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London, Intermediate Technologies Publications, 1979. 126 p.This bibliography was compiled by the Appropriate Health Resources and Technologies Action Group Limited, an organization which functions as a clearing house for information on alternative forms of health care and which is also an official collaborating center of WHO. The bibliography provides references on the use of auxiliary health personnel in the delivery of primary health care services. There are 357 references and each one includes an abstract. The bibliography is divided into 2 sections. The 1st section contains references to 144 articles, books, and manuals which can serve as tools in education and training auxiliary health personnel. The documents provide information ranging from techniques to control houseflies and recipes for low cost weaning foods to techniques for disease diagnosis and methods for developing effective communication between health personnel and the community. The second section is entitled "Auxiliaries and Community Health and Development" and contains references to 213 documents. Most of these documents describe specific programs in which auxiliary health personnel participate or discuss the potential of using auxiliary health personnel to promote development programs. Names and addresses of a variety of organizations, universities, and agencies concerned with the training and utilization of nonprofessional health personnel are listed by country.
AMERICAN JOURNAL OF PUBLIC HEALTH. 1979 Oct; 69(10):981-3.The article, "Ascaris and Growth Rates: A Randomized Trial of Treatment" published in the October 1979 issue of the American Journal of Public Health, highlights some of the ethical problems confronted by scientists engaged in international health research. The researchers utilized the new collaborative international research model; local scientists played a role in the research and the results of the study were of direct value to the community where the research was conducted. This approach grew out of charges made in the 1960s that developed countries were using the inhabitants of developing countries as guinea pigs; were depriving the developing countries of the benefits of research conducted in their country; and were refusing to recognize the contribution made by third world scientists. The researcher did confront another type of ethical dilemma stemming from the fact that ethical standards used in the U.S. are not always appropriate for application in other countries. The researchers had to decide whether to administer levamisole to the school children in a Tanzanian community despite the impossibility of obtaining parental consent. The decision was made to substitute the concept of local community leadership consent for the individual consent concept. When confronted with issues such as this, scientists are at risk of being accused of applying a double standard if they do proceed with mass administration of a drug and of arbitrarily imposing U.S. standards if they decide not to administer the drug. In reference to clinical trials, the application of U.S. derived standards for clinical testing may be inappropriate when applied to other countries. After a drug has been cleared through phase 3, it is released for distribution on the open market. In some countries this leads to excessive and inappropriate use of the drug. Under these conditions drug distributions might be more adequately controlled by society than by the free market system. In order to overcome this problem, the WHO program for Human Reproductive Research advocates a 4th testing phase during which the drug could be evaluated for mass distribution.