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International Journal of Gynecology and Obstetrics. 2008 Sep; 102(3):223-225.The editors of Contemporary Issues in Women's Health solicited reporters and correspondents from throughout the world to make contributions to this feature. Items submitted were stories on breastfeeding, FGM, Saudi women and ban on female drivers, and useful sources for women's health information.
Journal of School Health. 2008 Jul; 78(7):368-373.India made 2 important policy statements regarding tobacco control in the past decade. First, the India Tobacco Control Act (ITCA) was signed into law in 2003 with the goal to reduce tobacco consumption and protect citizens from exposure to secondhand smoke (SHS). Second, in 2005, India ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). During this same period, India conducted the Global Youth Tobacco Survey (GYTS) in 2003 and 2006 in an effort to track tobacco use among adolescents. The GYTS is a school-based survey of students aged 13-15 years. Representative national estimates for India in 2003 and 2006 were used in this study. In 2006, 3.8% of students currently smoked cigarettes and 11.9% currently used other tobacco products. These rates were not significantly different than those observed in 2003. Over the same period, exposure to SHS at home and in public places significantly decreased, whereas exposure to pro-tobacco ads on billboards and the ability to purchase cigarettes in a store did not change significantly. The ITCA and the WHO FCTC have had mixed impacts on the tobacco control effort for adolescents in India. The positive impacts have been the reduction in exposure to SHS, both at home and in public places. The negative impacts are seen with the lack of change in pro-tobacco advertising and ability to purchase cigarettes in stores. The Government of India needs to consider new and stronger provisions of the ITCA and include strong enforcement measures. (author's)
MMWR. Morbidity and Mortality Weekly Report. 2008 May 23; 57(20):545-549.Tobacco use is one of the major preventable causes of premature death and disease in the world. The World Health Organization (WHO) attributes approximately 5 million deaths per year to tobacco use, a number expected to exceed 8 million per year by 2030. In 1999, the Global Youth Tobacco Survey (GYTS) was initiated by WHO, CDC, and the Canadian Public Health Association to monitor tobacco use, attitudes about tobacco use, and exposure to secondhand smoke (SHS) among students aged 13-15 years. Since 1999, the survey has been completed by approximately 2 million students in 151 countries. A key goal of GYTS is for countries to repeat the survey every 4 years. This report summarizes results from GYTS conducted in Sri Lanka in 1999, 2003, and 2007. The findings indicated that during 1999-2007, the percentage of students aged 13-15 years who reported current cigarette smoking decreased, from 4.0% in 1999 to 1.2% in 2007. During this period, the percentage of never smokers in this age group likely to initiate smoking also decreased, from 5.1% in 1999 to 3.7% in 2007. Future declines in tobacco use in Sri Lanka will be enhanced through development and implementation of new tobacco-control measures and strengthening of existing measures that encourage smokers to quit, eliminate exposure to SHS, and encourage persons not to initiate tobacco use. (excerpt)
MMWR. Morbidity and Mortality Weekly Report. 2008 Jan 25; 57(1):1-28.Tobacco use is a major contributor to deaths from chronic diseases. The findings from the Global Youth Tobacco Survey (GYTS) suggest that the estimate of a doubling of deaths from smoking (from 5 million per year to approximately 10 million per year by 2020) might be an underestimate because of the increase in smoking among young girls compared with adult females, the high susceptibility of smoking among never smokers, high levels of exposure to secondhand smoke, and protobacco indirect advertising. This report includes GYTS data collected during 2000-2007 from 140 World Health Organization (WHO) member states, six territories (American Samoa, British Virgin Islands, Guam, Montserrat, Puerto Rico, and the U.S. Virgin Islands), two geographic regions (Gaza Strip and West Bank), one United Nations administered province (Kosovo), one special administrative region (Macau), and one Commonwealth (Northern Mariana Islands). For countries that have repeated GYTS, only the most recent data are included. For countries with multiple survey sites, only data from the capital or largest city are presented. GYTS is a school-based survey of a defined geographic site that can be a country, a province, a city, or any other geographic entity. GYTS uses a standardized methodology for constructing sampling frames, selecting schools and classes, preparing questionnaires, conducting field procedures, and processing data. GYTS standard sampling methodology uses a two-stage cluster sample design that produces samples of students in grades associated with students aged 13-15 years. Each sampling frame includes all schools (usually public and private) in a geographically defined area containing any of the identified grades. In the first stage, the probability of schools being selected is proportional to the number of students enrolled in the specified grades. In the