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The role of food safety in health and development. Report of a Joint FAO-WHO Expert Committee on Food Safety.
World Health Organization Technical Report Series. 1984; (705):1-79.This document presents the recommendations of a Joint Food and Agriculture Organization (FAO)-World Health Organization (WHO) Expert Committe on Food Safety. Illness due to contaminated food is perhaps the most widespread health problem in the world and a major cause of reduced economic productivity. The safety of food is affected by food systems, sociocultural factors, food chain technology, ecologic factors, nturitional aspects, and epidemiology. It was the assumption of the Committee that, if food safety is given sufficient priority within national planning, countries can prevent and control foodborne disease, especially pathogen-induced diarrheal syndromes, and interrupt the vicious cycle of diarrhea-malnutrition-disease. Attainment of this objective requires a national commitment and the collaboration of all ministries and agencies concerned with health, agriculture, finance, planning, and commerce as well as the food industry, the biamedical and agricultural scientific community, and the consuming public. Prevention and control interventions should aim to avoid or minimize contamination, to destroy or denature the contaminant, and to prevent the further spread or multiplication of the contaminant. The Committee outlined a series of recommendations for achieving a worldwide reduction in the morbidity and mortality caused by foodborne hazards. Food safety should be considered an integral part of the primary health care delivery system. Food safety should also be regarded as an integral part of the total food system. National food control infrastructures should be strengthened, and regional, national, multinational, and international surveillance of foodborne diseases should be carried out. Each country should aim to develop at least 1 laboratory capable of identifying the etiologic agents of diarrhea and other foodborne diseases. Health workers should be trained to play a role in identifying and monitoring critical control points in food production and preparation. Health education, within the context of the cultural and social values of the community, should inform the public about food safety hazards and preventive measures. Finally, the hazard analysis critical control point approach to prevention is recommended.
In: Mortality and health policy. Proceedings of the Expert Group on Mortality and Health Policy, Rome, 30 May to 3 June 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 270-88. (International Conference on Population, 1984; ST/ESA/SER.A/91)This paper reviews the technical cooperation efforts undertaken by the United Nations Department of Technical Cooperation for Development (DTCD) to help combat the high mortality levels in developing countries and to evolve policies in response to the World Population Plan of Action. Although the transfer of medical technology and the provision of drugs and other medical supplies remain important means of controlling death and disease, there is growing recognition of the need to develop national skills to deal with mortality, to maintain a continuous record of mortality and morbidity levels and their response to ameliorative programs, and to analyze the interrelationships between demographic, health, and socioeconomic variables. DTCD has focused on data collection and analysis, the integration of research findings into population policy formulation, and training and skill development to facilitate self-reliance. However, the lack of regular mechanisms for coordinating the activities of the various United Nations agencies that play a role in in technical cooperation in the areas of mortality and health policy has been a serious limitation. Another problem has been the dearth of tested alternative techniques for conducting simple health surveys whose results could be used in planning. Closer cooperation between United Nations agencies in this field is urged. It is also important that the recent reassignment of a low priority to data collection and analysis on the part of the United Nations Development Program be reversed. Unless data collection, analysis, and evaluation are reassigned a high priority, planners will be forced to depend on subjective judgments to evolve mortality policies. Finally, technical cooperation activities that aim to integrate mortality and morbidity control into population policies must be responsive to human rights.
Mortality and health policy: highlights of the issues in the context of the World Population Plan of Action.
In: Mortality and health policy. Proceedings of the Expert Group on Mortality and Health Policy, Rome, 30 May to 3 June 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 37-79. (International Conference on Population, 1984.; ST/ESA/SER.A/91)This paper reviews the major issues that have emerged in the analysis of mortality and health policy since the 1974 World Population Conference. The 1st part summarizes current mortality conditions in the major world regions and evaluates progress toward achieving the goals of the World Population Plan of Action. It is noted that the current mortality situation is characterized by continued wide disparities between the more developed and less developed regions, especially during the 1st year of life. The 2nd part focuses on the synergistic relationship between health and development, including social, economic, and health inequalities. It is asserted that mortality rates in developing countries are a function of the balance governments select between development strategies favoring capital accumulation and concentrated investments on the 1 hand and strategies oriented toward meeting basic needs and reducing inequalities in income and wealth. Data from developed countries suggest that economic development does not necessarily lead to steady gains in life expectancy. Some variations in mortality may reflect changes in family relationships, especially women's status, that are induced by social and economic development, however. The 3rd part of this paper analyzes the effect of health policies on mortality, including curative and preventive programs and primary health care. The lack of community participation is cited as a key factor in the weak performance of primary health care in many developing countries. In addition, there is strong evidence that the concepts and technologies of modern medicine must be adapted to existing systems of disease prevention and care to gain acceptability. The 4th section, on the implementation of health policies, discusses health care management, planning, and financing. It is noted that successful implementation of health policies is often hindered by scarcity, inadequate allocation, and inefficient utilization of health resources. Finally, more effective means to cope with rising costs of health care are needed.
