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Lancet. 2007 Oct 20; 370(9596):1394.Eradicating poliomyelitis presents many challenges. Financing essential activities can be difficult when donors fail to meet funding targets (a US$60 million funding gap currently exists for the fourth quarter of 2007). Security issues in two of the four polio-endemic countries-Afghanistan and Pakistan-make access to children difficult for immunisation teams. And in Nigeria, low vaccine coverage and an outbreak of disease from vaccine-derived poliovirus (VDPV) could set back global eradication efforts. Over the past 10 years there have been nine outbreaks of poliomyelitis derived from the oral vaccine in nine countries. Nigeria has seen the largest outbreak; 69 children have been paralysed this year. VDPVs are rare but occur when the live virus in an oral polio vaccine mutates and reverts to neurovirulence. This loss of attenuation does not matter so much in populations who are fully immunised with oral vaccine, since they will be protected from wild and vaccine-derived poliovirus, but in Nigeria,where vaccine coverage is 39% (and even lower in some northern states), it is a problem. (excerpt)
New York, New York, United Nations Development Programme [UNDP], . 14 p.The deepening of democratic institutions, gains in macroeconomic stability and rapid expansion of prosperity contribute to an overall encouraging context for sustainable development in Brazil. Yet, despite these numerous advances, real poverty has only moderately declined, and inequality persists. In Brazil, economic and social status tends to vary by geography, race and gender, a legacy of the country's history. Imposed and de facto colonial and post-colonial divisions among indigenous peoples and descendents of Portuguese settlers, African slaves and European, Middle Eastern and Asian immigrants created persistent structures of exclusion and inequality. In the 1950s, during the military government, a strategy of import substitution prioritized rapid industrial expansion, and helped to bring about significant, sustained economic growth. Benefits, however, accrued disproportionately to the upper classes at the expense of workers and unions. The industrialization contributed to the expansion of the favelas (urban slums), one of Brazil's greatest contemporary challenges, by promoting urban migration while infrastructure and social support did not expand at the same pace. (excerpt)
UN Chronicle. 2003 Dec; 40(4): p..The media, as an important agent of socialization in the modern world, either support or contest cultural conceptions, and have a significant impact on the social construction of gender. The media's effects operate at the level of gender belief systems, affecting individual "beliefs and opinions about males and females, and about the purported qualities of masculinity and femininity". The mass media have been found to play a critical role in maintaining the gender-power imbalance, "passing on dominant, patriarchal/sexist values". But such a situation is not inherent in the nature of media. They can instead be agents of development and progress if guided by clear, socially relevant policies. Their hoped-for positive contribution to women's advancement will only take place in the context of a framework that clearly defines policy objectives, maps out actions and decisions which comprise the particular policy, defines the minimum standards to be met by all participants in the process, and provides mechanisms for assessing progress towards policy objectives. (excerpt)
Health Transition Review. 1997 Apr; 7(1):61-71.The World Development Report 1993 announced that global life expectancy was then 65. Experience in the developed world suggests that the World Health Organization’s dictum, ‘health is a state of complete physical, mental and social well-being’, is simply not attainable for the foreseeable future. As physical health has improved, mental problems have become more prominent and a sense of well-being has declined. Furthermore, as the population ages and medical technology improves, the cost of health care grows almost exponentially. Since the population of the developed world is continuing to age and aging is spreading rapidly throughout the developing world, knowledge is the principal way of dealing with this seemingly intractable problem: we must know, quantitatively, the age-specific causes of ill health, and we must know which means of prevention and treatment are effective. Finally, we must apply that knowledge rationally. (author's)
Forum for Development Studies. 2005; 32(1):275-283.The article takes as its point of departure the programmatic point developed in the introduction to Ahead of the Curve – that the UN’s role in producing ideas should be contextualised, that is be seen as not only the source of ideas, but the carrier of ideas originating in some other source. The author finds several of the contributions that he has been able to read very strong analytically and empirically. But on some issues a few of the contributions could have been addressing the programmatic point more consciously; one example is population policy. The author also argues that the position of the UN, for instance in the public opinion, is a matter that could have been addressed more extensively in order to measure the impact and the legitimacy of the world organization in a situation where major reorganization of it is on the international agenda. (author's)
Talking points for Bill Gates, UN Media Leaders Summit on HIV / AIDS, January 15, 2004. 8-10 minute remarks.