second sampling stage, classes within the selected schools are selected randomly. All students in selected classes attending school the day the survey is administered are eligible to participate. Student participation is voluntary and anonymous using self-administered data collection procedures. The GYTS sample design produces independent, cross-sectional estimates that are representative of each site. The findings in this report indicate that the level of cigarette smoking between boys and girls is similar in many sites; the prevalence of cigarette smoking and use of other tobacco products is similar; and susceptibility to initiate smoking among never smokers is similar among boys and girls and is higher than cigarette smoking in the majority of sites. Approximately half of the students reported that they were exposed to secondhand smoke in public places during the week preceding the survey. Approximately eight in 10 favor a ban on smoking in public places. Approximately two in 10 students own an object with a cigarette brand logo on it, and one in 10 students have been offered free cigarettes by a tobacco company representative. Approximately seven in 10 students who smoke reported that they wanted to stop smoking. Approximately seven in 10 students who smoked were not refused purchase of cigarettes from a store during the month preceding the survey. Finally, approximately six in 10 students reported having been taught in school about the harmful effects of smoking during the year preceding the survey. The findings in this report suggest that interventions that decrease tobacco use among youth (e.g., increasing excise taxes, media campaigns, school programs in conjunction with community interventions, and community interventions that decrease minors' access to tobacco) must be broad-based, focused on boys and girls, and have components directed toward prevention and cessation. If effective programs are not developed and implemented soon, future morbidity and mortality attributed to tobacco probably will increase. The synergy between countries in passing tobacco-control laws, regulations, or decrees; ratifying the WHO Framework Convention on Tobacco Control; and conductingGYTS offers a unique opportunity to develop, implement, and evaluate comprehensive tobacco-control policy that can be helpful to each country. The challenge for each country is to develop, implement, and evaluate a tobacco-control program and make changes where necessary. (author's)
Non-communicable diseases and global health governance: Enhancing global processes to improve health development.
Globalization and Health. 2007 May 22; 3(1):2.This paper assesses progress in the development of a global framework for responding to non-communicable diseases, as reflected in the policies and initiatives of the World Health Organization (WHO), World Bank and the UN: the institutions most capable of shaping a coherent global policy. Responding to the global burden of chronic disease requires a strategic assessment of the global processes that are likely to be most effective in generating commitment to policy change at country level, and in influencing industry behaviour. WHO has adopted a legal process with tobacco (the WHO Framework Convention on Tobacco Control), but a non-legal, advocacy-based approach with diet and physical activity (the Global Strategy on Diet, Physical Activity and Health). The paper assesses the merits of the Millennium Development Goals (MDGs) and the FCTC as distinct global processes for advancing health development, before considering what lessons might be learned for enhancing the implementation of the Global Strategy on Diet. While global partnerships, economic incentives, and international legal instruments could each contribute to a more effective global response to chronic diseases, the paper makes a special case for the development of international legal standards in select areas of diet and nutrition, as a strategy for ensuring that the health of future generations does not become dependent on corporate charity and voluntary commitments. A broader frame of reference for lifestyle-related chronic diseases is needed: one that draws together WHO's work in tobacco, nutrition and physical activity, and that envisages selective use of international legal obligations, non-binding recommendations, advocacy and policy advice as tools of choice for promoting different elements of the strategy. (author's)
Toxicology. 2004 May 20; 198(1-3):39-44.The United States Public Health Service set an interim standard of 50 mg/l in 1942, but as early as 1962 the US Public Health Service had identified 10 mg/l as a goal which later became the World Health Organization Guideline for drinking water in 1992. Epidemiological studies have shown that about one in 10 people drinking water containing 500 mg/l of arsenic over many years may die from internal cancers attributable to arsenic, with lung cancer being the surprising main contributor. A prudent public health response is to reduce the permissible drinking water arsenic concentrations. However, the appropriate regulatory response in those developing countries with large populations with much higher concentrations of arsenic in drinking water, often exceeding 100 mg/l, is more complex. Malnutrition may increase risks from arsenic. There is mounting evidence that smoking and arsenic act synergistically in causing lung cancer, and smoking raises issues of public health priorities in developing countries that face massive mortality from this product. Also, setting stringent drinking water standards will impede short term solutions such as shallow dugwells. Developing countries with large populations exposed to arsenic in water might reasonably be advised to keep their arsenic drinking water standards at 50 mg/l. (author's)
