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Bulletin of the World Health Organization. 2014; 92:389.The World Health Organization (WHO) in 2012 set up a Consultative Group on Equity and Universal Health Coverage. The final report, entitled Making fair choices on the path to universal health coverage, was launched in London on 1 May 2014.5 The report addresses and clarifies the key issues of fairness and equity that arise on the path to univer¬sal coverage and recommends ways in which countries can manage them. (Excerpts)
Ten targets: 2011 United Nations General Assembly Political Declaration on HIV / AIDS: Targets and elimination commitments.
Geneva, Switzerland, UNAIDS, 2011.  p.Ten targets in the campaign to achieve universal access to HIV prevention, treatment, care and support by 2015 are listed. Targets include: Reduce sexual transmission of HIV by 50% by 2015; Reduce transmission of HIV among people who inject drugs by 50% by 2015; Eliminate new HIV infections among children by 2015 and substantially reduce AIDS-related maternal deaths; Reach 15 million people living with HIV with lifesaving antiretroviral treatment by 2015; Reduce tuberculosis deaths in people living with HIV by 50 percent by 2015; Close the global AIDS resource gap by 2015 and reach annual global investment of US$22-24 billion in low- and middle-income countries; Eliminate gender inequalities and gender-based abuse and violence and increase the capacity of women and girls to protect themselves from HIV; Eliminate stigma and discrimination against people living with and affected by HIV through promotion of laws and policies that ensure the full realization of all human rights and fundamental freedoms; Eliminate HIV-related restrictions on entry, stay and residence; Eliminate parallel systems for HIV-related services to strengthen integration of the AIDS response in global health and development efforts.
From advocacy to access: Uganda. The power of networks: How do you mobilize funds for reproductive health supplies? Fact chart.
London, England, IPPF, 2009 Nov.  p.In Uganda the IPPF Member Association, Reproductive Health Uganda (RHU) coordinated civil society and mobilized advocates and champions to increase the availability of RH supplies and family planning. Results to date include: The Government of Uganda increased funding for RH supplies in the 2010 budget; The Government of Uganda disburses funds directly to the National Medical Stores on an annual basis enabling the bulk purchase of contraceptives; 30 out of 80 districts have committed to increasing their resource allocation for family planning and RH supplies.
Geneva, Switzerland, UNAIDS, .  p.Funding for AIDS has grown significantly over the past decade. In 2007, US$10 billion is expected to be available for the AIDS response - about one third coming from developing countries - compared to less than US$300 million in 1995. The substantial increase in financial resources has allowed countries to scale up their AIDS response with the ultimate goal of achieving universal access to HIV prevention, treatment, care and support. However, many countries face difficulties in effectively implementing large-scale grants made available by funding bodies such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank, and bilateral actors. They require rapid and adequate technical support to effectively implement AIDS programmes. To address this implementation challenge, UNAIDS has taken a leading role in "making the money work" in countries. It has invested significant resources over the past two years in strengthening countries' national AIDS programmes, particularly through the establishment of Technical Support Facilities in five regions. (excerpt)
Geneva, Switzerland, UNAIDS, . 17 p.The Global Coalition on Women and AIDS (GCWA) was launched by UNAIDS and partners in February 2004 in response to rising rates of HIV infection among women globally, and a growing concern that existing AIDS strategies did not address social and economic inequalities that make women particularly vulnerable to HIV. The GCWA is structured as an informal, global alliance of civil society groups, networks of women living with HIV, and UN organizations with four key goals: to raise the visibility of issues related to women, girls and AIDS; to highlight strategies to strengthen women's access to HIV prevention and care services; to build partnerships for action; and, in so doing, to scale up efforts that will lead to concrete, measurable improvements in the lives of women and girls. The GCWA focuses on women and AIDS rather than gender and AIDS. This is deliberate. Whilst acknowledging that gender inequalities fuel and sustain the epidemic, the profound changes required in attitudes, behaviour and societal structures may well take generations. In the meantime, nearly two-thirds of young people living with HIV are adolescent girls. The GCWA seeks to include but move beyond gender-based analyses to action. It seeks to work with men and women, with existing allies, as well as new partners in the women's movement to prevent women from becoming infected and to live full lives, even when infected or profoundly affected by HIV. (excerpt)