[Unpublished] 2004. 4 p.The media have played a crucial role in highlighting the most important issues of our time—civil rights, apartheid, political oppression. Yet HIV/AIDS may be the greatest challenge of all. You have played a remarkable role already. In fact, the media had a great influence on my own commitment to fight diseases in the developing world. Early on, when my wife, Melinda, and I were thinking about our philanthropy and how we could have the greatest impact with our resources, my father sent me a clip from a newspaper about preventable deaths in poor countries. I remember reading a chart that listed the world’s deadliest diseases. One disease I had never even heard of— rotavirus—was killing literally half a million kids each year. I thought: That can’t be true, that’s got to be a typo. If a single disease was killing that many kids, we would have heard about it—it’d be front-page news. But it isn’t. As Melinda and I have become more engaged in global health issues over the past decade, one thing has become clear: not enough is being done about the millions of preventable deaths each year from diseases like AIDS or malaria. In part, that’s because people aren’t aware of what is happening. We don’t see these issues covered enough in newspapers, radio and television. (excerpt)
Human Rights Quarterly. 2004; 26:873-878.Leonard S. Rubenstein offers a thoughtful response to my article on how international monitoring and advocacy organizations that use a methodology of public shaming can best advance economic, social, and cultural (ESC) rights. His article makes three basic points. First, he notes that such organizations can make useful contributions beyond exposing government misconduct and subjecting it to public opprobrium. Namely, he suggests that they can provide technical assistance to governments on implementing ESC rights and help with capacity building for national or local NGOs that seek such rights. Second, he contends that such international organizations need not be as concerned with advocating tradeoffs among competing ESC rights because fears of limited resources— a “zero-sum game”—are overblown. Third, he disagrees with my perceived preference for condemning “arbitrary” government conduct to the exclusion of violations of particular ESC rights. On the first point, I largely agree with him. On the second, I regretfully suspect he has an overly sanguine view of the problem. And on the third, I fear he has misunderstood me. (excerpt)
[Toward a new international penal law: some general reflections at the end of the century] Vers un nouveau droit international pénal: quelques réflexions générales à la fin du siècle.
In: La protection des droits de l'Homme entre la législation interne et le droit international. Actes du colloque organisé par le Centre de Recherches sur la Coopération Internationale pour le Développement de la Faculté de Droit de Marrakech avec le concours de la Fondation Hanns-Seidel, les 21 et 22 janvier 2000. Rabat, Morocco, Revue Marocaine d'Administration Locale et de Developpement, 2001. 33-56. (Thèmes Actuels No. 26)In classic international law, since the individual is separated from the international sphere by the legal fiction of the State, while international law at the dawn of the twenty-first century no longer governs only co-existence among States or the pursuit of their common goals, but also collective interests proper to the international community as a whole, the protection of human rights today is no longer part of the domain reserved to States. At the present time, we find that the individual is the subject of rights and the State is the subject of new duty, namely the respect of human rights. It is possible to identify, through the practice of diplomacy and international jurisprudence, a few general rules, divided into those relating to substance and those relating to procedure. Among the rules relating to substance, it is possible to identify the principles of sovereignty and cooperation, the elementary rules of humaneness and the rule of individual criminal liability. In the area of international sanction mechanisms in international law, the first image we see is that of the courts of Nuremberg and Tokyo. The classic approach to the sanctioning of individuals has really changed only since the end of the 1980's. These sanctions had long been in the hands of the State. In all cases, at least on the normative level, they left in their hands the obligation to obey and to enforce international criminal law, which at the present time is conveyed, among other ways, through the action of international tribunals, bilateral cooperation through international criminal judiciary assistance and multilateral cooperation. Several humanitarian tragedies, such as those in the former Yugoslavia, Iraq and Rwanda, have called into question the effectiveness of these new enforcement and sanction procedures; however the participation of public opinion and non-governmental organizations (NGO's), the political and judicial action of the United Nations have reinforced it.