Annals of Oncology. 2006; 17 Suppl 8: p..The burden of cancer in developing countries is growing and threatens to exact a heavy morbidity, mortality, and economic cost in these countries in the next 20 years. The unfolding global public health dimensions of the cancer pandemic demand a widespread effective international response. The good news is that the majority of cancers in developing countries are preventable, and the efficacy of treatment can be improved with early detection. Currently, the knowledge exists to implement sound, evidence-based practices in cancer prevention, screening/early detection, treatment, and palliation. It is estimated that the information at hand could prevent up to one-third of new cancers and increase survival for another one-third of cancers detected at an early stage. To achieve this, knowledge must be translated into action. To facilitate the call to action in the fight against cancer, the World Health Organization (WHO) has developed a comprehensive approach to cancer control. The WHO has produced many valuable guidelines and resources for the effective implementation of national cancer control programs. Several milestones in the WHO's efforts include the Framework Convention for Tobacco Control, and global strategies for diet and exercise, reproductive health, and cervical cancer. This review examines the strategies and approaches that have successfully resulted into global action to confront the rising global burden of cancer in the developing world. (author's)
Over-the-counter access, changing WHO guidelines, and contraindicated oral contraceptive use in Mexico.
Studies in Family Planning. 2006 Sep; 37(3):197-204.This study examines the prevalence of contraindications to the use of oral contraceptives in Mexico by sociodemographic characteristics and by whether this family planning method was obtained with or without a doctor's prescription. Using data on smoking behavior and blood-pressure measurements from the 2000 Mexican National Health Survey, the authors found that, under the 1996 World Health Organization (WHO) medical eligibility guidelines, the prevalence of contraindications is low and that no significant differences in contraindications exist at any level between those who obtain oral contraceptives at clinics and those who obtain them at pharmacies. In 2000, however, WHO substantially revised its criteria regarding the level of hypertension that would constitute a contraindication for oral contraceptive use. Applying the new guidelines, the authors found that 10 percent of pill users younger than 35 and 33 percent aged 35 and older have health conditions that are either relative or absolute (Category 3 or 4) contraindications. The relevance of these findings to the larger debate concerning screening and over-the-counter access to oral contraceptives is discussed. (author's)
FHI's quick reference chart for the WHO medical eligibility criteria for contraceptive use. To initiate or continue the use of combined oral contraceptive (COC), Noristerat (NET-EN), Depo-Provera (DMPA), copper intrauterine device (Cu-IUD).
[Research Triangle Park, North Carolina], FHI, 2004 Mar.  p.I/C (Initiation/Continuation): A woman may fall into either one category or another, depending on whether she is initiating or continuing to use a method. For example, a client with current PID who wants to initiate IUD use would be considered as Category 4, and should not have an IUD inserted. However, if she develops PID while using the IUD, she would be considered as Category 2. This means she could generally continue using the IUD and be treated for PID with the IUD in place. Where I/C is not marked, a woman with that condition falls in the category indicated - whether or not she is initiating or continuing use of the method. (excerpt)
Bulletin of the World Health Organization. 2004 Dec; 82(12):923-927.Using religion to improve health is an age-old practice. However, using religion and enlisting religious authorities in public health campaigns, as exemplified by tobacco control interventions and other activities undertaken by WHO's Eastern Mediterranean Regional Office, is a relatively recent phenomenon. Although all possible opportunities within society should be exploited to control tobacco use and promote health, religion-based interventions should not be exempted from the evidence-based scrutiny to which other interventions are subjected before being adopted. In the absence of data and debate on whether this approach works, how it should be applied, and what the potential downsides and alternatives are, international organizations such as WHO should think carefully about using religion-based public health interventions in their regional programmes. (author's)
Respect for AIDS victims rights, wars against polio, smoking asked - World Health Assembly - includes related article.