SAfAIDS News. 2005 Sep; 11(3):2.Most people living with HIV and AIDS (PLWHA) are found in severely resource-constrained settings, where the pandemic continues to grow at an alarming rate, throwing into disarray the already enormous treatment challenge. High AIDS mortality rates are mainly experienced in sub-Saharan Africa, particularly in the southern Africa region. Yet recent events paint a gloomy picture regarding financial support for international remedial efforts against HIV and AIDS. There is uncertainty over continued funding of AIDS programmes in the future, forcing us to ask tough questions such as whether the aim of providing antiretroviral therapy (ART) to individuals clinically qualified to receive these medicines will be feasible and whether it will be possible to retain those already on treatment in the future. (excerpt)
New York, New York, SIECUS, .  p. (SIECUS PEPFAR Country Profiles: Focusing in on Prevention and Youth)Zambia is home to 11 million people, who represent more than 70 different ethnic groups, many sharing a common language, Bantu. Today roughly 35% of people live in urban areas. Although at one point the country was becoming increasingly urbanized, intense poverty on the rise since the 1970s has seen many people returning to rural areas. Religious beliefs in the country are varied. It is estimated that between half and three-quarters of Zambians practice Christianity, and that between a quarter and one-half practice Islam or Hinduism. A small minority practice indigenous faiths. Zambia gained its independence from Britain in 1964, and then was under one-party rule until the early 1990s. President Levy Mwanawasa was elected in 2001, although opposition parties claim the elections were marred by irregularities. Mwanawasa, however, has actively worked to rectify the perception of corruption in the government. For example, he lifted his predecessor Frederick Chiluba's immunity from investigation and prosecution regarding allegations of corruption. The next elections are scheduled for 2006. (excerpt)
New York, New York, SIECUS, .  p. (SIECUS PEPFAR Country Profiles: Focusing in on Prevention and Youth)Uganda is home to over 26 million people, comprising at least 18 different ethnic groups. The largest group, the Baganda people, make up 17% of the population. Today, an increasing number of people practice some form of Christianity, roughly 66% of the population, with an equal number subscribing to Roman Catholic and Protestant teachings. Of the remaining 34%, half practice Islam and half practice traditional, indigenous religions. Uganda is struggling to emerge from a turbulent and violent political history. President Yoweri Museveni seized power through a military rebellion in 1986. In 1996, he became the country's first directly elected president and was re-elected in 2001. He is also the chair of the National Resistance Movement (NRM), the only fully and freely functioning political organization in the country. Although there are seven organizations that could be characterized as political parties, Museveni has declared that the NRM is not a political party but a movement that "claims the loyalty of all Ugandans."2 Presidential elections are scheduled for February 2006, and although the constitution limits presidents to two terms in office, Musevini is campaigning to alter the constitution to permit him to run for a third term. (excerpt)
New York, New York, SIECUS, .  p. (SIECUS PEPFAR Country Profiles: Focusing in on Prevention and Youth)The United Republic of Tanzania, which consists of the mainland and the island of Zanzibar, is home to 36.8 million people. The vast majority (99%) are native Africans, of which 95% are Bantu (an ethnic group consisting of more than 130 tribes). While mainland Tanzanians hold a variety of beliefs (35% Muslim, 35% indigenous, and 30% Christian), more than 99% of the inhabitants of Zanzibar practice Islam. Tanzania was formed through the merger of Tanganyika and Zanzibar in 1964, after the two nations gained independence from U.N. trusteeship administered by Britain. In 1995, one-party rule came to an end with the first democratic elections held in the country in nearly 30 years. Since that time, two contentious elections have been conducted, with the ruling party declaring victory despite claims of voting irregularities by international observers. (excerpt)