Pretoria, South Africa, Africa Insitute of South Africa, Peace and Governance Programme, 2002. vi, 14 p. (Africa Institute Occasional Paper No. 68; Peace and Governance Programme No. 4)If lasting peace is to be sustained, it is important that preventive diplomacy be effectively applied in future, something which has thus far not always been managed successfully. The mistakes that have been made in the past can serve as a guideline to formulate a series of recommendations for the future. First, it is essential to define the concept preventive diplomacy. The next step is to describe the dimensions of the conflict in Sierra Leone. Bilateral negotiations between parties, appeals by international actors and the threat or use of force in the maintenance and restoration of regional balances of power are selected as a few key preventive tools for analysis. Finally, recommendations are made in this volume about how preventive diplomacy should be applied in future to prevent the country's fragile peace from falling apart yet again. (excerpt)
In: All of us. Births and a better life: population, development and environment in a globalized world. Selections from the pages of the Earth Times, edited by Jack Freeman and Pranay Gupte. New York, New York, Earth Times Books, 1999. 430-3.It is estimated that as the year 2000 approaches, the world population will surpass 6 billion. This projection is because either economic stagnation or social disintegration affects rapid demographic growth. Curtailing population growth alone can not solve the world's social and environmental ills; however, it requires a substantial reduction of human fertility in order to have a meaningful improvement of the human condition. To achieve this, organizations have implemented population and family planning programs in less developed countries. Although most of these efforts were not initiated until the 1960s and 1970s, there have been a number of notable successes. Contraceptive prevalence among married women of reproductive age has increased over the past 30 years from 25% to 56%. The annual rate of world population growth has declined from 2.06% to 1.4%. Within the past decade, the annual increase in human numbers has slowed from almost 90 million to less than 80 million. While these demographic trends are both important and encouraging, they do not signal victory in the world's continuing struggle to contain its human growth. This paper traces the changes in international public opinion concerning the importance of population stabilization, as long as it is based on human rights and voluntary acceptance of family planning.
Development. 2000 Mar; 43(1):23-7.This article is an excerpt of the research report on the Children's Movement for Peace in Colombia. The research conducted by Sara Cameron in 1998, interviewed 150 Colombian children about their opinion of war and their efforts to build peace. This research was then submitted to the Nobel Committee in support of the nomination of the Children's Movement for Peace for the 1998 Nobel Peace Prize. Most of the cases being related by these children include killing of parents, killing young innocent people, conflict within the family, and war between the army and guerrillas. The Children's Movement for Peace exerted effort to build peace by conducting workshops and counseling of the children victimized by violence. Also, they help these victims express their feelings either verbally or through paintings. Lastly, the volunteers of peace movement in Colombia hope to promote peace in the home, community, and the country.
In: Evaluation and development: proceedings of the 1994 World Bank conference, edited by Robert Picciotto and Ray C. Rist. Washington, D.C., World Bank, 1995. 261-4. (World Bank Operations Evaluation Study)This postscript focuses on issues concerning evaluation and development. Program evaluation is an act or diagnostic study of evaluating a particular program according to its relevance, efficacy, and efficiency. Accountability, sustainability, and institutional development are few of the factors associated with evaluation. Independent evaluation must not only influence decision-makers but also inspire them to action. The centrality of side effects has many implications for evaluation such as the need for complementary evaluation tools to supplement both micro and macro types of assessments. Researchers and evaluators advocated the use of social experimentation, econometrics, meta-analysis, and careful construction of counterfactuals in evaluation.
In: Evaluation and development: proceedings of the 1994 World Bank conference, edited by Robert Picciotto and Ray C. Rist. Washington, D.C., World Bank, 1995. 255-9. (World Bank Operations Evaluation Study)This paper presents the opinions of Jin Liqon, Mark Baird, John Eriksson, Asmarni Sjamsu, James Adams, and Pablo Guerrero concerning the methods and procedures in evaluating development results. The paper addresses several issues including cost-effectiveness of educational programs, linking evaluation and research as well as objectives and indicators, and identifying performance indicators for the evaluation of structural adjustment loans. Stabilization, structural reforms, and trade policy reform were identified as the three basic components of a structural program. The conference reaffirmed the importance of using several approaches such as quantitative and qualitative measures and cost-benefit analysis.