UN Chronicle. 1988 Sep; 25(3): p..Respect for the human rights of victims of acquired immune deficiency syndrome (AIDS) and campaigns against polio and smoking have been called for by the 41st World Health Assembly. The 166-member body which guides the work of the World Health Organization (WHO), also urged that "unprecedented measures" be taken to help the least developed countries improve the health of their people. Governments were also called on to increase their primary health care efforts in order to attain the WHO goal of "Health for All by the Year 2000" so that all the peoples of the world could lead socially and economically productive lives. At a solemn ceremony on 4 May to celebrate the 40th anniversary of WHO, outgoing Director-General Dr Halfdan Mahler said the organization had made "a unique contribution to the restoration of social justice in health matters by demonstrating how health can be achieved by all and not just by the privileged few". (excerpt)
UN Chronicle. 1986 Aug; 23: p..The World Health Assembly at its thirty-ninth session (Geneva, 5-16 May) called for action to improve health strategies of developing countries and to combat drug abuse, tobacco use and the acquired immune deficiency syndrome (AIDS) eqidemic. Delegates representing most of the 166 member States of the World Health Organization (WHO) expressed support for the WHO "Global Strategy for Health for All by the Year 2000' and appealed to developed countries and international organizations and agencies to assist developing countries with their national health strategies. The appeal, contained in a resolution adopted on 15 May, was made in view of the "widespread economic crisis which had resulted in a fall in living standards in many countries and provoked serious unemployment and formidable austerity policies', which in some countries resulted in substantial cuts in health care. The crisis, particularly in developing countries, had been aggravated by the persistent rise in the foreign debt and deterioration of the balances of trade', and endangered the possibility of reaching the goal of health for all by the year 2000. (excerpt)
UN Chronicle. 1986 Apr; 23: p..The first global evaluation of the World Health Organization's "Strategy for Health for All by the Year 2000' was reviewed by the 31-member Executive Board of the World Health Organization (WHO)(Geneva, 8-22 January). The Board also demanded action to protect the rights of non-smokers and to prevent and control the spread of the Acquired Immune Deficiency Syndrome (AIDS). The Board also asked for a special report on health and development in Africa, for review by the special session of the United Nations General Assembly on the critical economic situation in Africa in May. Noting that 86 per cent of Member States had reported on evaluation of their national health strategies, the Board urged all Member States to work towards reducing "socioeconomic and related health disparities among people'. (excerpt)
Lancet. 2005 Nov 5; 366(9497):1586.Next week, on Nov 8, an important deadline for ratifying the WHO Framework Convention on Tobacco Control (FCTC) approaches. Any country that has not ratified the convention by then will not become a full party to its governing body, which will meet for the first time at the Conference of the Parties in Geneva, Feb 6–17, next year. At that meeting parties will take decisions on technical, procedural, and financial issues relating to the implementation of the convention. The FCTC has been rightly hailed as a milestone for the promotion of public health worldwide and WHO can be proud of its achievement. So far, 94 countries have ratified the FCTC, 41 of these in 2005, with China, Rwanda, Nigeria, Cyprus, and the Democratic Republic of the Congo becoming the latest nations to do so this October. China, with the world’s largest cigarette market and with an estimated 350 million smokers, is a particularly important signatory. By ratifying the FCTC, China has taken an important and welcome step to protect its people’s health. Rapid economic changes make China’s large population especially vulnerable to a future epidemic of chronic diseases. (excerpt)
Manila, Philippines, WHO, Regional Office for the Western Pacific, 2003.  p.This educational package is designed for the use of individuals, groups, and organizations involved in promoting adolescent health and development among a variety of audiences. The main target users are primary health care givers - doctors, nurses and midwives - who deal with adolescents in various settings, and who wish to involve their colleagues in advocacy work for and with adolescents. This package can also be useful for programme managers and policy-makers advocating adolescent health and development programmes and policies. In whole or in part, this package can be used to structure workshops and discussions on adolescent health and development issues. Ideally, adolescents should be invited to participate in these activities in order to achieve heightened understanding of their needs and concerns. The image of a butterfly emerging from its cocoon is depicted many times in this package. This symbolizes the metamorphosis that takes place as adolescents go through development. This image serves to remind us of the need to nurture adolescents as they go through this challenging phase. The image also foretells what adolescents can be, as they transform into the future of their countries. (excerpt)
