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Geneva, Switzerland, World Health Organization [WHO], 2010.  p. (Discussion Paper Series on Social Determinants of Health No. 1)Today an unprecedented opportunity exists to improve health in some of the world's poorest and most vulnerable communities by tackling the root causes of disease and health inequalities. The most powerful of these causes are the social conditions in which people live and work, referred to as the social determinants of health (SDH). The Millennium Development Goals (MDGs) shape the current global development agenda. The MDGs recognize the interdependence of health and social conditions and present an opportunity to promote health policies that tackle the social roots of unfair and avoidable human suffering. The Commission on Social Determinants of Health (CSDH) is poised for leadership in this process. To reach its objectives, however, the CSDH must learn from the history of previous attempts to spur action on SDH. This paper pursues three questions: (1) Why didn't previous efforts to promote health policies on social determinants succeed? (2) Why do we think the CSDH can do better? (3) What can the Commission learn from previous experiences -- negative and positive -- that can increase its chances for success? (Excerpt)
American Journal of Public Health. 2008 Oct; 98(10):1737.The 1994 Cairo International Conference on Population and Development helped governments, the organs and agencies of the United Nations system, and nongovernmental organizations move beyond the confines of traditional family planning approaches. This watershed event fostered and defined subsequent international and national reproductive and sexual health policies and programs as well as global efforts to realize reproductive and sexual rights. However, moving beyond history, or the "archeology of Cairo" (as a participant at a meeting I recently attended called it), are we now simply using the language of the Cairo conference with little attention to the conceptual and operational implications of its words? Has the politically charged notion of rights with its attendant government responsibility and accountability succumbed to the less controversial notion of health? As the public health community recognized even before the Cairo consensus, barriers to reproductive and sexual health operate on a number of levels-including legal, social, cultural, political, financial, attitudinal, and practical -- and interact in complex ways. What rights add to this mix is a framework for programming and for action and a legal rationale for government responsibility-not only to provide relevant services but also to alter the conditions that create, exacerbate, and perpetuate poverty, deprivation, marginalization, and discrimination as these affect reproductive and sexual health. By fixing attention on the responsibility and accountability of governments to translate their international-level commitments into national and subnational laws, policies, programs, and practices that promote and do not hinder reproductive and sexual health, the actions of governments are open to scrutiny to determine their influences-both positive and negative-on reproductive and sexual health, including barriers that affect the availability, accessibility, acceptability, and quality of reproductive and sexual health services, structures, and goods. Despite the framework that the Cairo conference helped put into place, work falling under the rubric of reproductive and sexual rights now includes everything from the provision of abortion services to the reduction of maternal mortality -- as though simply working on these issues is equal to working on rights. Consequently, one has to ask this: Are reproductive, and even sexual, rights becoming synonymous with reproductive, and sexual, health? Those who understand their work to be in the area of reproductive and sexual rights sorely need to discuss whether their efforts are aligned with the politics that underlie the words of the Cairo conference or whether, bluntly speaking, the politics are a historical artifact and it is simply time to move on. Bringing the political back into reproductive and sexual rights would require going beyond the technical dimensions of addressing reproductive and sexual health issues to the application of the norms and standards that are engaged by a human rights discourse. This includes attention to the basics of reproductive and sexual rights: the efforts that exist to ensure the sustained participation of affected communities; how discrimination that affects both vulnerability to ill health and access and use of services is being tackled; the extent to which any legal, political, and financial constraints are being addressed; how rights considerations are brought into policy and program design, implementation, and evaluation; and the existence of mechanisms that require government as well as intergovernmental and nongovernmental institution accountability. And so yes, in a word, words do matter. And they matter for the actions they inspire. (full-text)
Cambridge, Massachusetts, Belknap Press, 2008. xiv, 521 p.Rather than a conspiracy theory, this book presents a cautionary tale. It is a story about the future, and not just the past. It therefore takes the form of a narrative unfolding over time, including very recent times. It describes the rise of a movement that sought to remake humanity, the reaction of those who fought to preserve patriarchy, and the victory won for the reproductive rights of both women and men -- a victory, alas, Pyrrhic and incomplete, after so many compromises, and too many sacrifices. (Excerpt)
Jornal de Pediatria. 2006; 82 Suppl(3):S1-S3.In the last few decades, immunization -- one of the greatest breakthroughs in health sciences -- has increasingly gained significant ground all over the world. Advances in general sciences, microbiology, pharmacology and immunology have, together with results of epidemiology and sociology studies, demonstrated the remarkable impact of vaccines on society and the importance of vaccination in health promotion and disease prevention. In the beginning of the 17th century, smallpox was one of the most devastating communicable diseases in the world; it affected most individuals before they reached adulthood, and had high mortality rates. Lady Mary Montagu, wife of the British ambassador in Istanbul at the time, observed that the disease could be avoided by using a technique adopted by Muslims, who inoculated dried pus from smallpox pustules obtained from an infected patient into the skin of healthy individuals. This procedure, known as "variolation," probably originated in China; later, it was taken to Western Europe. Although it led to several cases of death due to smallpox, it was used in England and in the United States until the beginning of investigations by British physician Edward Jenner, whose research results were published in the study Variolae Vaccinae in 1798. Dr. Jenner studied peasants who developed a benign condition known as "vaccinia" due to their contact with cowpox, and his investigation resulted in the development of the first immunization techniques. (excerpt)