New York, New York, Rockefeller Brothers Fund, Global Interdependence Initiative, 1997. 36 p. (Paper No. 1)This paper is based on an October 7-8, 1996, conference held at the Pocantico Conference Center in the US. The meetings were hosted by the Rockefeller Brothers Fund and the World Bank. Discussion focused on social stewardship (SS) and the need for cooperation among nations, if interdependent nations are to advance their common interests in economic growth, military security, and the promotion of health, social stability, and human potential SS. This paper is also based on subsequent discussions and other sources. SS is valued for reasons of national security, as a building block of economic growth, and as a reflection of moral values. The US budget does not reflect a meaningful measure of commitment to SS. The US now ranks 4th in the world in bilateral assistance, behind Japan, France, and Germany. Multilateral aid has also declined. The budget declines reflect political and budgetary constraints. Assistance has shifted to disaster relief. Conference participants did not answer whether the decline in assistance meant there were no other alternatives for achieving SS. Chapters in this paper refer to the challenge of global interdependence, the retreat from SS, and building support for SS. Political leadership is key to raising the importance of international issues and SS. A critical mass of Americans could generate the political will. Nongovernmental organizations are key to mobilizing the community in a constituency-building effort. The effort must be directed to women, people of faith, youth, educators, business people, labor union leadership, mass media owners and employees, and foundation staff and trustees. Multilateral and bilateral agencies need to be changed to meet current needs. It is time to recognize that prosperity and security are closely connected to human well-being.
SEXUAL HEALTH EXCHANGE. 1998; (3):4.Two decades of Family Planning Association of Hong Kong (FPAHK) advocacy of husband-wife communication and cooperation in family planning led Hong Kong's population to finally accept the notion of male responsibility in family planning. Recent surveys have documented high rates of male contraceptive use. The FPAHK established its first clinic to provide men with birth control advice and services in 1960, then set up a vasectomy clinic and installed condom vending machines. Working against prevailing traditional beliefs that childbearing is the exclusive domain of women and that vasectomy harms one's health, the FPAHK began campaigns to motivate men to take a positive and active role in family planning and to correct misinformation on vasectomy. Successful FPAHK efforts to stimulate male support for family planning include the 1977 "Mr. Family Planning" campaign, the 1982 "Family Planning - Male Responsibilities" campaign, and the 1986-87 "Mr. Able" campaign. Although these campaigns ended in the 1980s, men may now be counseled on contraception at 3 of the 8 FPAHK-run birth control clinics.
[From the end of World War II to the Cairo conference: the international community facing the problem of world population growth] De la fin de la seconde guerre mondiale a la conference du Caire: la communaute internationale face au probleme de la croissance de la population mondiale.
In: La population du monde: enjeux et problemes, edited by Jean-Claude Chasteland and Jean-Claude Chesnais. Paris, France, Presses Universitaires de France, 1997. 585-617.The global shift from the view that governments should not try to influence demographic trends to a general belief that they can and should intervene in such matters is examined. The author describes how a group of population activists worked toward creating an international conference that would legitimize government intervention in population matters, and how this goal was gradually achieved over the course of the conferences held in Belgrade, Bucharest, Mexico City, and Cairo. The role of these activists in getting the United Nations involved in population activities is also described.
BALTIMORE SUN. 1994 Aug 24; 13A.A fellow at the American Enterprise Institute remarked that population growth slowed from 1.73% to 1.57% during 1990 to 1994. In Eastern Europe alone population declined by 1 million in the past 4 years. Fertility decline is evident even in Africa and a rapid fertility transition has appeared in Iran. The data are based on figures recently generated by the UN and published in "World Population Prospects: 1994 revision." The projected medium fertility variant was 9.8 billion by 2050 and 10 billion in 2054. UN statisticians have reported that the real numbers are likely to be even higher despite their own reports of fertility decline. The UN believes that sustaining 2.1 children per woman at replacement level will not be allowed by countries. The more developed countries are now at or below replacement: Japan at 1.5, Korea at 1.7, Germany at 1.3, and Italians at 1.3. Large population numbers threaten stability and are related to famine, pollution, war, and animal and plant species decimation. The evidence from Rwanda and Bosnia is clear. A more desirable and realistic estimate should be 7-8 billion by 2050. World population in preparation for the International Conference on Population and Development is being publicized as a problem so that the UN and environmentalists can increase their funding and attain a high spot on the global agenda. The author's experience as part of the US delegation to the International Population Conference in Mexico City in 1984 led to the conclusion that these international policy conferences are really public relations events. Gloom and doom predictions are constantly being modified; for instance, what was the "coming ice age" is now "global warming." The world has survived thus far, while the numbers have been increasing. If the world does not prosper in the years ahead, it is unlikely to be due to too many people.