Geneva, Switzerland, World Health Organization [WHO], 2001. 62 p. (WHO/NMH/TFI/ 01.3 Rev. 1)This paper examines the major problems posed by tobacco as they relate to the provisions of the Convention on the Rights of the Child, particularly in relation to civil rights and freedoms, basic health and welfare, and child labour. The UN Convention on the Rights of the Child was adopted by the UN General Assembly on 20 November 1989 and came into force in September 1990. Interpretation of the articles of the Convention by the Committee on the Rights of the Child and the practice of States demonstrates that tobacco is indeed a human rights issue. As a legally binding international Convention, ratified States are legally bound to ensure that children can enjoy all of the rights guaranteed under the Convention, including protection from tobacco. According to the World Health Organization (WHO), around 4 million people die prematurely from tobacco-related illness each year, with deaths expected to rise to 10 million annually by the year 2030. Many of tobacco's future victims are today's children. Tobacco use generally begins during adolescence and continues through adulthood, sustained by addiction to the nicotine in tobacco. Although the scientific evidence that tobacco use causes death and disease is overwhelming, tobacco use among young people continues to rise as the tobacco industry aggressively promotes its products to a new generation of potential smokers. If current trends continue, 250 million children alive today will be killed by tobacco. (excerpt)
In: Towards adulthood: exploring the sexual and reproductive health of adolescents in South Asia, edited by Sarah Bott, Shireen Jejeebhoy, Iqbal Shah, Chander Puri. Geneva, Switzerland, World Health Organization [WHO], Department of Reproductive Health and Research, 2003. 31-42.The World Health Organization defines “adolescence” as 10–19 years old, “youth” as 15– 24 years old, and “young people” as 10–24 years old. Nevertheless, adolescence should be considered a phase rather than a fixed age group, with physical, psychological, social and cultural dimensions, perceived differently by different cultures. As a group, adolescents include nearly 1.2 billion people, about 85% of whom live in developing countries. Behaviours formed in adolescence have lasting implications for individual and public health and, in many ways, a nation’s fate lies in the strength and aspirations of its youth—important reasons to invest in adolescent health and development. This presentation describes the general situation of adolescent health (exploring adolescent sexual and reproductive health in particular) and highlights some key elements of successful programmes. (excerpt)
Lancet. 2004 Apr 3; 363(9415):1162.I commend Lee Jong-Wook for his Public health article, the most shocking statistic of which highlights the fact that almost a fifth of all deaths across the world occur in developing countries in children younger than 5 years. Efforts by WHO to alleviate this terrible burden are to be acclaimed. I find it disheartening, however, that a 5000-word essay on global health improvement makes only a few general references to noncommunicable diseases and fails to mention the Framework Convention on Tobacco Control (FCTC), one of WHO’s signal achievements. In fact, the words smoking and tobacco do not appear anywhere in the article, despite WHO’s acknowledgment that 4·9 million people are dying each year from tobacco use—a figure that will double within a generation. According to WHO’s own statistics, the burden of disease is currently shared evenly by developed and developing countries, but 70% of this risk will be borne by those in developing countries by the 2020s. (excerpt)
Health Promotion International. 2003; 18(3):255-264.In the World Health Organization's Western Pacific Region, being born male is the single greatest risk marker for tobacco use. While the literature demonstrates that risks associated with tobacco use may vary according to sex, gender refers to the socially determined roles and responsibilities of men and women, who initiate, continue and quit using tobacco for complex and often different reasons. Cigarette advertising frequently appeals to gender roles. Yet tobacco control policy tends to be gender-blind. Using a broad gender-sensitivity framework, this contradiction is explored in four Western Pacific countries. Part I of the study discusses issues surrounding gender and tobacco, and analyses developments in Malaysia and the Philippines. Part II deals with Singapore and Vietnam. In all four countries, gender was salient for the initiation and main tenance of smoking, and in Malaysia and the Philippines was highly significant in cigarette promotion. Yet, with a few exceptions, gender was largely unrecognized in control policy. Suggestions for overcoming this weakness in order to enhance tobacco control are made in Part II. (author's)
