico, and Brazil. Influenced by public policy makers in the United States, such organizations as the World Bank, International Monetary Fund, and World Trade Organization have advocated policies that encourage reduction and privatization of health care and public health services previously provided in the public sector. Multinational managed care organizations have entered managed care markets in several Latin American countries at the same time as they were withdrawing from managed care activities in Medicaid and Medicare within the United States. Corporate strategies have culminated in a marked expansion of corporations' access to social security and related public sector funds for the support of privatized health services. International financial institution and multinational corporations have influenced reforms that, while favorable to corporate interests, have worsened access to needed services and have strained the remaining public sector institutions. A theoretical approach to these problems emphasizes the falling rate of profit as an economic motivation of corporate actions, silent reform, and the subordination of polity to economy. Praxis to address these problems involves opposition to policies that enhance corporate interests while reducing public sector services, as well as alternative models that emphasize a strengthened public sector. (author's)
UN Chronicle. 2004 Mar-May; 41(1): p..When soldiers from Eritrea put on their uniform belts, they not only carry with them hand grenades, ammunition cases and canteens but, since 2003, also a leather pouch that holds four-pack condoms. With distribution ongoing, these pouches are now standard military issue equipment of the Eritrean Defense Force and thus a weapon against HIV/AIDS, which in the last twenty years has claimed more lives in sub-Saharan Africa than all wars on that continent in the last century. More than twenty years since the disease was first identified, the Joint United Nations Programme on HIV/ AIDS (UNAIDS) said that it has continued to spread not only in Africa but also in many parts of the world, killing some 8,000 people each day, while another 14,000 are infected, adding to some 42 million living with the virus. While the fight against the pandemic is pursued on many levels and in many sectors, efforts in recent years of the United Nations and its Member States have begun to specifically target the role that military and police personnel--the so-called "uniformed services"--play in the spread of the infection. The initial focus will be on peacekeepers. With many of them young and sexually active, often deployed to or from regions with high HIV/AIDS prevalence, and by profession inclined to risky behaviour, some consider the peacekeepers to be "more likely to contract or transmit the virus than the average population", Roxanne Bazergan, HIV/AIDS Policy Adviser with UNAIDS and the UN Department of Peacekeeping Operations (DPKO), told the UN Chronicle. (excerpt)
Dialectical Anthropology. 2004; 28(3-4):245-259.In the past quarter century HIV/AIDS has intensified poverty and suffering world wide, more so in underdeveloped countries and poor neighborhoods of cities within industrial nations. UNAIDS and WHO estimate that 40-60 million people are living with the disease worldwide. The poorest nations in Africa and the Caribbean in which HIV/AIDS have spread most rapidly also live under political, social and economic insecurity. For example, Haiti has experienced a brief civil war and a hurricane disaster in 2004; however, AIDS is the leading cause of death for adults, accounting for 5.9% of deaths and 20% of deaths among adult women. Many of the poorest African countries have also suffered concomitantly from civil wars and high HIV/AIDS prevalence. In the 1980s when Uganda had a civil war, this country was the epicenter of the pandemic world-wide, with an adult HIV prevalence of 30%. Liberia ended her civil war in 2003 and currently records an HIV prevalence of 8.2%. Sierra Leone also had a civil war which ended officially in 2002 with HIV/AIDS prevalence among the army of 46% and a rise in prevalence among the general population. Finally Rwanda emerged from civil war, genocide and mass dislocation in the 1990s and records 11.2% of adult prevalence. The economic crises from poor countries arose from "weak agricultural growth, a decline in industrial output, poor export production, high debt and deteriorating social indicators and institutions." Botswana with 35% prevalence and South Africa with 25% prevalence, though relatively more prosperous, continue to be weighed down by the legacy of apartheid in the form of a high migrant labor system and disruption of family life. (excerpt)
Condemned to death: thanks to the US-led drug war, AIDS is exploding among injection drug users. (Thailand).