[Unpublished] 1989. 7 p.The World Bank President at a meeting of the World Resources Institute in 1989 addressed the issues of World Bank accomplishments, public awareness, industrial nations' responsibilities, and the link of poverty to population and the environment. Collective responsibility is urged. The cumulative effect of human activity will determine the fate of the planet. The World Bank has created a central Environment Department. Staff assigned full time to environmental issues has increased to 65 over 3 years. Environmental Issues Papers have been prepared for the most active borrowers, which in August 1989 included 70 countries. The Environmental Technical Assistance Program has US$5 million to distribute for environmental projects. Regional studies in an Asian urban environmental clean up and a Mediterranean environmental project were initiated and jointly funded with the European Investment Bank. By June 30, 1989, more than 100 projects with environmental components will be approved for funding, which is 35% of total yearly projects. 60% of all agricultural projects funded have environmental components. Funding for forestry projects is expected to double to US$950 million in the next 3 years, and US$1.3 million will be lent for environmental projects. Bringing environmental awareness to developing countries has been made difficult be fears that advanced countries are trying to impede economic development and to interfere with foreign sovereignty. Collective responsibility has not been agreed upon. Industrialized countries must be prepared to accept and remedy their own environmental shortcomings. 71% of industrial emission of carbon dioxide (CO2) comes from North America and Western Europe, which has only 8.2% of the world's population. Meanwhile, 7% of CO2 emissions come from developing countries, which have 70% of the world's population. The US produces 5 tons of CO2/person, while the world average is 1 ton/person. The US exports agricultural chemicals that are hazardous to human health. The US leads all industrial nations, except Canada, in energy use/unit of production of goods and services. 33% of all chlorofluorocarbons are released in the US. The population growth rate has a serious and life-threatening impact on human life. Natural resource constraints will limit growth. The solution is to provide family planning and expand the carrying capacities right now.
The forest resources of the temperate zones. Main findings of the UN-ECE / FAO 1990 Forest Resource Assessment.
New York, New York, United Nations, 1992. v, 32 p. (ECE/TIM/60)The main findings of the UN-ECE/FAO Forest Resource Assessment, 1990, now reflect a virtually complete set of basic forest inventory statistics of countries providing information for the assessment. This tool would be valuable and useful for policy makers, managers, and others concerned with forestry, ecology, conservation, and socioeconomic development. About 50% of the world's total forest resources are covered in this assessment. In process is the collection of corresponding data on the tropical and temperate zone developing regions. Assessment is made of 1) the world context, 2) basic information (land-use classification, forest types, species groups, stocked and unstocked forests, ownership and management status, number and size distribution of holdings, change in area over time, standing volume and growing stock, standing volume and mass of biomass, annual increment, fellings, and removals, 3) benefits and functions of the forests, and 4) conclusions. The main findings are that 2.06 billion hectares or about 50% of the world's total forests and wooded land are located in temperate zones. Almost 25% is in the USSR and almost 20% in North America. Forest covers nearly 39% of land area or 1.62 hectares/capita in temperate regions. Forest area, growing stock, and increment have continued to increase since the 1950s. there were 1.86 billion m3 overbark fellings in 1990 of which 40% was in North America; fellings are still less than net annual increment. The environmental and other nonwood goods and services of the forests are becoming increasingly important to society, and will receive emphasis in policy and planning for protection, water regulation, nature conservation, and recreation. Public attitudes have been changing. Conflicts do exist between, for instance, wood production and environmental protection. Almost all temperate zone countries have in common the continuing expansion of the forest resources and specifically nonwood functions. The next joint session of FAO European Forestry Commission and UN-ECE Timber Committee will consider the implications of the net productivity for the whole range of goods and services relative to the deterioration of an overmature forest.
Report of the ESCAP/UNDP Expert Group Meeting on Population, Environment and Sustainable Development: 13-18 May 1991, Jomtien, Thailand.
