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Trips and public health: solutions for ensuring global access to essential AIDS medication in the wake of the Paragraph 6 Waiver.
Journal of Contemporary Health Law and Policy. 2008 Fall; 25(1):142-65.In 2003, the World Trade Organization (WTO) proposed a waiver to the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), known as the "Paragraph 6 Waiver," in order to create flexibility for developing countries and to allow easier importation of cheap generic medication. ... To the companies who own pharmaceutical patents, the notion that a government can use their product without the permission of the patent holder seems unfair and counterproductive. ... Canada was one of the first countries to enact legislation for the sole purpose of exporting generic drugs to developing countries and its experience is indicative of the problems presented by compulsory licensing and the Paragraph 6 Waiver. ... Exact amounts and methods for determining remuneration vary but presumably a fair system would compensate patent holders for the loss of their patent rights while maintaining the system's cost effectiveness for countries issuing the compulsory licenses. (excerpt)
Plan of action for the eradication of harmful traditional practices affecting the health of women and children in Africa.
[Unpublished] 1987. 14 p.The traditional and harmful practices such as early marriage and pregnancy, female circumcision, nutritional taboos, inadequate child spacing, and unprotected delivery continue to be the reality for women in many African nations. These harmful traditional practices frequently result in permanent physical, psychological, and emotional changes for women, at times even death, yet little progress has been realized in abolishing these practices. At the Regional Seminar of the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children in Africa, held in Ethiopia during April 1987, guidelines were drawn by which national governments and local bodies along with international and regional organizations might take action to protect women from these unnecessary hazardous traditional practices. These guidelines constitute this "Plan of Action for the Eradication of Harmful Traditional Practices Affecting the Health of Women and Children in Africa." The plan should be implemented within a decade. These guidelines include both shortterm and longterm strategies. Actions to be taken in terms of the organizational machinery are outlined, covering both the national and regional levels and including special support and the use of the mass media. Guidelines are included for action to be taken in regard to childhood marriage and early pregnancy. These cover the areas of education -- both formal and nonformal -- measures to improve socioeconomic status and health, and enacting laws against childhood marriage and rape. In the area of female circumcision, the short term goal is to create awareness of the adverse medical, psychological, social and economic implications of female circumcision. The time frame for this goal is 24 months. The longterm goal is to eradicate female circumcision by 2000 and to restore dignity and respect to women and to raise their status in society. Also outlined are actions to be taken in terms of food prohibitions which affect mostly women and children, child spacing and delivery practices, and legislative and administrative measures. Women in the African region have a critical role to play both in the development of their countries and in the solution of problems arising from the practice of harmful traditions.
In: Cost recovery in the health care sector: selected country studies in West Africa, by Ronald J. Vogel. Washington, D.C., The World Bank, 1988. 126-58. (World Bank Technical Paper No. 82)This chapter is a case analysis of Ghana's health care sector based on a 2-week mission that included site visits to the Christian Hospital Association, which coordinates 35 mission hospitals and 34 mission clinics with the USAID mission and UNICEF in Accra; interviews and analysis of the cost recovery questionnaire given to key planners and health personnel in Accra; site visits to the Government's Industrial Holding Company (GIHOC); and to the Ridge and Korle Bu Hospitals in Accra. Ghana faced severe economic hardship during the 1980's affecting the ability of the health sector to function effectively. Between 1978- 83 per capital health expenditures declined from US 63.6 cents to US 8.3 cents while raising again in 1985 to US 23.0 cents and between 1981-84 physician emigration went from 1700 to 800 because of low morale and the low government pay scale. Under the auspices of the World Bank and the International Monetary Fund, cost recovery for health care was instituted in 1983 and is becoming more comprehensive in coverage. Ghana's cost recovery ratio went from 7.9% in 1986 to 12.1% in 1987. In 1983 the Government revised its 1983 cost recovery law mandating "cost recovery for all government health-care institutions, and creating a uniform collecting and reporting system. It also insisted on full-cost pricing for drugs and pharmaceuticals." The major policy questions addressed in this chapter are: 1) the structure of health care prices and the amounts of revenue collected; 2) patient reaction to cost recovery; 3) equity aspects; and 4) administrative problems and collection costs.
It's our move now: a community action guide to the UN Nairobi forward-looking strategies for the advancement of women.