Nation. 2004 Apr 26; 278(16): p..In addition to the obligatory red ribbons, the logo for the XV international AIDS Conference features three Asian elephants raising their trunks as if in welcome. The world's most important gathering of AIDS specialists will be held this July in Bangkok, a location chosen not only because Asia is thought to be the site of the next big wave of HIV infections but because Thailand is one of only a few developing countries that have thus far seemed able to control them. International experts have hailed Thailand's 100 percent condom program, which in the 1990s distributed some 60 million condoms for free sex establishments, engaged brothel owners and government officials alike to make sure they were used and helped bring down rates of HIV and sexually transmitted infections as much as fourfold. Thailand is also the first developing country to create a functional program to stop mother-to-child HIV transmission, providing free prenatal care and preventive medication to more than three-quarters of pregnant women testing positive for HIV. Last June Kofi Annan's praise of Thailand was one of the few bright spots in an otherwise grim report to the UN General Assembly on lack of global progress against AIDS. (excerpt)
Preventing violence: a guide to implementing the recommendations of the World Report on Violence and Health.
Geneva, Switzerland, World Health Organization [WHO], Department of Injuries and Violence Protection, 2004.  p.Interpersonal violence is violence between individuals or small groups of individuals. It is an insidious and frequently deadly social problem and includes child maltreatment, youth violence, intimate partner violence, sexual violence and elder abuse. It takes place in the home, on the streets and in other public settings, in the workplace, and in institutions such as schools, hospitals and residential care facilities. The direct and indirect financial costs of such violence are staggering, as are the social and human costs that cause untold damage to the economic and social fabric of communities. With the publication in 2002 of the World report on violence and health, an initial sense of the global extent of the interpersonal violence problem was provided, and the central yet frequently overlooked role of the health sector in preventing such violence and treating its victims was made explicit. The report clearly showed that investing in multi-sectoral strategies for the prevention of interpersonal violence is not only a moral imperative but also makes sound scientific, economic, political and social sense, and that health sector leadership is both appropriate and essential given the clear public health dimensions of the problem and its solutions. The report also reviewed the increasing evidence that primary prevention efforts which target the root causes and situational determinants of interpersonal violence are both effective and cost-effective. In support of such approaches, the report recommended six country-level activities, namely: 1. Increasing the capacity for collecting data on violence. 2. Researching violence – its causes, consequences and prevention. 3. Promoting the primary prevention of violence. 4. Promoting gender and social equality and equity to prevent violence. 5. Strengthening care and support services for victims. 6. Bringing it all together – developing a national action plan of action. (excerpt)
Pathways. 2004 Oct; 4.The past few months in the Advocacy unit have been busy! We’ve held public forums in Seattle, Washington and Portland, Oregon, organized Advocacy Day on Capitol Hill with the Pathfinder Board of Directors, and continue to expand our newly revamped Advocacy E-Center. As always, our goal is to inform and educate the public debate on international family planning and reproductive health policies and programs. Two of our Pathfinder country representatives — Milka Dinev from Peru and Charles Thube from Kenya — were big hits as the keynote speakers at several public forums in Seattle and Portland. Through unique partnerships with the Sierra Club and Planned Parenthood Federation of America, environmental and domestic reproductive rights activists learned about our programs in Peru and Kenya, and the impact that U.S. policies are having on the delivery of services there. The forums focused on our recent research and participation in “Access Denied: U.S. Restrictions on International Family Planning,” a study of the impact of the global gag rule in several countries around the world. (excerpt)
Public Administration and Development. 2004; 24(1):41-50.This article reviews the way in which three very different international organizations concerned with reproductive health policy responded to the reproductive rights agenda during the 1990s. The intention is not to evaluate these responses but to describe how these organizations saw their roles with respect to establishing and promoting reproductive rights in developing countries. We seek to explore their different strategies of defining and interpreting rights, to examine the imperatives behind these strategies and to consider how these variously fed into the practical actions and agendas with which these organizations were engaged. The organizations included were the Women’s Global Network for Reproductive Rights, the International Federation of Family Planning Associations and the UK’s Department for International Development. Their diverse understandings about implementing reproductive rights contribute to a plural political environment in which these rights and their interpretation are debated. For all the three, their particular conception of reproductive rights is an important organizing principle through which their efforts around reproductive health are given wider meaning. (author's)
Brown Journal of World Affairs. 2004 Summer-Fall; 11(1):11-16.There is currently a global network of organizations working to fight AIDS. In addition to UNAIDS, there is the World Health Organization (WHO), the Global Fund, and the International AIDS Vaccine Initiative (IAVI). What role does UNAIDS play among these organizations? UNAIDS stands for the Joint United Nations Programme on HIV/AIDS. It is a coalition of nine United Nations organizations, ranging from the World Bank to the WHO to the United Nations Children's Fund (UNICEF). The goal is to ensure that AIDS remains a central concern throughout the UN system, and that it is addressed in an effective and coordinated manner. We make sure, for example, that all organizations use the same policies. There is no other example in the UN system where there is such integration. This may sound very bureaucratic, but that is how it works-we have one work plan, one budget, and we divide the work. The WHO is responsible for treatment because it is in the medical sphere. UNICEF deals with orphans, the World Bank with finance, and UNESCO with education. Organizations such as the Global Fund and the International AIDS Vaccine Initiative (IAVI) are different. While we work closely with both of them, they are outside the UN system and have different goals. The Global Fund was created to raise additional money for AIDS, not only from governments but also from the private sector. It is an investment fund and therefore it does not have any staff in affected countries and it relies on us for technical support. IAVI concentrates exclusively on the developments of an AIDS vaccine. (excerpt)
The promise of science. Today's innovations bring hope, but will they reach low-resource areas tomorrow?