Genus. 2005 Jul-Dec; 61(3-4):141-163.World demographic growth at the time of the Rome Conference in 1954 was characterized by unprecedented high rates of natural increase. This was the consequence of the combined effect of faster declines in death rates and sustained high birth rates. As a result, world population would double from three to six billion between 1960 and 1999 and from 5 to 6 billion in just 12 years (1987-1999), while it had taken the world four times as much to double from 1.5 to 3 billion and nearly a millennium to reach the first billion. What triggered this growth were primarily unprecedented mortality declines, a better control of major killer diseases and increases in survival particularly in the developing countries (life expectancy increased from 41 to 65 years on average over the last three decades). With such unprecedented growth rates, the theory of demographic transition acquired particular policy significance in the late 1950s to raise a serious concern about the impact of current and projected growth rates both within countries and internationally at the economic, social and geopolitical levels. This theory would soon become the driving force behind all population policy objectives aimed at third world countries where governments were encouraged to formulate population policies, establish policy institutions and programme structures to implement family planning programmes, bring about smaller-sized families and help couples avoid unwanted pregnancies. (excerpt)
Genus. 2005 Jul-Dec; 61(3-4):69-90.For most of human history, life was especially brutal. The growth of world population was kept in check largely by famines, deadly diseases and wars. Living conditions were poor and death rates were high. Infant and child deaths and maternal mortality were common, and few reached 60 years of age. And prior to 1800, centenarians, those aged 100 or older, are not believed to have lived. As a result of high birth and death rates, world population grew slowly for most of the past. Two thousand years ago, world population is believed to have been around 300 million people. Near the close of the 15th century world population was approaching the half billion mark. And when Malthus wrote his essay on population at the end of the 18th century, world population had not yet reached the one billion mark. Up until the modern era, nearly all of the world's population lived off the countryside. A thousand years ago, a few percent of the world's population of roughly 300 million lived outside rural areas. Even in 1700, the proportion urban had changed little and only five cities had more than a half a million inhabitants: Istanbul, Tokyo, Beijing, Paris and London. By 1800, about three percent of the world's population of some 1 billion lived in cities or urban places. By 1900, about 15 percent of the world's population of 1.6 billion resided in urban areas and the number of cities with more than a half a million inhabitants had increased eight-fold. (excerpt)
Pakistan Development Review. 2004 Winter; 43(4 Pt 1):423-440.Pakistan's development project that was initiated in the 1950s with a focus on creating a prosperous and equitable society, making the benefits of scientific advancement and progress available to all the people, got lost somewhere in the labyrinth of development fashions and econometric modelling learned in American universities and World Bank/IMF seminars. The latest of these fashions being eagerly followed by the economic managers of the state is the implementation of structural adjustments, termed "Washington Consensus" by some, flowing from the operative rules and ideological framework of neo-liberal globalisation. In practice these adjustments, euphemistically called reforms, have foreclosed the possibility of improving the condition of working masses, not only in Pakistan but globally, including the developed West. If Pakistan is to reclaim its original people-centred development project, it will have to set its own priorities of development in the context of indigenous realities shared in common with its South Asian neighbours. Following the globalisation agenda at the behest of the Washington-based IFIs will sink the country into ever greater debt and mass poverty. (author's)
INTERNATIONAL JOURNAL OF HEALTH SERVICES. 1997; 27(3):523-40.This article draws largely on the work of Linda Gordon's "Woman's Body, Woman's Right" and of Bonnie Mass's "Population Target" to analyze the history of the birth control movement and trace the elements present in current debate to their origins in the conflicts and contradictions of the movement's history. After noting that humans have attempted to control births since ancient times, the article begins with the efforts of English radical neo-Malthusians to promote birth control and continues by sketching the change in emphasis from poverty reduction to women's rights. By the 20th century in the US, changing views of sexuality and working-class militancy ignited the US birth control movement and inspired the work of Margaret Sanger. After Sanger split with social radicals, professionals and eugenicists began to play a major role in population control efforts. Eugenicists and racists attempted to use birth control for social engineering; it was to be used again as a tool in a new era of social planning after World War II when it metamorphosized into "family planning." The US need for the resources of developing countries led to concerns about population growth fueling nationalistic fires. Thus, private agencies began a postwar population control effort in developing countries. This received official US approval with the 1958 report of the Draper Committee that targeted world population growth as a US security issue. In 1966, Dr. Ravenhold led the US Agency for International Development into the population field. Population control efforts garnered international opposition at the World Population Conference in Bucharest in 1974, however, but this had little impact on the strong US commitment to population control.
