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Reproductive Health Matters. 2009 May; 17(33):91-104.This paper examines why progress towards Millennium Development Goal 5 on maternal health appears to have stagnated in much of the global south. We contend that besides the widely recognised existence of weak health systems, including weak services, low staffing levels, managerial weaknesses, and lack of infrastructure and information, this stagnation relates to the inability of most countries to meet two essential conditions: to develop access to publicly funded, comprehensive health care, and to provide the not-for-profit sector with needed political, technical and financial support. This paper offers a critical perspective on the past 15 years of international health policies as a possible cofactor of high maternal mortality, because of their emphasis on disease control in public health services at the expense of access to comprehensive health care, and failures of contracting out and public–private partnerships in health care. Health care delivery cannot be an issue both of trade and of right. Without policies to make health systems in the global south more publicly-oriented and accountable, the current standards of maternal and child health care are likely to remain poor, and maternal deaths will continue to affect women and their families at an intolerably high level.
Lancet. 2007 Dec 1; 370(9602):1808-1809.Important questions about implementation of the new guidance by WHO and UNAIDS on provider-initiated HIV testing and counselling were raised by Daniel Tarantola and Sofia Gruskin. Their comments and those by other critics centre on individuals' rights to confidentiality, to refuse testing, and to not disclose their status if they fear negative consequences. We are concerned that a singular focus on the individual's rights of refusal overlooks the rights of the individual's sexual partners to protect themselves from HIV. Human rights and public health will be best served by an ethical framework which recognises that both persons in a sexual relationship or exchange have equal rights and responsibilities for their mutual pleasure and protection. Further, these individual rights are meaningless unless each partner respects the rights of the other. Protection of the human rights of both partners needs more commitment from health systems, and from societies, than simply ensuring informed consent and confidentiality. (excerpt)
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)
Exploring disparities between global HIV / AIDS funding and recent tsunami relief efforts: an ethical analysis.
Developing World Bioethics. 2007; 7(1):1-7.The objective was to contrast relief efforts for the 26 December 2004 tsunami with current global HIV/AIDS relief efforts and analyse possible reasons for the disparity. Methods: Literature review and ethical analysis. Just over 273,000 people died in the tsunami, resulting in relief efforts of more than US$10 bn, which is sufficient to achieve the United Nation's long-term recovery plan for South East Asia. In contrast, 14 times more people died from HIV/AIDS in 2004, with UNAIDS predicting a US$8 bn funding gap for HIV/AIDS in developing nations between now and 2007. This disparity raises two important ethical questions. First, what is it that motivates a more empathic response to the victims of the tsunami than to those affected by HIV/AIDS? Second, is there a morally relevant difference between the two tragedies that justifies the difference in the international response? The principle of justice requires that two cases similarly situated be treated similarly. For the difference in the international response to the tsunami and HIV/AIDS to be justified, the tragedies have to be shown to be dissimilar in some relevant respect. Are the tragedies of the tsunami disaster and the HIV/AIDS pandemic sufficiently different, in relevant respects, to justify the difference in scope of the response by the international community? We detected no morally relevant distinction between the tsunami and the HIV/AIDS pandemic that justifies the disparity. Therefore, we must conclude that the international response to HIV/ AIDS violates the fundamental principles of justice and fairness. (author's)
A report of a theological workshop focusing on HIV- and AIDS-related stigma, 8th-11th December 2003, Windhoek, Namibia. Supported by UNAIDS.