Countdown 2015: Sexual and Reproductive Health and Rights for All. 2004; (Spec No):103-104.This publication has shown that the ICPD’s Programme of Action covers cultural, behavioural, and policy issues that all favour a comprehensive approach to sexual and reproductive health and rights. Questions of equity— in access to information, education, technology, and services—lie at the heart of many of the goals. In getting to these goals, science has an immensely important role to play. We have already seen enormous scientific strides in global health during our lifetimes—in prevention, treatment and cure. New vaccines and better delivery systems have saved the lives and health of countless children. New ways to regulate fertility have expanded women’s reproductive health choices. Antiretroviral treatments are powerful tools for reducing or delaying the effects of HIV infection. New tests are helping us detect sexually transmitted infections (STIs) faster, cheaper, and more accurately, reducing complications and chances for further transmission. (excerpt)
Can we get there from here? Ten years of work raise the question of whether the ICPD goals are plausible or only a pipe dream [editorial]
Countdown 2015: Sexual and Reproductive Health and Rights for All. 2004; (Spec No):4-7.A decade ago the world witnessed the end of apartheid and celebrated Nelson Mandela’s triumphant ascent to South Africa’s presidency. We also watched in horror as the Rwandan genocide unfolded, and breathed a collective sigh of relief as the peace plan for Bosnia-Herzegovina was signed. In that same year, 1994, thousands of senior policy makers and activists gathered in Cairo for what turned out to be a watershed moment—the International Conference on Population and Development. In a dramatic shift, ICPD put the concepts of rights and choice at the centre of population policy, signalling the end of the population control era. Instead of pursuing demographic targets via population policies based on family planning programmes, the goals now were to achieve broad improvements in reproductive health, to meet young people’s reproductive health needs, and to empower women. The world of sexual and reproductive health today is dramatically different from that of 1994. It is the right time not only to take stock of progress made, but also to assess the challenges we still face and the actions we need to take now as a community. It is appropriate that we celebrate the successes achieved since Cairo and acknowledge the disappointments. We must learn from both. (excerpt)
Menlo Park, California, Henry J. Kaiser Family Foundation, 2004 Jul.  p. (HIV / AIDS Policy Fact Sheet)Young people continue to bear the brunt of the global HIV/AIDS epidemic, with youth under age 25 accounting for more than half of all new HIV infections each year. Those between the ages of 15-24 are particularly hard hit, especially girls and young women who comprise the majority of young people living with the disease. Young people face particular vulnerabilities that put them uniquely at risk for HIV, but they are also critical to the response to the epidemic; where HIV transmission has been reduced, the greatest reductions are often seen among young people. (excerpt)
Population 2005. 2004 Sep-Oct; 6(3):14-15.Parliamentarians and representatives of regional parliamentarian groups have been actively promoting the Program of Action of the International Conference on Population and Development (ICPD) during this 10th anniversary year of the historic consensus achieved at the conference in Cairo in September, 1994. Most recently, they interacted with participants at the NGO Roundtable in London, organized by the IPPF. Yoshio Yatsu, MP, Chair of the Asian Forum of Parliamentarians on Population and Development (AFPPD), addressed the opening session with Dr. Steven Sinding, Director General IPPF, and Dr. Thoraya Obaid, UNFPA’s Executive Director. The Roundtable also heard from Dr. Taro Nakayama, MP (Japan) and Chair of Japan Parliamentarians Federation on Population and the Asian Population and Development Association (APDA), Senator Rodolfo G. Biazon of the Philippines, Dr. Surya Chandra, MP (Indonesia), Al Haji Abdullah Salifu of the African Forum, Bille Miller of the Inter-American Forum, and Ruth Genner of the Inter- European Forum. (excerpt)