New York, New York, SIECUS, .  p. (SIECUS PEPFAR Country Profiles: Focusing in on Prevention and Youth)South Africa is home to over 44 million people. South Africa's population is diverse-- the country officially recognizes 11 different languages and is home to a variety of ethnic groups and religions. Until 1991, South African law divided the population into four major racial categories: African (black), white, coloured, and Asian. Although this law has been abolished, many South Africans still view themselves and each other according to these categories. Black Africans from various ethnic groups comprise about 79% of the population. White people of European descent comprise about 10% of the population. Coloured people, who are mixed-race people primarily descending from the earliest settlers and the indigenous peoples, comprise about 9% of the total population. Asians, who descend from Indian workers brought to South Africa in the mid-19th century to work on the sugar estates in Natal, constitute about 2.5% of the population and still live primarily in the KwaZulu-Natal Province. Over half of South Africans identify as Christian, and 28.5% hold traditional, indigenous and/or animist beliefs. South Africans who identify as Muslim and Hindu (60% of whom are Indian) represent 2% and 1.5% of the population, respectively. (excerpt)
New York, New York, SIECUS, .  p. (SIECUS PEPFAR Country Profiles: Focusing in on Prevention and Youth)The Republic of Rwanda is home to approximately 8,441,000 people. More than 90% of the population lives in rural areas, in part because lack of economic opportunities and violence are driving people from urban areas. Rwanda's population is comprised of two main ethnic groups -- the Hutus (84%) and the Tutsis (15%). Rwandans are largely Christian (56.5% Roman Catholic, 26% Protestant, 11.1% Adventist), with a small minority holding Islamic beliefs (4.6%). Rwanda gained independence from the Britain in 1962 and has recently experienced dramatic governmental upheaval and civil war, beginning in 1990 and culminating in the 1994 genocide of approximately 800,000 people. During the conflict, roughly two million refugees fled to neighboring countries. While most refugees have returned to Rwanda, many continue to live in the Democratic Republic of Congo (DROC), Uganda, and Zambia. Conversely, Rwanda shelters nearly 38,000 refugees from the DROC, as well as over 4,000 internally displaced persons. With much of the population uprooted and in light of the real and perceived political dominance of Rwanda's ruling party, attempts at ethnic reconciliation have been complicated. In the aftermath of the 1994 genocide, however, Rwanda has been able to hold local, legislative, and presidential elections. In 2003, Rwandans, in addition to adopting a new constitution, overwhelmingly supported the election of President Paul Kagame, who was originally appointed to the office in 2000 by members of Parliament. The next presidential election is scheduled for 2008. (excerpt)
Clinical Infectious Diseases. 2006 Jan 15; 42(2):260-261.The global HIV/AIDS pandemic poses the greatest global health challenge in recent history. Effective, large-scale treatment of the several million infected individuals has appeared to present an almost insurmountable task. An ambitious global approach to this challenge was developed by the World Health Organization (WHO) "3 by 5" program in 2003, with the goal of providing treatment to 3 million affected individuals in low- and middle-income countries by the end of 2005. Although the immediate goal of the "3 by 5" program has not been achieved, 1500,000 Africans are now receiving antiretroviral therapy (ART). This initial WHO initiative has been of tremendous value in shifting the international emphasis from "if" to "when" universal access to antiretroviral treatment can be achieved. An additional thoughtful analysis of the essential elements of an effective approach to worldwide scale-up of ART was presented by the Institute of Medicine in early 2005. (excerpt)
Population 2005. 2002 Mar-Apr; 4(1):12-15.In a world where demand for secure reproductive health commodities far exceeds supply, leaving people vulnerable to unwanted pregnancies and diseases, a report from the United Nations Population Fund calls for a secure supply of commodities and effective protection to curb the spread of diseases like HIV/AIDS. The report draws up a "shopping list" of commodities that save lives: pills that allow couples to plan for pregnancy, soap, plastic sheets and razor blades to cut umbilical cords, antiseptics and medical equipment for inserting intrauterine devices, and condoms for protection from HIV/AIDS. Commodity shortages threaten the health and lives of millions in developing countries. Each $1 million shortfall in commodity support for contraceptives means an estimated 360,000 more unwanted pregnancies, 150,000 additional induced abortions, 800 maternal deaths, 11,000 infant deaths and 14,000 additional deaths of children under 5, the report says. Overall, only one third of what the donors promised in Cairo at the International Conference on Population and Development (ICPD) is available now. Specifically, the shortage in funds to purchase contraceptives is projected to reach hundreds of millions of dollars by 2015 – a shortage so severe that it threatens to reverse or stall the world’s progress in reproductive health and rights. (excerpt)
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)
Report of the fifteenth meeting of the UNAIDS Programme Coordinating Board, Geneva, 23 and 24 June 2004.