Bangkok, Thailand, United Nations, Economic and Social Commission for Asia and the Pacific [ESCAP], 1991. iv, 41 p. (Asian Population Studies Series No. 106)The 1991 meeting of the Economic and Social Commission for Asia and the Pacific considered the following topics: the interrelationships between population and natural resources, between population and the environment and poverty, and between population growth and consumption patterns, technological changes and sustainable development; the social aspects of the population-environment nexus (the effect of social norms and cultural practices); public awareness and community participation in population and environmental issues; and integration of population, environment, and development policies. The organization of the meeting is indicated. Recommendations were made. The papers on land, water, and air were devoted to a potential analytical model and the nature of the interlocking relationship between population, environment, and development. Dynamic balance was critical. 1 paper was presented on population growth and distribution, agricultural production and rural poverty; the practice of a simpler life style was the future challenge of the world. Several papers focused on urbanization trends and distribution and urban management policies. Only 1 paper discussed rural-urban income and consumption inequality and the consequences; some evidence suggests that increased income and equity is associated with improved resource management. Carrying capacity was an issue. The technological change paper reported that current technology contributed to overproduction and overconsumption and was environmentally unfriendly. The social norms paper referred to economic conditions that turned people away from sound environmental, cultural norms and practices. A concept paper emphasized women's contribution to humanism which goes beyond feminism; another presented an analytical summary of problems. 2 papers on public awareness pointed out the failures and the Indonesian experience with media. 1 paper provided a perspective on policy and 2 on the methodology of integration. The recommendations provided broad goals and specific objectives, a holistic and conceptual framework for research, information support, policies, resources for integration, and implementation arrangements. All activities must be guided by 1) unity of mankind, 2) harmony between population and natural resources, and 3) improvement in the human condition.
Development. 1989; (4):52-5.The Brundtland Commission on Environment and Development has contributed the critical concept of sustainable development. The objective at present for developing countries is to deal with the limits of the global life support system's capacity to absorb the impact of human activity. In each country and in a cooperative global effort, attention must be given to the impact of global warming for the survival of mankind. Development must follow the priority of human survival. Carbon dioxide emissions which have a substantial impact on global warming need to be limited or held constant. It has been suggested that sharp limits would require a sharp reduction in economic growth for both developing and developed countries. A collective effort is needed which aims to increase energy efficiency globally, to reduce destructive energy sources, and to develop alternative energy generation and technology. Scientific cooperation is needed for understanding the impact of weather changes on agricultural patterns and animal life. Notwithstanding the problem of safe technologies, population growth must also be curbed. Migration flows already reflect the income disparities. The gap between rich and poor must be narrowed. A mandate has been proposed for expansion of the UN Security Council to include environmental crises, and to replace the mandate of the Trusteeship Council with maintenance of the global environment. A constraint is the lack of representation of Third World countries in economic summits. The Group of 5 or 7 is concerned with the coordination of the economies for their respective countries. International Monetary Fund (IMF) and World Bank issues can be de facto vetoed by the Group of 5 or 7. Longterm economic and political sense dictates a more cooperative arrangement in the UN with developing countries, such as occurs within the IMF. There is a lack of accountability to any body of the global economy and the priority access of giant corporations. National, cultural, and religious continuity is desired. Nongovernmental organizations must be included in the UN network and regional bodies. With the decline in world detente, regional and indigenous conflicts will emerge. The question is how prepared is the UN or the world to make the necessary changes.
FAR EASTERN ECONOMIC REVIEW. 1992 Feb 20; 28-9.As the AIDS epidemic and HIV transmission in India increasingly resembles that observed in sub-Saharan Africa, Indian society's arrogant perception of invulnerability to the pandemic is proving to be considerably ill-conceived. The dimensions of the epidemic have multiplied greatly since AIDS was 1st identified among prostitutes in Madras, with the trends observed in Maharashtra and Tamil Nadu being especially ominous. AIDS has forced Indian society and research professionals to acknowledge the existence of domestic prostitution, homosexuals, and drug users. While only 103 AIDS cases and 6,400 HIV infections have been officially identified, it is clear that these cases represent only a tiny fraction of the true extent of the epidemic in India. The government will therefore spend up to US$7.75 million on an anti-AIDS program aimed at ensuring secure blood supplies, and checking heterosexual transmission through education and the promotion of condoms. The program also targets IV-drug users and truck drivers for education and behavioral change. India is the 2nd country after Zaire to accept foreign loans for such a purpose. It will receive US$85 million over 5 years from the World Bank in addition to supplemental funds from the WHO and the U.S. Weak attempts, however, have been made to test blood supplies, with only 15% being tested in Tamil Nadu. A large gap also remains between health educators and needy target groups. Finally, while some top officials realize the need for immediate action against AIDS, broad public awareness and coping will come only after AIDS mortality begins to mount in the population.