Population 2005. 2004 Dec; 6(4):3.Cairo was a turning point in development thinking. Cairo put the focus where it should be—on improving the quality of life of all people. It put the focus on protecting human rights and the natural resources on which all life depends, and bringing our world into greater balance. It recognized that what happens in one part of the world affects what occurs in another, and migration, urbanization, and poverty and sustainable development are interconnected. With emphasis on gender equality and reproductive health and rights, the ICPD Program of Action was ahead of its time. It was and is, and we have some serious catching up to do. All over the world, people are demanding information and services to prevent HIV/AIDS and unwanted pregnancy. Increasing numbers of women are speaking out against the violence they face, and a growing number of men are standing by their side, demanding that justice be served. (excerpt)
[Health, equity, and the Millennium Development Goals] Salud, equidad y los Objetivos de Desarrollo del Milenio.
Revista Panamericana de Salud Pública / Pan American Journal of Public Health. 2004; 15(6):430-439.In September 2000 representatives of 189 countries met for the Millennium Summit, which the United Nations convened in New York City, and adopted the declaration that provided the basis for formulating the Millennium Development Goals (MDGs). The eight goals are part of a long series of initiatives that governments, the United Nations system, and international financial institutions have undertaken to reduce world poverty. Three of the eight goals deal with health, so the health sector will be responsible for implementing, monitoring, and evaluating measures proposed to meet targets that have been formulated: to reduce by two-thirds the mortality rate in children under 5 years of age between 1990 and 2015; to reduce by three-quarters the maternal mortality rate between 1990 and 2015; and to halt and begin to reverse the spread of HIV/AIDS by the year 2015, as well as to halt and begin to reverse the incidence of malaria, tuberculosis, and other major diseases. The health sector must also work with other parties to achieve targets connected with two other of the goals: to improve access to affordable essential drugs, and to reduce the proportion of persons who do not have safe drinking water. Adopting a strategy focused on the most vulnerable groups—ones concentrated in locations and populations with the greatest social exclusion—would make possible the largest total reduction in deaths among children, thus reaching the proposed target as well as producing greater equity. In the Region of the Americas the principal challenges in meeting the MDGs are: improving and harmonizing health information systems; designing health programs related to the MDGs that bring together the set of services and interventions that have the greatest impact, according to the special characteristics of the populations who are intended to be the beneficiaries; strengthening the political will to support the MDGs; and guaranteeing funding for the measures undertaken to attain the MDGs. (author's)
Manila, Philippines, WHO, Regional Office for the Western Pacific, STI, HIV and AIDS Focus, 2004. 41 p.This document is intended to support the 100% condom use programme (CUP) technical staff to: anticipate the kinds of questions that may be asked about the programme; and, begin to plan the approach and to identify points of information that may help to respond in their settings. Contained in this document are a sample of 25 questions that have, at one point or another, been posed to programme staff about the 100% CUP. Points that might be addressed in a response to these questions are also suggested. (excerpt)
Manila, Philippines, World Health Organization [WHO], Regional Office for the Western Pacific, 2004.  p.This publication is intended as a guide to Ministries/ Departments** of Health in Member States to enable an understanding of the country’s legislative structure and process to be gained prior to technical legislative assistance being provided. It will enable relevant materials to be collected and informative descriptions compiled so that the maximum time is available for providing the technical assistance. Even if external technical assistance in health legislation is not being sought, the carrying out of the tasks covered in this Guide will provide a Ministry of Health with an essential legislative resource that will be available to all concerned with the development and implementation of health policy. (excerpt)