Geneva, Switzerland, UNAIDS, 2005 Feb. 62 p. (UNAIDS/05.01E)Stigma is difficult to define. Generally, though, it implies the branding or labelling of a person or a group of persons as being unworthy of inclusion in human community, resulting in discrimination and ostracization. The branding or labelling is usually related to some perceived physical, psychological or moral condition believed to render the individual unworthy of full inclusion in the community. We may stigmatize those we regard as impure, unclean or dangerous, those who are different from ourselves or live in different ways, or those who are simply strangers. In the process we construct damaging stereotypes and perpetuate injustice and discrimination. Stigma often involves a conscious or unconscious exercise of power over the vulnerable and marginalized. The purpose of this document is to identify those aspects of Christian theology that endorse or foster stigmatizing attitudes and behaviour towards people living with HIV and AIDS and those around them, and to suggest what resources exist within Christian theology that might enable churches to develop more positive and loving approaches. It is not a theological statement, but rather a framework for theological thinking, and an opportunity, for church leaders, to pursue a deeper Christian reflection on the current crisis. (excerpt)
Geneva, Switzerland, UNAIDS, 2000 Jul. 47 p. (UNAIDS Best Practice Collection. Key Material; UNAIDS/00.28E)Surveillance is the radar of public health. Nevertheless, its precise contours and justifications remain a matter of contention. Although the World Health Organization (WHO) Epidemiological Surveillance Unit in the Division of Communicable Diseases has defined disease surveillance quite broadly, most public health authorities, such as the United States Centers for Disease Prevention and Control (CDC) and the World Health Assembly, typically identify three key elements of surveillance. Surveillance involves the ongoing, systematic collection of health data, the evaluation and interpretation of these data for the purpose of shaping public health practice and outcomes, and the prompt dissemination of the results to those responsible for disease prevention and control. Surveillance, then, encompasses more than just disease reporting. "The critical challenge in public health surveillance today," conclude two prominent figures who have helped to define surveillance in the United States, "remains the ensurance of its usefulness." Two issues emerge from this understanding of surveillance. The first entails a question of efficacy. The second involves matters of privacy. Although conceptually distinct, the two are nevertheless intimately related. While the necessities of surveillance may justifiably limit some elements of privacy, such limitations are only justifiable to the extent that they in fact benefit the public's health. (excerpt)
Geneva, Switzerland, UNAIDS, 2000 May. 48 p. (UNAIDS/04.07E)In the present document, UNAIDS seeks to offer guidance emanating from this process. This document does not purport to capture the extensive discussion, debate, consensus, and disagreement which occurred at these meetings. Rather it highlights, from UNAIDS' perspective, some of the critical elements that must be considered in HIV vaccine development activities. Where these are adequately addressed, in UNAIDS' view, by other existing texts, there is no attempt to duplicate or replace these texts, which should be consulted extensively throughout HIV vaccine development activities. Such texts include : the Nuremberg Code (1947); the Declaration of Helsinki, first adopted by the World Medical Association in 1964 and subsequently amended in 1975, 1983, 1989 and 1996; the Belmont Report - Ethical Principles and Guidelines for the Protection of Human Subjects of Research, issued in 1979 by the US National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research; the International Ethical Guidelines for Biomedical Research Involving Human Subjects, issued by the Council for International Organizations of Medical Sciences (CIOMS) in 1993 (and developed in close cooperation with WHO); the World Health Organization's Good Clinical Practice (WHO GCP) Guideline (1995); and the International Conference on Harmonisation's Good Clinical Practice (ICH GCP) Guideline (1996). It is hoped that this document will be of use to potential research participants, investigators, community members, government representatives, pharmaceutical companies, and ethical and scientific review committees involved in HIV preventive vaccine development. It suggests standards, as well as processes for arriving at standards, and can be used as a frame of reference from which to conduct further discussion at the international, national, and local levels. (excerpt)