Tashkent, Uzbekistan, Analytical and Information Center, 2003 May. ix, 30 p.This preliminary report documents the changes that have occurred in the medical-demographic situation of Uzbekistan since the 1996 Demographic and Health Survey. Additional information is provided concerning issues of both male and female adult health: life style practices, knowledge and attitudes towards tuberculosis, HIV/AIDS, STDs, risk factors for cardiovascular diseases, and information about respiratory, digestive, and dental diseases. (excerpt)
New York Times. 2002 Oct 31;  p..The World Health Organization today identified 10 major health risks it said accounted for up to 40 percent of the 56 million deaths around the world each year. The 10 risks are lack of food, unsafe sex, high blood pressure, smoking, alcohol, unsafe water or sanitation, high cholesterol, nutritional deficiencies, obesity and indoor smoke from cooking or heating fires, predominantly in Africa and South Asia. (excerpt)
Lancet. 2002 Oct 12; 360(9340):1108-1110.This paper reports on the organization and administration of WHO under the management of Director-General Gro Harlem Brundtland. It describes the three broad categories of the work of WHO and the several areas that are considered to be organization-wide priorities for WHO.
Geneva, Switzerland, WHO, 1996 Aug. 6 p. (Fact Sheet N 127)This fact sheet presents trends in substance use and associated health problems, facts about alcohol, tobacco addiction, and WHO programs that address these social problems.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1988; (773):1-81.This booklet presents the report of the Study Group on Smokeless Tobacco Control to the World Health Organization. The use of smokeless tobacco is increasing. 3 million people in the US and over 100 million people in India and Pakistan use some form of it -- snuff, chewing tobacco, or betel quid. They contain nicotiana and areca alkaloids, nitrosamines, phenols, aldehydes, and numerous other mutagenic and carcinogenic compounds. Smokeless tobacco has been associated with oral, nasal, pharyngeal, laryngeal, pancreatic and urinary cancers, as well as precancerous oral effects, such as leukoplakia. Smokeless tobacco has all the same effects on the cardiovascular system as nicotine in cigarettes, and it is equally addictive. In countries where smokeless tobacco is not yet used, its manufacture or importation should be forbidden, and in countries where it is already in use, all forms of promotion should be forbidden. Smokeless tobacco products should be highly taxed and should carry health warnings. Educational campaigns should be used to make the public, especially teenagers and young adults, aware of the danger. The greatest obstacles to the control of smokeless tobacco will be the tobacco companies, and action should be taken to keep them from gaining control in developing countries where smokeless tobacco-making is still mainly a cottage industry. The World Health Organization, member states, other UN agencies, and intergovernmental organizations should cooperate in this campaign. The Study Group recommended to the World Health Organization that promotion of smokeless tobacco should be banned, taxes on it should be raised, priority should be given to replacing tobacco by other crops, sales to minors should be prohibited, products should be required to display health warnings, smokeless tobacco use should be banned in public places, education campaigns should be directed at decision-makers and young people, smokeless tobacco should be included in the World Health Organization's program combatting tobacco, and the World Health Organization should cooperate with other international organizations to control smokeless tobacco.
Geographical variation in the major risk factors of coronary heart disease in men and women aged 35-64 years.
WORLD HEALTH STATISTICS QUARTERLY/RAPPORT TRIMESTRIEL DE STATISTIQUES SANITAIRES MONDIALES. 1988; 41(3-4):115-40.This is an overview of the WHO MONICA project which was "designed to measure the trends in mortality and morbidity from coronary heart disease (CHD) and stroke, and to assess the extent to which they are related to changes in known risk factors in different populations in 27 countries. Risk-factor data are collected from population samples examined in at least two population surveys (one at the beginning of the study and the other at the end). The results of the baseline population surveys are presented." Risk factors considered include smoking, and blood pressure and cholesterol levels for men and women. (SUMMARY IN FRE) (EXCERPT)