Geneva, Switzerland, UNAIDS, 2004 Jul 30. 62 p. (UNAIDS/PCB(15)/04.15)The fifteenth meeting of the Joint United Nations Programme on HIV/AIDS (UNAIDS) Programme Coordinating Board (PCB) took place at the Ramada Park Hotel, Geneva, Switzerland, on 23 and 24 June 2004. The participants are listed in Annex 3. On behalf of Zambia, the outgoing Chair of the PCB, H.E. Dr Brian Chituwo, Minister of Health, opened the fifteenth meeting of the PCB and welcomed all those attending. Dr Chituwo stated that it had been an honour and a privilege on behalf of Zambia to chair the PCB. In light of various international proclamations, including the United Nations Millennium Development Goals, the Copenhagen Consensus and the World Health Organization (WHO) Commission on Macroeconomics and Health, he felt that the global community had given a broad mandate to UNAIDS to take the fight against the pandemic to higher levels, and he noted that UNAIDS had responded by scaling up activities significantly. He warned against complacency, however, and cited the particular challenges posed by the “3 by 5” Initiative, including his country’s own efforts to scale up treatment. He paid tribute to Dr Peter Piot (Executive Director of UNAIDS) and his team and thanked them for their close support during his tenure in office. In closing, he urged all to remain united in the fight against HIV/AIDS. (excerpt)
Nature. 2004 Jul 8; 430:133.Next week, some 15,000 delegates will converge on Bangkok, Thailand, for the XV International AIDS Conference. It is appropriate, given the meeting's location in a fast-developing country that has done much to protect its citizens from HIV, that its theme is 'access for all'. For the poor countries hit hardest by AIDS, this is the crucial issue -- they need access to lifesaving drugs, to interventions that can limit the spread of HIV, and to the money to pay for it all. At the last international conference, in Barcelona in 2002, hopes were high that the rich world would begin to provide the cash to allow developing nations, particularly those in sub-Saharan Africa, to fight back against HIV. "Bangkok will be a time of accountability," observed Peter Piot, executive director of UNAIDS, the Joint United Nations Programme on HIV/AIDS (see Nature 418, 115;2002). Now it is time to take stock. Today's balance sheet reveals a mixed picture. On the plus side, more people than ever before are being treated with cocktails of antiretroviral drugs. According to UNAIDS, 230,000 AIDS patients in developing countries were getting these drugs at the end of 2001; two years later, this figure had risen to 400,000. Price reductions have driven this progress -- negotiations by philanthropic organizations have helped to lower costs from a minimum of US $300 per person, per year in 2002 to today's figure of $140. (excerpt)
In: While the world sleeps: writing from the first twenty years of the global AIDS plague, edited by Chris Bull. New York, New York, Thunder's Mouth Press, 2003. 401-412.Public concern over the global AIDS epidemic, particularly in Africa, has grown enormously in recent years, but there is considerable debate about what the international community can and should do about it. Especially controversial has been the high cost of antiretroviral drugs used to extend the lives of people with AIDS. The pharmaceutical companies that make these drugs price them beyond reach of the world's poor, but in November 2001 at the WTO meeting in Doha, Qatar, these companies were forced to accede to pressure from developing-country governments, nongovernmental organizations, and activists, and allow poor governments to adjust certain rigid patent rules applying to vaccines and drugs in order to protect public health. Despite this apparent triumph of international pressure, far more needs to be done. A coalition of governments and nongovernmental organizations, led by the UN, recently launched the Global Fund Against AIDS, Tuberculosis, and Malaria (referred to here as the Global Fund), and its performance will test how well such a global institution can confront the most serious health crises of our time, and perhaps in all of human history. (excerpt)
[Unpublished] 1981 Aug 28. 222 p. (AID/LAC/P-085)The background, goals, projected activities and beneficiaries, financial requirements, and implementation plans for a Family Planning Outreach Project in Haiti are detailed. The project is intended to assist the Government of Haiti to establish a cost-effective national family planning program. Population growth continues to accelerate in Haiti, despite high infant and child mortality, significant emigration, and declining fertility. The government does not have an articulated population policy. Although family planning and maternal and child health services have been in existence since 1971, there is no effective access to these services. This project is viewed as a means of achieving a substantial and sustained reduction in family size and improving health status. It is also a means of strengthening the Haitian family so it can participate more directly in the national development process. The purpose of the project will be accomplished through the following activities: 1) improvement of the organization and management of the national family planning program; 2) improvement of the quality and quantity of maternal and child health and family planning services; 3) expansion of the participation of private and voluntary organizations, other governmental, and local community groups in service provision; 4) increase in the availability of contraceptives at reasonable prices through rural and urban commercial channels; and 5) formulation of appropriate population and family planning policies. By the end of the project, all government health facilities and 75% of private facilities will actively counsel and provide family planning services; integrated models of community health and family planning services will have been developed to serve 60% of the population; basic drugs and contraceptives will be available at reasonable subsidized prices throughout the country; and 25% of women ages 15-45 at risk of pregnancy will be continuing users of effective contraceptive methods. The project will be implemented by the existing infrastructure of private and public organizations, primarily by the Department of Public Health and Population and its Division of Family Hygiene. The US Agency for International Development (USAID) is providing US$9.615 million (54%) toward the estimated US$17.980 million cost of the 5-year project. An additional US$6.555 million (36%) will be provided by the Government of Haiti.