Transactions of the Royal Society of Tropical Medicine and Hygiene. 2006 Jul; 100(7):603-607.The health and human rights communities have much in common. Recently, the international community has begun to devote more attention to the right to the highest attainable standard of health (‘the right to health’). Today, this human right presents health and human rights professionals with a range of new opportunities and challenges. The right to health is enshrined in binding international treaties and constitutions. It has numerous elements, including the right to health care and the underlying determinants of health, such as adequate sanitation and safe water. It empowers disadvantaged individuals and communities. If integrated into national and international policies, it can help to establish policies that are meaningful to those living in poverty. The author introduces his work as the UN Special Rapporteur on the right to health. By way of illustration, he briefly considers his interventions on Niger’s Poverty Reduction Strategy, Uganda’s neglected (or tropical or poverty-related) diseases, and the recent US—Peru trade negotiations. With the maturing of human rights, health professionals have become an indispensable part of the global human rights movement. While human rights do not provide magic solutions, they have a constructive contribution to make. The failure to use them is a missed opportunity of major proportions. (author's)
Population 2005. 2002 Sep-Oct; 4(3):8.The HIV/AIDS epidemic shows no sign of leveling off in the hardest hit countries and as much as $10 billion is needed annually to fight it effectively, according to UNAIDS Executive Director Peter Piot. Addressing the 14th international AIDS conference in Barcelona in July, Mr. Piot said that unless the global community provided more assistance to countries with high rates of HIV/AIDS, like debt relief, there could be catastrophic results. “The epidemic hit the world 20 years ago but we failed to contain the increase in HIV cases. The answers point towards politics, power and priorities. $10 billion is needed annually to combat the menace,” he said. Mr. Piot told his audience they must mobilize political support, scale up AIDS prevention and treatment, eliminate stigma, develop a vaccine and arrange funds to fight the disease. (excerpt)
Boston, Massachusetts, Harvard School of Public Health, François-Xavier Bagnoud Center for Health and Human Rights, 2000. 10 p.Before human rights, there was altruism and after human rights there is altruism—the unselfish concern for the welfare of others. Altruism has been and remains an integral part of the beliefs, behaviors and practices of public health practitioners. But altruism means different things to different people. What human rights does for public health is to provide an internationally agreed upon framework for setting out the responsibilities of governments under human rights law as these relate to people’s health and welfare. Human rights as they connect to health should be understood, in the first instance, with reference to the description of health set forth in the preamble of the WHO Constitution, and repeated in many subsequent documents and currently adopted by the 191 WHO Member States: Health is a “state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” This definition has important conceptual and practical implications, as it illustrates the indivisibility and interdependence of rights as they relate to health. Rights relating to autonomy, information, education, food and nutrition, association, equality, participation and non-discrimination are integral and indivisible parts of the achievement of the highest attainable standard of health, just as the enjoyment of the right to health is inseparable from other rights, whether categorized as civil and political, economic, social or cultural. Thus, the right to the highest attainable standard of health builds on, but is by no means limited to, Article 12 of the International Covenant on Economic, Social and Cultural Rights. It transcends virtually every single other right. This paper highlights the long evolution that has brought health and human rights together in mutually reinforcing ways. It will summarize key dimensions of public health and of human rights and will suggest a manner in which these dimensions intersect in a framework of analysis and action. It will address these issues against the background of the progress being made by the World Health Organization towards defining its roles and functions from a health and human rights perspective. (excerpt)
International responses to drug abuse among young people: assessing the integration of human rights obligations.
