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AMBIO. 1992 Feb; 21(1):112-5.The UN can set standards and provide a framework for collaborative projects, but sustainable development will require the full participation of many sectors of society, both public and private. This review of sustainable development considers the role of UN-sponsored special conferences in the past 20 years, identifies a conceptual tool for assessing options, and suggests a global action plan that radically restructures the UN, based on popular sovereignty. The concern is for the protection of popular rights and welfare that could be ignored by powerful governments and powerful transnational corporations beyond government control; responsibility for the environment, natural resources, technologies, and other global issues cannot be overlooked. The concept is to develop an "international public sector for the management of interdependence" which can correct, as necessary the "international market process and ensure equitable distribution of resources." The Stockholm Conference on the Human Environment in 1972 marked the beginning of special conferences dealing with sustainable development. The UN General Assembly in 1974 adopted a mandate and programs for increasing the pace of economic and social development. In 1980 and 1990 further UN development strategies were adopted. The most recent strategy incorporated much from the Brundtland Commission Report but did not urge the change in attitudes and orientation of political and economic institutions. The Assembly of the World Conservation Union (IUCN) adopted strategies for conservation and development in 1990. Nongovernmental organizations have united to cooperate in the global effort to achieve sustainable development. However, there are 5.4 billion people and an increase of 2 billion expected in 20 years. Bureaucratic rivalry and the inherent weakness of the UN has lead to splintering of objectives and irrelevant decision making. After concept development, which is a noteworthy effort, there must be negotiation with government delegates and policy planners and decision makers. The priorities are to shift from economic development to social development, to shift from maximum use of inappropriate technologies to resource efficient and saving technologies, and integration of population with national environmental strategies.
How to estimate incremental resource requirements and costs of alternative TT immunization strategies: a manual for health and program managers. Revised version.
Arlington, Virginia, John Snow, Inc. [JSI], Resources for Child Health Project [REACH], 1989 Jun. , 22 p. (USAID Contract No. DPE-5927-C-00-5068-00)The REACH Project originally prepared this manual for health and program managers for WHO workshops in Africa on the control of neonatal tetanus. The manual provides rapid methods for determining incremental resource requirements and costs of tetanus toxoid (TT) immunization programs. Its design allows for flexibility. It categorizes costs into variable costs such as vaccines, syringes, and needles and fixed costs such as training, personnel, supervision, and transportation. The manual provides a worksheet for calculating the variable costs for programs which requires the managers to consider the target population (pregnant women or women of childbearing age) and coverage objective (TT2 or TT5). Further it presents a formula for determining costs of additional personnel (a variable cost): personnel costs=number of workers x proportion of time for TT vaccination for each worker x annual gross earnings of each workers. It also has guidelines for determining fixed costs such as cold chain equipment costs. Transportation costs consists mostly of fuel costs but also includes the costs of vehicles to move vaccines, supplies, and personnel. Training costs include production of training materials, travel, per diem, and proportion of annual salaries of trainers and trainees for training time. The manual also has worksheets for determining supervision and monitoring costs. Further it has a worksheet to calculate additional media costs for TT immunization including radio. TV, and posters. Once managers have determined the costs of various components of TT immunization programs, they can sum the costs up and determine the cost effectiveness of TT immunization strategies on another worksheet. The manual concludes with a formula to assist managers determine whether changing from 1 strategy to another would save them more money and be more cost effective.