AIDS Policy and Law. 2002 Jan 18; 17(1):4.This news article discusses details of the WHO report entitled, "Macroeconomics and Health: Investing in Health for Economic Development". The report asserts that partnership between poorer and richer countries could provide improved access to essential health services and generate economic benefits.
Project appraisal document on a proposed International Development Association credit in an amount of US$24 million to the Islamic Republic of Mauritania for a health sector investment project. [Document d'évaluation de projet : proposition de crédit d'un montant de 24 millions de dollars US à l'Association Internationale pour le Développement à la République Islamique de Mauritanie en vue d'un projet d'investissement dans le secteur sanitaire]
Washington, D.C., World Bank, Africa Region, 1998 Feb 24. 24,  p. (Report No. 17396-MR)This project appraisal document presents the proposed international development association credit in an amount of US$ 24 million to the Islamic Republic of Mauritania for a health sector investment project. The overall objective of the Program is to improve the health status of the population in general (and of underserved groups in particular) through the provision of more accessible and affordable quality health services. Specifically, the Program aimed to improve health services quality and coverage; improve health sector's financing and performance; mitigate the effects of major public health problems; and promote social action and create an environment conducive to health. This document is outlined into nine sections which covers the topics on project development objective; strategic context; project description summary; project rationale; summary project analyses; sustainability and risks; main credit conditions; readiness for implementation; and compliance with bank policies. Several annexes are also included in this document.
UNFPA fifth country programme of assistance to the government of Kenya, 1997 to 2001. Framework for the reproductive health sub-programme.
[Unpublished] 1997 Dec. xiii, 32 p.This project between the UN Population Fund and Kenya's Ministry of Health proposes to strengthen technical and institutional capacity at all levels in the effective provision of reproductive health (RH) services during 1997-2001. The aims are to increase quality and accessibility of RH by a specific percentage, to reduce maternal mortality by 20%, to reduce perinatal morbidity and mortality by 30%, and to increase contraceptive prevalence by 20% in selected districts and Nairobi slums. The aims are also to provide youth-appropriate RH services, to reduce the spread of sexually transmitted infections (STIs) including HIV/AIDS, and to intensify IEC activities in support of RH services and other activities. This proposal describes the background, justification, and health reforms in Kenya; the RH achievements and lessons learned; selected issues to be addressed in the national RH program; goals; strategies and activities; monitoring and evaluation; the institutional framework; related activities and funding sources; and the summary budget. The budget will be shared between the Government (60%) and implementing nongovernmental organizations (40%). About 10% will be directed to IEC. The total summary budget is US$13 million. The main strategy for preventing STIs and HIV/AIDS is to integrate the education within day-to-day activities of health staff and to train service providers (SPs) at all levels. Surgical gloves and male-friendly services will be provided to all SP points. Technical support will be provided by advisers in Addis Ababa, selected national consultants, and field office program staff.
Watertown, Massachusetts, Pathfinder International, 1996. 24 p.Pathfinder International seeks to build capacity to create and improve access to the fullest possible range of quality information and services to enable individuals and couples to make reproductive health choices. The agency's annual report for 1996 opens with a message from its president that characterizes 1996 as an astonishing year because the US government instituted an 85% budget cut in international family planning (FP) programs and because Pathfinder received the UN Population Award. The US cuts have occurred at a time when governments of other industrialized countries have increased support for international FP programs and when demand for FP has grown. The UN award afforded Pathfinder a platform for advocating replacing US support to reproductive health services. The next section highlights Pathfinder's receipt of the UN award and reproduces letters of congratulations from US Senators. This is followed by a chronology of Pathfinder's first 40 years of operation. The report continues with a description of programs and activities that seek improvement in quality of reproductive health care, collaboration with other organizations, increased access to services, and integration of reproductive health services and also place a focus on youth. The report ends with a list of foundations that provided support during 1996, of individual donors, and of the members of the Board of Directors as well as a financial statement. A free copy of this report can be ordered from Carrie Hubbell, Technical Communications Unit, 9 Galen Street, Suite 217, Watertown, Massachusetts 02172, USA.