Boston, Massachusetts, Harvard School of Public Health, François-Xavier Bagnoud Center for Health and Human Rights, 2000. 15 p.Drug use and abuse among young people is increasing worldwide. Young people are starting to take drugs at younger ages and report use of a wide variety of drugs including heroin, cocaine and amphetamines. It is estimated that the entire illicit drug industry is worth US$500 billion per year, dwarfing the US$62 billion spent on development assistance per year. The health impacts of drug abuse are evident: dependency, addiction, overdose and sometimes death. The goal of this paper is to highlight the intersection of health and human rights with respect to drug abuse among young people. The paper argues two points. The first is that the failure of governments to respect, protect and fulfill human rights leads to less effective prevention drug abuse as well as to less effective treatment of drug abusers. The second point, which comprises the bulk of this paper, is that the international community, and international drug control bodies in particular, because of their focus on drug supply reduction, are in large part responsible for States’ human rights violations against young people who use and abuse drugs, as well those who are vulnerable to drug abuse. The paper is divided into four sections. The first will discuss why drug abuse is a human rights issue. The second will provide readers with some definitions that are central to this topic. The paper will then explore international responses to drug prevention and abuse among young people and suggest how governmental responses are shaped by international responses. The last section will provide the reader with recommendations for how the international response to drug abuse could be more effective in terms of the integration of human rights principles and obligations. (excerpt)
Paris, France, UNESCO, 2004. 30 p.This paper uses a framework for quality education developed by UNESCO’s Education Sector, Division for the Promotion of Quality Education (ED/PEQ) to show how education systems can and must change in their analysis and conduct in relation to HIV/AIDS. It summarises the 10 dimensions of the framework, considers how HIV/AIDS manifests itself in relation to these quality dimensions and summarises some practical applications of how education has responded and can respond to the pandemic from a quality perspective. A more detailed annex to the paper provides evidence on the manifestations of the pandemic on education systems, and how systems have responded in practical ways. Some general conclusions are drawn and a final section promotes some practical and strategic actions in support of quality education that reflects and responds to HIV/AIDS. The paper was developed for the UNAIDS Inter-Agency Task Team (IATT) on HIV and Education. The IATT is convened by UNESCO and includes as members the UN co-sponsoring agencies of UNAIDS, bi-lateral and private donors, and NGOs. The IATT focuses on mobilising commitment to prevention education, acting as a catalyst for the exchange of information about what is known, what is available, and what still needs to be known about how education can be most effective in mitigating the effects of the HIV/AIDS crisis. It seeks to examine and strengthen existing tools for monitoring and evaluating education systems’ responses to the crisis, identify weaknesses in these responses and overcome these weaknesses, analyse what is known to strengthen information and materials exchange, and stimulate research and evidence-based policy-making. (excerpt)
Lancet. 2005 Feb 19; 365:723-725.Ensuring environmental sustainability is essential to achieving all the Millennium Development Goals. Longterm solutions to problems of drinking-water shortages, hunger, poverty, gender inequality, emerging and reemerging infectious diseases, maternal and childhood health, extreme local weather and global climate changes, and conflicts over natural resources need systematic strategies to achieve environmental sustainability. For this reason, the UN Millennium Project Task Force on Environmental Sustainability has concluded that protection of the environment is an essential prerequisite and component of human health and well-being. Economic development and good health are not at odds with environmental sustainability: they depend on it. One important dimension of environmental sustainability is the need to maintain ecosystem services critical to the human population. These services include providing food, shelter, and construction materials; regulating the quantity and quality of fresh water; limiting soil erosion and regenerating nutrients; controlling pests and alien invasive species; providing pollination; buffering human, wild plant, and animal populations from interspecific transfer and spread of diseases; and stabilising local weather conditions and sequestering greenhouse gases to contain climate change. A second and equally important dimension of environmental sustainability is the need to control water pollution and air pollution, including the emission of greenhouse gases that drive climate change. These so-called brown issues can have a severe effect on human health and ecosystem function. (excerpt)
Issue paper: Review of the human rights content of frameworks to assess the effectiveness of HIV / AIDS programming.
Geneva, Switzerland, UNAIDS, 2004. Prepared for the 4th Meeting of the UNAIDS Global Reference Group on HIV / AIDS and Human Rights, August 23-25, 2004. 7 p.This paper examines approaches used by some of the primary intergovernmental and governmental agencies in assessing the effectiveness of HIV/AIDS programmes, as they have been reviewed by the UNAIDS Monitoring and Evaluation Reference Group (MERG). This is to attempt to begin to shed light on how the effectiveness of HIV/AIDS programs are currently assessed by UNAIDS, its partners, and other major organizations, and to understand the extent and ways in which human rights considerations form parts of these assessments. (excerpt)
HIV testing of specific populations: recruits of the armed forces. Issue paper: 3rd Meeting, UNAIDS Global Reference Group on HIV / AIDS and Human Rights, 28-30 January 2004.
Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS [UNAIDS], 2004. 6 p.In 2001, the United Nations Security Council established an Expert Panel to study the issue of whether the UN should institute HIV testing of peacekeeping personnel. This article, based on a 9 July 2002 presentation to the 14th International AIDS Conference, reports on the findings of a paper prepared for the Expert Panel by the Canadian HIV/AIDS Legal Network. The paper examined whether it is permissible for the UN to implement mandatory HIV testing of its peacekeeping personnel, and whether HIV-positive UN peacekeeping personnel should be excluded or restricted from service on the basis of their HIV status or HIV disease progression. The article describes some of the court cases in which these issues have been considered; discusses the importance of analyzing such issues in the context of a human rights–based approach to the pandemic; and formulates a series of key principles for guiding UN decision-making. The article concludes that a policy of mandatory HIV testing for all UN peacekeeping personnel cannot be justified on the basis that it is required in order to assess their physical and mental capacity for service; that HIV-positive peacekeeping personnel cannot be excluded from service based on their HIV status alone, but only on their ability to perform their duties; and that the UN cannot resort to mandatory HIV testing for all UN peacekeeping personnel to protect the health and safety of HIV-negative personnel unless it can demonstrate that alternatives to such a policy would not reduce the risk sufficiently. In the end, the Expert Panel unanimously rejected mandatory testing and instead endorsed voluntary HIV counselling and testing for UN peacekeeping personnel. (excerpt)
Getting representation right for women in development: accountability, consent and the articulation of women's interests.
In: Getting institutions right for women in development, edited by Anne Marie Goetz. London, England, Zed Books, 1997. 31-43.Consent, as a basis of political authority, remains a forcefully compelling principle because it recognizes so many of the human qualities - autonomy, dignity, responsibility - which we collectively value. But to revere the concept of consent means that we must respect the unpalatable decisions made by others and respect, in turn, means than we cannot ultimately challenge the autonomy of the decision-makers. Thus the more we respect consent, the less capable we are of investigating the context of choice; and the less satisfied we are with the context of choice, the less respect we have for the principle of consent in practice. To break this circle we must be willing to probe and to query the choices and decisions of 'autonomous' agents; for consent itself is not only a moral construct but, more tangibly, a potently political device for ensuring obedience. Instruments of such palpable power must always be carefully and consistently scrutinized, and we must be brave enough to say whether consent has been won at too high a price. (excerpt)
In: Getting institutions right for women in development, edited by Anne Marie Goetz. London, England, Zed Books, 1997. 44-60.Most of the development literature considers accountability either as a political or an organizational issue and few consider it as a cognitive issue. All three must be examined in order to acquire a broader understanding of accountability. Accountability has to do with the organizational characteristics (goals, procedures, staffing, incentive systems) of all agencies involved, as well as with the political context, that is, the political commitment of the stakeholders to a project, whether the options of 'exit' and 'voice' are available and whether democratic accountability exists. Finally, accountability cannot be discussed without understanding the 'discourse' underlying a particular policy area, in our case gender policy. How do different stakeholders define 'gender issues'? On what basis should resources be allocated to women? The perceived cause of gender constraints will also determine what solutions are proposed. To what extent is there agreement between different stakeholders on the nature of the issue and the proposed solutions? These are some of the questions we might ask as we explore gendered institutions. Therefore, I will begin by analysing the conditions that limit and promote accountability within these three major categories: the organizational context, the political context and the cognitive context. (excerpt)
Population 2005: News and views on further implementation of Cairo Program of Action. 2003 Sep; 5(3):4-6.I further dedicate this award to those men and women who are active today in the population field - including, of course, those serving at the grass roots level in outstanding organizations throughout the world, such as the Family Planning Association of Kenya, this year's institutional winner -- as well as to those who will follow in our toot- steps. They need not be reminded that a few rays of light shining in does not mean that we have reached the end of the tunnel, While the current generation of leadership in the population field has focused on helping couples to have only the family size they want, the next generation must tackle issues growing in their enormity and importance -- issues including aging, migration, urbanization, and deadly diseases, The recent announcement by the United Nations Population Division that world population may now stabilize at 8.9 billion is welcome news. The projection attests to the fact that we know what works. It attests to the fact that where and when couples the world over have access to the necessary information, means, and methods to control their fertility, they are motivated to have smaller families. (excerpt)