New York, New York, International Women's Tribune Centre, 1987 Sep. vi, 112 p.The document Forward-looking Strategies for the Advancement of Women (also referred to as the FLS document) reflects a commitment on the part of governments to work to improve women's status through legislative, social, and economic reforms. The document stresses the full participation of women in all areas of society. It further emphasizes the close relationship between the 3 goals of the United Nations Decade for Women--equality, peace, and development. It is essential, however, that women's organizations take responsibility for monitoring government compliance with the principles of the FLS. This community action guide was prepared to increase awareness of the existence of the FLS document and to help women develop campaigns for pressuring their governments to enforce the recommendations they agreed to at the Nairobi World Conference. Although the FLS document covers 100s of issues important to women's lives, this action guide focuses on 13 issue: decision making, education and training, employment, energy and the environment, exploitation of women, food and water, health, housing and transport, legal rights, media and communications, migrants and refugees, peace, and young and old women. For each issue, activities are suggested that can encourage fundamental social change.
COMMUNIQUE. 1987 Nov; 8(2):13.8 countries reported in 1987 on what they are doing to meet the terms of the Convention on the Elimination of All Forms of Discrimination Against Women, and 2 of the countries covered voluntary sterilization in their report. The countries made their reports to the UN body responsible for monitoring the implementation of the convention -- the Committee on the Elimination of Discrimination against Women (CEDAW). This convention is the 1st international treaty that requires countries to remove biases against women in their laws and practices and to ensure that women have equal access to family planning services. All 8 countries -- Bangladesh, Colombia, France, Greece, the Republic of Korea, Poland, Spain, and Sri Lanka -- have constitutional or legal provisions on the right to health care, but only the reports from Colombia and Spain specifically addressed voluntary sterilization as a choice in health services. In 1983 Spain established tubal occlusion and vasectomy as legal medical procedures, and since that time voluntary sterilization has been somewhat more accessible. In Colombia, PROFAMILIA, the national nongovernmental family planning association, has performed over 59,000 tubal occlusions and over 2000 vasectomies, but the government is not active in this field. Under the terms of the convention, a government's failure to support family planning services can be interpreted as impairing women's access to health care. The French delegation did not mention voluntary sterilization in its report, but a member of CEDAW noted that, under French law, an individual's right to voluntary sterilization is not guaranteed. Physicians and hospitals in France have been confused about the legality of sterilization and often are reluctant to provide the service. The French delegation responded that voluntary sterilization is permitted only for therapeutic reasons and only after the individual has consented. Otherwise, the procedure is considered illegal. Family planning associations and other groups have begun to use the annual CEDAW meeting as a forum to discuss barriers to contraceptive services. The 92 countries that have ratified the convention are required to report to CEDAW within 1 year of ratification and every 4 years thereafter.
Washington, D.C., World Bank, 1986. v, 421, v, 360 p.The WORLD BANK GLOSSARY contains not only financial and economic terminology and terms relating to the Bank's procedures and practices, but also terms that occur frequently in Bank documents. Terms in such diverse fields as agriculture, education, energy, housing, law, technology, and transportation--all fields related to economic development--have been assembled here for ease of reference. The glossary is intended to serve the Bank's translators and interpreters. Volume I contains English-French and French-English terms; volume II includes English-Spanish and Spanish-English terms. Both volumes contain a list of acronyms occurring frequently in Bank texts and a list of international, regional, and national organizations. The glossary does not define terms.
World plan of action for the implementation of the objectives of the International Women's Year: a summarized version.
New York, New York, United Nations, 1976. 43 p.This booklet's objective is to bring the World Plan of Action for the Implementation of the Objectives of the International Women's Year to a wide audience. The 1st section focuses on national action -- overall national policy, national machinery and national legislation, funding, and minimum objectives to be realized by 1980. The 2nd section covers specific areas for national action: international cooperation and the strengthening of international peace; political participation; education and training; employment and related economic roles; health and nutrition; the family in modern society; population; housing and related facilities; and other social questions. The subsequent 4 sections deal with the following: research, data collection and analysis; mass media; international and regional action; and review and appraisal. A major focus of the Plan is to provide guidelines for national action for the 10-year period up to 1985 which the Generaly Assembly, at its 30th session, proclaimed as the Decade for Women: Equality, Development and Peace. Its recommendations are addressed primarily to governments and to all public and private institutions, political parties, employers, trade unions, nongovernmental organizations, women's and youth groups and all other groups, and the mass communication media. Governments are urged to establish short, medium, and longterm targets and objectives to implement the Plan. The following are among the objectives envisaged as a minimum to be achieved by 1980: literacy and civic education should be significantly increased, especially among rural women; coeducational, technical, and vocational training should be available in both industrial and rural areas; equal access at every level of education, including compulsory primary school education, should be ensured; employment opportunities should be increased, unemployment reduced, and discriminatory employment conditions should be eliminated; infrastructural services should be established and increased, where necessary, in both rural and urban areas; legislation should be introduced, where necessary, to ensure women of voting and electoral rights, equal legal capacity, and equal employment opportunities and conditions; there should be more women in policymaking positions locally, nationally, and internationally; more comprehensive measures for health education, sanitation, nutrition, family education, family planning, and other welfare services should be provided; and equal exercise of civil, social, and political rights should be guaranteed.