WASHINGTON POST. 1994 Jan 12; A4.Foreign policy changes in the US mean that the objective of the Clinton administration will be to provide family planning (FP) services worldwide by the year 2000 to every woman who desires contraception. Current funding of $500 million will need to be doubled in order to meet universal access needs. The concern is that the world's present population of 5.5 billion will double in the next 35-40 years before leveling off. This population growth will jeopardize the present level of quality of life and respect for individuals and will threaten the natural environment. The policy changes reflect a refocusing on "new global realities." The aim is improvement in the well-being of the world's have-nots and environmental protection. The State Department Counsel Timothy E. Wirth states that population control, the environment, human rights, counter-terrorism, and anti-drug efforts will be a priority. FP objectives will be addressed at the International Conference on Population and Development scheduled for September 1994 in Cairo. The conference is expected to be as important as the Rio de Janeiro environmental conference was in 1992. Egypt is an appropriate conference site for addressing rapid population growth issues and cultural norms favoring large families. Muslim leaders and predominately Catholic nations have actively opposed government FP programs. The US will follow through with its objectives by increasing its population control funding for fiscal year 1995.
VACCINE. 1988 Oct; 6(5):393-8.In developing countries, where economic development is lacking and literacy rates are low, priority must be given to primary health care and to the establishmend of sustainable health care delivery systems. The World Health Organization's Expanded Program of Immunization was designed with the goal of immunizing all children against measles, pertussis, tetanus, poliomyelitis, tuberculosis, and diphtheria by 1990. A second function of the immunization program is to establish a health care delivery system. Today 50% of infants receive 3 doses of diptheria/pertussis/tetanus and polio vaccines, and 70% receive at least 1 dose. Measles kills 2 million children every year. The standard strain of attenuated vaccine is given at 9 months, and 1 dose protects 95% of children for life. Tetanus kills 800,000 infants every year. The vaccine must be refrigerated, and 2 doses are essential. Tuberculosis kills 2 million children under 5 every year. The attenuated BCG vaccine should be given at birth, and a single dose confers some protection. Diphtheria is most common among poor, urban children in termperate climates, and 3 doses of toxoid at monthly intervals are recommended. Poliomyelitis paralyzes 250,000 children a year. 4 doses of live attenuated Sabin vaccine are recommended. The vaccine is very sensitive to heat. Other vaccines in use or being developed include yellow fever, meningococcus, Japanese B encephalitis, rubella, hepatitis B, cholera, rotavirus, pneumonococcus, and Haemophilus influezae. 2 problems that confront the delivery of health services, including immunization, are lack of funds and lack of access to susceptible populations. Approaches to the lack of funds problem include fee for service, taxation, beter management of existing resources, reallocation of health resources, and increased funding from donor nations. Approaches to the problem of access include vaccination whenever children come into contact with a health facility for any reason, channeling by members of the community, involvement of traditional healers and birth attendants, outreach services, mass campaigns, pulse technics, and financial incentives.
Washington, D.C., World Bank, 1984. 36 p. (International Conference on Population, 1984; Statements)In his address to national leaders in Nairobi, Kenya, Clausen expresses his views on population growth and development. Rapid population growth slows development in the developing countries. There is a strong link between population growth rates and the rate of economic and social development. The World Bank is determined to support the struggle against poverty in developing countries. Population growth will mean lower living standards for hundreds of millions of people. Proposals for reducing population growth raise difficult questions about the proper domain of public policy. Clausen presents a historical overview of population growth in the past 2 decades, and discusses the problem of imbalance between natural resources and people, and the effect on the labor force. Rapid population growth creates urban economic and social problems that may be unmanageable. National policy is a means to combat overwhelmingly high fertility, since governments have a duty to society as a whole, both today's generation and future ones. Peoples may be having more children than they actually want because of lack of information or access to fertility control methods. Family planning is a health measure that can significantly reduce infant mortality. A combination of social development and family planning is needed to teduce fertility. Clausen briefly reviews the effect of economic and technological changes on population growth, focusing on how the Bank can support an effective combination of economic and social development with extending and improving family planning and health services. The World Bank offers its support to combat rapid population growth by helping improve understanding through its economic and sector work and through policy dialogue with member countries; by supporting developing strategies that naturally buiild demand for smaller families, especially by improving opportunities in education and income generation; and by helping supply safe, effective and affordable family planning and other basic health services focused on the poor in both urban and rural areas. In the next few years, the Bank intends at least to double its population and related health lending as part of a major effort involving donors and developing countries with a primay focus on Africa and Asia. An effective policy requires the participation of many ministeries and clear direction and support from the highest government levels.