BMJ. British Medical Journal. 2003 Nov 8; 327:1101-1103.Over the past 20 years, the public health community has learnt a tremendous amount about the HIV/AIDS epidemic. Yet, despite widespread discussion about the epidemic and some measurable progress, the overall response has been insufficient: globally 42 million people are already infected with HIV, prevalence continues to rise, and less than 5% of those affected have access to lifesaving medicines. In the face of this growing crisis, the World Health Organization has made scaling up treatment a key priority of the new administration. We argue that not only is the HIV/AIDS epidemic an emergency, but its devastating effects on societies may qualify it as one of the most serious disasters to have affected humankind. As such, this crisis warrants a full disaster management response. (excerpt)
In: Women's human rights: unfinished business, edited by Adriana Gomez and Deborah Meacham. Santiago, Chile, Latin American and Caribbean Women's Health Network, 2003. 10-14. (Women's Health Collection No. 7)The legal and political realms of international women's rights have both influenced each other more than criminal law. Developments in the protection of human rights through criminal law is a recent phenomenon compared to the wider framework of women's human rights protection. Although the political recommendations, such as those found in Platforms for Action, do not have the force of law, they do provide a starting point for working towards the goal of agreements on the commitments and priorities not only between the governments, but with civil society as well. However, these processes have not been without conflict, and the dialogue with civil society has incorporated other movements and NGOs whose interests are far from consistent with those of the women's movement. (excerpt)
Oxford, England, Oxford University Press, 1990. xix, 136 p.The Commission on Health Research for Development is an independent international consortium formed in 1987 to improve the health of people in developing countries by the power of research. This book is the result of 2 years of effort: 19 commissioned papers, 8 expert meetings, 8 regional workshops, case studies of health research activities in 10 developing countries and hundreds of individual discussions. A unique global survey examined financing, locations and promotion of health research. The focus of all this work was the influence of health on development. This book has 3 sections: a review of global health inequities and why health research is needed; findings of country surveys, health research financing, selection of topics and promotion; conclusions and recommendations. Some research priorities are contraception and reproductive health, behavioral health in developing countries, applied research on essential drugs, vitamin A deficiency, substance abuse, tuberculosis. The main recommendations are: that all countries begin essential national health research (ENHR), with international partnership; that larger and sustained international funding for research be mobilized; and that larger and sustained international funding for research be mobilized; and that international mechanisms for monitoring progress be established. The book is full of graphs and contains footnotes, a complete bibliography and an index.
Economics, health and development: some ethical dilemmas facing the World Bank and the international community.
Journal of Medical Ethics. 2001 Aug; 27(4):262-7.The World Bank is committed to "work[ing] with countries to improve the health, nutrition and population outcomes of the world's poor, and to protect[ing] the population from the impoverishing effects of illness, malnutrition and high fertility". Ethical issues arise in the interpretation of these objectives and in helping countries formulate strategies and policies. It is these ethical issues--which are often not acknowledged by commentators--that are the subject of this paper. It asks why there should be a focus on the poor, and explores the link between improving the health of the poor, and reducing health inequalities between the poor and better-off. It discusses difficult ethical issues at both the global level (including debt relief and the link between country ownership and donor commitment) and the country level (including user fees and whether providing assistance to the non-poor may in the long run be a way of helping the poor). (author's)
In: Ethics for a small planet: new horizons on population, consumption, and ecology, [by] Daniel C. Maguire and Larry L. Rasmussen. Albany, New York, State University of New York Press, 1998. 1-63. (SUNY Series in Religious Studies)This essay on population, consumption, and ecology, opens with a short review of the crisis caused by overpopulation and the inequitable distribution of resources. This discussion is then amplified by a close look at conditions and responses to these conditions in Egypt, China, and the Indian state of Kerala and at the six most common interrelated problems that threaten our existence: maldistribution, the perversion of national governments into the service of the elite, unfair distributional patterns protected by a military support system, male dominance, indifference, and a lack of reproductive health services. Next, the essay considers the role of government and ways to achieve freedom of reproductive choices while reducing birth rates. The remainder of the essay is devoted to a consideration of the role of religions in the next millennium; the prospects for religious revolution and renaissance; the nature of religion and of God, whether God exists; the experience of the sacred; the relationship of ethics and religion; the incongruity of a sacramental, monotheistic view of God with the violence of nature; the maleness of the God-symbol; the "posthumous egoism" that seeks an afterlife and views the earth as a mere stopping-off place on the journey; and the need for religion, as a sense of the sacred, to fuel the cultural revolution needed to solve the planet's problems. The essay concludes that, despite the fact that the apocalypse is reality for much of the world, hope remains and was palpable during the 1994 International Conference on Population and Development.