[Unpublished] 1981 Jun 19. 46 p. (A/36/215)The Advisory Committee for the International Youth Year, established by the General Assembly of the UN in 1979, met in Vienna, Austria, from March 30-April 7, 1981 to develop a program of activities to be undertaken prior to and during the UN designated 1985 International Youth Year; this report contains the draft program of activities adopted by the committee at the 1981 meeting. The activities of the International Youth Year will be undertaken at the national, regional, and international level; however, the major focus of the program will be at the national level. Program themes are development, peace, and participation. The objectives of the program are to 1) increase awareness of the many problems relevant to today's youth, (e.g., the rapid increase in the proportion of young people in the population; high youth unemployment; inadequate education and training opportunities; limited educational and job opportunities for rural youth, poor youth, and female youth; and infringements on the rights of young people); 2) ensure that social and economic development programs address the needs of young people; 3) promote the ideals of peace and understanding among young people; and 4) encourage the participation of young people in the development and peace process. Program guidelines at the national level suggest that each country should identify the needs of their young people and then develop and implement programs to address these needs. A national coordinating committee to integrate all local programs should be established. Specifically each nation should 1) review and update legislation to conform with international standards on youth matters, 2) develop appropriate educational and training programs, 3) initiate action programs to expand nonexploitive employment opportunities for young people, 4) assess the health needs of youth and develop programs to address the special health needs of young people, 6) transfer money from defense programs to programs which address the needs of young people, 7) expanding social services for youths, and 8) help young people assume an active role in developing environmental and housing programs. Activities at the regional and international level should be supportive of those at the national level. At the regional level, efforts to deal with youth problems common to the whole region will be stressed. International efforts will focus on 1) conducting research to identify the needs of young people, 2) providing technical assistance to help governments develop and institute appropriate policies and programs, 3) monitoring the program at the international level, 4) promoting international youth cultural events, and 5) improving the dissemination of information on youth. Young people and youth organizations will be encouraged to participate in the development and implementation of the program at all levels. Nongovernment agencies should help educate young people about development and peace issues and promote the active participation of youth in development programs. The success of the program will depend in large measure on the effective world wide dissemination of information on program objectives and activities. A 2nd meeting of the advisory committee will convene in Vienna in 1982 to assess progress toward implementing the adopted program. A 3rd and final meeting in 1985 will evaluate the entire program. This report contains a list of all the countries and organizations which participated in the meeting as well as information on program funding.
Who Chronicle. 1985; 39(3):104-6.In Africa the issue of smoking and health is complicated by the fact that in many countries tobacco is grown commercially and is relied upon to bring in foreign exchange through export, of revenue for the government if sold on the home market. Consequently, in some nations the ministries of health and of agriculture are working at cross purposes. This contradiction is recognized in the report issued recently of a World Health Organization (WHO) seminar on smoking and health organized for English-speaking Member States of the WHO African Region, and held in Zambia. In opening the seminar, the prime minister of Zambia, Mr. N. Mundia, stated that governments had an obligation to educate people on the risks involved in the use of tobacco but that this could pose a moral dilemma where tobacco production made an apparently significant contribution to the economy. Additionally, he warned that developing countries are considered valuable markets by tobacco companies and stressed that if the promotion of tobacco products by such companies represented a threat "to the health of our people, we cannot let it happen." This point was endorsed by Mr. W.C. Mwambazi, the National WHO Program Coordinator who stated that smoking was on the increase in many developing countries as a result of unscrupulous marketing practices by cigarette manufacturers and that smoking was a major threat to the realization of health for all by the year 2000. Aspects of smoking and health that have special relevance for Africa are emphasized in the report. The few studies carried out in Africa tend to confirm findings from the developed world that smoking increases the risk of cancer and coronary heart disease. Not only is tobacco smoked in Africa, but it is chewed and taken as snuff, and these uses also entail a risk to health. Case studies included in the report show that transnational tobacco companies take full advantage of the present lack of legislation in most African countries on the promotion and use of tobacco. Health hazards are the primary reason why smoking controls are needed, but there are also economic arguments. Tobacco cultivation requires land that could otherwise be used for the production of much needed food. Curing tobacco leaves requires vast amounts of heat that is generated by burning either expensive (and usually imported) oil or timber, the consumption of which ultimately leads to deforestation, soil erosion, and desertification. Although tobacco may be cultivated primarily as an export crop, the country of origin rarely escapes the health hazards of smoking and their economic consequences, including increased cost of health care and absenteeism from work. According to the report, control measures should include the following: data collection; public information and education; and legislation. The report proposes that a functional committee on smoking control be established in the ministry of health to work especially within the primary health care machinery.