[Unpublished] 1991. Presented at the Demographic and Health Surveys World Conference, Washington, D.C., August 5-7, 1991. 32 p.Brazil's National Survey of Maternal-Child Health and Family Planning, conducted in 1986 as part of the international program of Demographic and Health Surveys, consolidated and extended the findings of 9 previous state-level surveys. This work outlines the impact of survey data on Brazil's private sector family planning organizations, donor agencies, the press and opinion leaders, and the federal government and legislators. The finding of the survey that the rate of contraceptive usage among women aged 15-44 married or in union was much higher than expected at 65.4%, initially suggested that the family planning organizations and donors had completed their tasks, but more careful scrutiny pointed up serious problems. Family planning problems identified in the survey included low levels of knowledge and use of contraception in the impoverished northeast and among groups with low levels of income and education; a very high proportion of users (80%) of just 2 methods, oral contraceptives (OCs) and female sterilization; low rates of use of other effective and reversible methods; a large number of unnecessary caesareans performed only to give the woman access to sterilization services, with fully 72% of sterilized women undergoing the procedure during a cesarean delivery; low average age (31.4 years) of sterilization acceptors and low parity of a substantial proportion; use of pharmacies to obtain supplies by over 93% of OC users and OC use at inappropriate ages; low male participation in family planning; and lack of family planning services for adolescents. The survey demonstrated the reality of family planning in Brazil and prompted a rethinking of the aims and goals of family planning programs. Many aspects of maternal-child health and sexual and reproductive health in addition to provision of contraceptives should be included in a high quality family planning program. The survey findings did not completely resolve all the polemics and controversies that have beset the family planning program in Brazil, but they helped dispel some charges against the program. For the most part, only the most strongly ideological opponents have remained unmoved.
HEALTH FOR THE MILLIONS. 1991 Aug; 17(4):20-3.Until recently, the only sustained AIDS activity in India has been alarmist media attention complemented by occasional messages calling for comfort and dignity. Public perception of the AIDS epidemic in India has been effectively shaped by mass media. Press reports have, however, bolstered awareness of the problem among literate elements of urban populations. In the absence of sustained guidance in the campaign against AIDS, responsibility has fallen to voluntary health activists who have become catalysts for community awareness and participation. This voluntary initiative, in effect, seems to be the only immediate avenue for constructive public action, and signals the gradual development of an AIDS network in India. Proceedings from a seminar in Ahmedabad are discussed, and include plans for an information and education program targeting sex workers, health and communication programs for 150 commercial blood donors and their agents, surveillance and awareness programs for safer blood and blood products, and dialogue with the business community and trade unions. Despite the lack of coordination among volunteers and activists, every major city in India now has an AIDS group. A controversial bill on AIDS has ben circulating through government ministries and committees since mid-1989, a national AIDS committee exists with the Secretary of Health as its director, and a 3-year medium-term national plan exists for the reduction of AIDS and HIV infection and morbidity. UNICEF programs target mothers and children for AIDS awareness, and blood testing facilities are expected to be expanded. The article considers the present chaos effectively productive in forcing the Indian population to face up to previously taboo issued of sexuality, sex education, and sexually transmitted disease.
PEOPLE. 1991; 18(1):7-8.This article attributes Sub-Saharan national population policy change to the attendance at the 2nd African Population Conference (APC) in Arusha in 1984, preliminary to attendance at the World Population Conference (WPC) in Mexico City in 1984, and the socioeconomic crises which precipitated the disparity between population growth and resources. Demographics are better understood. Family planning is now seen as reflecting traditional African values of birth spacing. Consequently countries have developed specific national policy statements. Liberia, Nigeria, Senegal in 1988, Zambia in 1989, and the Sudan in 1990, have developed comprehensive population policies in addition to those already established in Kenya and Ghana. Zaire and Zambia policies are in the process of endorsement; others formulating policy are Botswana, Burkina Faso, Cameroon, Chad, Cote d'Ivoire, Niger, Tanzania, Togo, and Zimbabwe. Policies are based on APC and WPC documents as well as the N'Djamena Plan of Action (1989). These guidelines tend to include detailed action and implementation plans, including targets for fertility reduction. Approaches to fertility reduction among specialists are still being debated. The significance of national population policy is as a public endorsement in addition to providing an analytical framework.