POPULATION AND DEVELOPMENT REVIEW. 1995 Jun; 21(2):361-86.At the 1993 Population Summit in New Delhi, 60 scientific academies represented at the Summit signed a joint statement affirming that reducing population growth is a necessary part of ecological sustainable development and that action is needed now. As an explanation of this statement, the Summit produced a book of essays entitled Population--The Complex Reality. There is, however, little consensus among the contributors about the complex relationship between population, development, and the environment. Given that scientists remain uncertain about the causal relationships linking population growth to economic and ecological change, concerned governments must be equally uncertain as to which demographic policies to adopt for economic development. This review of selected essays from the Summit collection argues that the complexity of the relationships between population, development, and the environment should not be an excuse for unresolved uncertainty. Rather, this same complexity should inspire a new and comprehensive approach to explaining how human social systems work and how they can be managed to achieve outcomes that people value. Some of the contributors to the collection explore the concept of openly applying ethical reasoning to demographic policy. While their ethical reasonings may well be debated, they are right to openly discuss ethics as a normal part of social science discourse, rather than allowing unspoken, and thereby unchallenged, moral assumptions to covertly shape their policies. They also affirm the value of historical and case-oriented methods of research as a necessary corrective to the standard quantitative methods, which are given to minimizing complexity rather than coping with it.
A peace perspective on population and environment: people before weapons. Paz, poblacion y medio ambiente: el ser humano antes que el armamentismo.
Chicago, Illinois, John D. and Catherine T. MacArthur Foundation, 1995. 16, 16 p. (International Lecture Series on Population Issues)Humanity's ability to continue to inhabit the earth is threatened by population growth and environmental degradation, and population and the environment are threatened by the ever-increasing militarization of the world. Developing countries spend $200 billion a year on armed forces and approximately $20.4 billion on arms purchases, whereas 4% of this budget would increase literacy by 50%, 12% would provide universal primary health care, and 8% would provide basic family planning services to all willing couples and stabilize world population by the year 2015. Weapons also destroy the environment, as seen in the case of Agent Orange in Viet Nam, in the Persian Gulf area after the recent war, and in areas of the world contaminated by nuclear testing. The arms trade flourishes despite the fact that most of the developing world faces no external enemy. Instead, 58 military regimes committed violent crimes towards their own citizens in 1992 alone. The atmosphere of violence spreads until arms are everywhere. In order to halt this cycle of death and destruction, a Global Demilitarization Fund must be established to distribute as a peace dividend voluntary contributions arising from reductions in military spending, and the UN Register of Conventional Arms must be strengthened. The US in particular must accept its role as a superpower and its responsibility to help the people of other nations. Thus, the US must stop using the sale of arms as a foreign policy strategy. Also, the US should increase its per capita amount of development assistance from its current disproportionately low level ($44 in 1991-92). In order to create a new world order, we need leaders who will use their power to improve conditions for mankind.