Women At Work. 1984; (2):1-71.This document describes the current status of maternity protection legislation in developed and developing countries and is based primarily on the findings of the International Labor Organization's (ILO's) global assessment of laws and regulations concerning working women before and after pregnancy. The global survey collected information from 18 Asian and Pacific countries, 36 African nations, 28 North and South American countries, 14 Middle Eastern countries, 19 European market economy countries, and 11 European socialist countries. Articles in 2 ILO conventions provide standards for maternity protection. According to the operative clauses of these conventions working women are entitled to 1) 12 weeks of maternity leave, 2) cash benefits during maternity leaves, 3) nursing breaks during the work day, and 4) protection against dismissal during maternity. Most countries have some qualifying conditions for granting maternity leaves. These conditions either state that a worker must be employed for a certain period of time or contributed to an insurance plan over a defined period of time before a maternity leave will be granted. About 1/2 of the countries in the Asia and Pacific region, the Americas, Africa, and in the Europe market economy group provide maternity leaves of 12 or more weeks. In all European socialist countries, women are entitled to at least 12 weeks maternity leave and in many leaves are considerably longer than 12 months. In the Middle East all but 3 countries provide leaves of less than 12 weeks. Most countries which provide maternity leaves also provide cash benefits, which are usually equivalent to 50%-100% of the worker's wages, and job protection during maternity leaves. Some countries extend job protection beyond the maternity leave. For example, in Czechoslovakia women receive job protection during pregnancy and for 3 years following the birth, if the woman is caring for the child. Nursing breaks are allowed in 5 of the Asian and Pacific countries, 30 of African countries, 18 of the countries in the Americas, 9 of the Middle East countries, 16 of European market economy countries, and in all of the European socialist countries. Several new trends in maternity protection were observed in the survey. A number of countries grant child rearing leaves following maternity leaves. In some countries these leaves can be granted to either the husband or the wife. Some countries have regulations which allow parents to work part time while rearing their children and some permit parents to take time off to care for sick children. In most of the countries, the maternity protection laws and regulations are applied to government workers and in many countries they are also applied to workers in the industrial sector. A list of the countries which have ratified the articles in the ILO convenants concerning maternity benefits is included.
The changing roles of women and men in the family and fertility regulation: some labour policy aspects
In: Family and population. Proceedings of the "Scientific Conference on Family and Population," Espoo, Finland, May 25-27, 1984, edited by Hellevi Hatunen. Helsinki, Finland, Vaestoliitto, 1984. 62-83.There is growing evidence that labor policies, such as those advocated by the International Labor Organization (ILO), promote changes in familial roles and that these changes in turn have an impact on fertility. A conceptual model describing these linkages is offered and the degree to which the linkages hypothesized in the model are supported by research findings is indicated. The conceptual model specifies that: 1) as reliance on child labor declines, through the enactment of minimum age labor laws, the economic value of children declines, and parents adopt smaller family size ideals; 2) as security increases for the elderly, through the provision of social security and pension plans, the elderly become less dependent on their children, and the perceived need to produce enough children to ensure security in old age is diminished; and 3) as sexual equality in job training and employment and the availability of flexible work schedules increase, sexual equality in the domestic setting increases, and women begin to exert more control over their own fertility. ILO studies and many other studies provide considerable evidence in support of these hypothesized linkages; however, the direction or causal nature of some of the associations has not been established. Development levels, rural or urban residence, and a number of other factors also appear to influence many of these relationships. Overall, the growing body of evidence accords well with ILO programs and instruments which promote: 1) the enactment of minimum age work laws to reduce reliance on child labor, 2) the establishment of social security systems and pension plans to promote the economic independence of the elderly, 3) the promotion of sexual equality in training programs and employment; 4) the promotion of the idea of sexual equality in the domestic setting; and 5) the establishment of employment policies which do not unfairly discriminate against workers with family responsibilities.