Tokyo, Japan, Asian Population and Development Association, 1996 Dec. 33 p. (APDA Resource Series 2)This paper presents an overview of the distinguishing features of the 20th century by focusing on the decades between the first and third World Population Conferences (1974-94). The essay opens with a prologue which describes the increasing concern about population growth which served as the background to the development of the progressive World Population Plan of Action (WPPA) in 1974 and presents current population projections and annual growth rate data. The next topic is the adoption of the WPPA, with its last minute attention to family planning programs, at the Bucharest Conference. This is followed by consideration of the "Bucharest effect" which included reversals by China and India which led to their adoption of new policies to control growth. Discussion of the "quiet gathering" at Mexico City which adopted recommendations to further implement the WPPA in 1984 is augmented with a look at the ripple caused by the denial of the US delegation of the possibility of achieving demographic goals before achieving economic development. The three global upheavals experienced in the 20th century after the watershed of World War II are then identified as the world population explosion, the destruction of the global environment, and the conflicts which followed the fall of the Berlin Wall. The ensuing discussion then considers the three most important aspects of the world population crisis: the population growth rate, the size of the annual increases, and total global population. Finally, the paper looks at the Fourth International Conference on Population and Development during which the WPPA became a Programme of Action which embraced a revolutionary strategy calling for the empowerment of women to achieve population stability and development, emphasizing reproductive health care, and establishing targets to reduce death rates. The essay concludes by calling for a revolution in thinking to derive ways to cope with the upcoming 30 years of rapid population growth.
POPULATION GEOGRAPHY. 1989 Jun-Dec; 11(1-2):86-96.This paper surveys the contributions of the International Geographic Union (IGU) and the International Cartographic Association (ICA) to the field of population studies over the past 3 decades. Reviewing the various focal themes of conferences sponsored by the organizations since the 1960s, the author examines the evolution of population studies in IGU and ICA. During the 1960s, IGU began holding symposia addressing the issue of population pressure on the physical and social resource in developing countries. However, it wasn't until 1972, at a meeting in Edmonton, Canada, when IGU first addressed the issue of migration. But since then, migration has remained on the the key concerns of IGU. In 1978, the union hosted a symposium on Population Redistribution in Africa -- the first in a series of conferences focusing on the issue of migration. As an outgrowth of migration, the IGU also began addressing the related issue of population education. The interest in migration has continued through the 1980s. In addition to studies of regional migration, the IGU has also focused on conceptual issues such as migrant labor, environmental concerns, women and migration, and urbanization. In 1984, IGU began cooperating with ICA in the areas of census cartography and population cartography. The author concludes his review of IGU and ICA activities by discussing the emerging trends in population studies. The author foresees a more refined study of migration and more sophisticated population mapping, the result of better study techniques and the use of computer technology.
Social Science and Medicine. 1990; 31(6):639-48.Sub-Sahara Africa (SSA) has gone from "classical colonialism to neocolonial debt bondage." this article traces SSA's deterioration from a master-servant relationship during colonialism to the present-day "hybrid of decay and anarchy" from which people's health status and health services in the region are being asphyxiated by the debt crisis. The tragedy facing the continent is a carryover from colonialism SSA remains dependent on outside multinational forces that continue to determine her policies, extract her natural wealth, and minimally invest in the SSA region. This continued "cola-colonization" or external control of SSA has resulted in the "catastrophic" decline of most of SSA's social and economic institutions reflecting the collapse in the economies of the West. By the end of 1986, SSA owed US $200 billion or 45% of its GDP--growing to over US$600 million by the year 2000. By 1990 all SSA countries had to accept structural adjustment policies (SAP's) imposed by the International Monetary Fund and the World Bank to monitor cuts in Government public spending, remove subsidies, trade liberalization and currency devaluation all leading to "tragic declines" in the standard of living. Health services in SSA also originated from colonialism and today remains dependent on the home government's. One of the major carry-over's is the urban/rural disparity; 70% of SSA's population is rural yet most health services and providers are in the urban areas contributing to higher infant mortality rates (2-5 times) in the rural areas. The debt crisis has compounded the magnitude of the lack of health services for the majority of people. Shortages exist for all essential drugs and equipment while social services and institutions have deteriorated, aggravating the already low health status in the region. SAP's have increased starvation, epidemics and the brain drain. Perhaps there is a need for a "Marshall Plan" to help SSA out of its underdevelopment.