In: Ghosh PK, ed. Health, food and nutrition in Third World development. Westport, Connecticut, Greenwood Press, 1984. 125-52. (International Development Resource Books No. 6)Malnutrition is a serious problem which can be solved only through the development of an effective international network of organizations and agencies committed to nutritional intervention. The magnitude of the malnutrition problem is described, the inadequacies of the current international structure to deal effectively with the problem are delineated, and suggestions for overcoming these inadequacies are provided. 1.3 billion individuals, or 2/3 of the population of the developing countries, suffer from some form of nutritional deficiency, and 900 million or these individuals, or 50% of the population of the developing countries, have a severe daily deficit of 250 calories. The major cause of malnutrition is poverty rather than food shortages. Other factors which contribute to malnutrition include cultural practices, health beliefs, cooking practices, intrafamily food distribution patterns, and deficient food production and distribution systems. Inaction in addressing these problems stems from a lack of coordination between the many agencies which deal with the problem, the failure to develop national and international nutrition policies, and a lack of knowledge about nutrition problems and the relative costs and benefits of different types of nutrition interventions. Currently there are a vast number of organizations and agencies which deal with nutrition either as a primary or secondary task. The majority of these organizations, committees, groups, and agencies are part of the UN structure. Many other national and voluntary agencies which have nutrition programs also have links with agencies within the UN. Although these diverse groups all interact with each other, there is a glaring lack of coordination between them. The functions performed by this loosely structured network include 1) collecting and dissemination information; 2) providing food, supplies, and technical assistance; 3) financing; and 4) coordination. Each of these functions is described, and the major organizations which perform these tasks are noted. Factors which reduce the effectiveness of the network include 1) inadequate coordination, 2) a failure to allocate responsibility and to delineate lines of authority, 3) inadequate review and evaluation mechanism, 4) a failure to depoliticize staff recruitment policies, and 5) the hesitancy of international agencies to take a stand on nutrition issues for fear of being accused of lacking respect for national sovereignty. Efforts to improve the current situation should include revamping the structure of the UN's nutrition network and expanding the role of the recently created World Food Council (WFC) of the UN. The WFC should assume the role coordinating the international network and of delineating the tasks of each agency or group within the network. The capacity of the WFC to function effectively in a leadership role will be realized only if the member states, especially the US and USSR, are willing to delegate sufficent authority to the WFC. In addition, nations and international agencies must place a higher priority on eradicating malnutrition and develop policies in accordance with this priority. Research directed toward identifying the costs and benefits of specific types of nutrition interventions can facilitate the development of effective policies.
London, England, IPPF, 1984 May. ii, 59 p.The Bellagio consultation was held in July, 1983 on the initiative of the Programme Committee of International Medical Advisory Panel to consider more closely what the needs of adolescents are and what more should be done to meet them. Participants from several countries--within and outside of IPPF--were invited. Before the Consultation, participants exchanged information, experience and ideas in writing as a basis for their discussion. 3 topics were focused on: 1) needs and problems; 2) information, education, and counselling; and 3) reproductive health management. An action plan for the next 3 to 5 years was drawn up. It offers broad suggestions about the kind of activities that would be appropriate for family planning associations and IPPF to take. Adolescents all over the world are in need of much better education and health care related to fertility, these are not the same in each society. A comprehensive approach to adolescent needs is favored. The recommendations form part of a broad discussion about how adolescents can best be helped to behave responsibly. Adolescent fertility has implications for health, psychological, social and economic well being. General program and operational guidelines are given, as are 8 areas for action: 1) creation of awareness and advocacy; 2) youth leadership and participation in adolescent programs; 3) information and education; 4) counseling; 5) fertility-related services; 6) sharing of experience, information and resources; 7) training and skill development; and 8) research. A list of participants and background papers is given.
[A possible objective from now to the year 2000: reduce infant mortality in the third world by half] Un objectif possible d'ici 1' an 2000: reduire de moitie la mortalite infantile dans les pays du tiers-monde
Hygiene Mentale. 1984 Jun; 3(2):41-9.Every day 40,000 children die throughout the world, most of them in developing countries. There is a close relationship between infant mortality, life expectancy at birth, the adult literacy rate and national income per capita. Why such huge differences between the infant mortality rate of 7/1000 (live births) in Sweden and 208 in Upper Volta? The 4 scourges which afflict developing countries: hunger (malnutrition), disease, ignorance and poverty are responsible for this state of affairs. The author suggests that coordinated action by governments and International Agencies should be taken to halve the infant mortality rate by the year 2000. He notes that in the past 3 mistakes were made which should not be repeated. The 1st was to improve the living conditions of the population. The green revolution in India provides a striking example of an important progress which benefited only the wealthier farmers. A 2nd mistake was to believe that only a medical approach reduces the infant mortality rate. A 3rd error was to overlook the importance of health education and not to seek the active participation of the people concerned. The author recalls that the International Union for Health Education carried out a sanitary and social program from 1975 to 1978 in Africa, south of the Sahara. To this effect, the IUHE had to find out what the people really wanted, whether they could be motivated to increase the welfare of the villagers by measures adapted to existing possibilities, and to study how the people could recruit health workers among the villagers and train them to create village health committees. 4 weapons used together should reduce the infant mortality rate by 1/2 in the developing world before the end of the century. They are: the promotion of breast feeding, the extended coverage of vaccinations, the early detection of malnutrition and the treatment at hoem of diarrheic diseases thanks to oral rehydration. (author's modified) (summaries in ENG, SPA)
Australian Society. 1984 Jun 1; 3(6):27-8.An estimated 15 million infants, largely from Africa, Asia, and Latin America, died in 1983. Many countries in the Third World have infant mortality rates of 150-200/1000 live births. UNICEF has outlines 7 steps that could significantly reduce the infant mortality rate: 1) use of growth monitoring charts, 2) oral rehydration therapy, 3) breastfeeding for at least 1 year, 4) a massive immunization campaign, 5) food supplementation for pregnant women and children at risk, 6) a family spacing education campaign, and 7) extension of female education. 2 other measures not emphasized by UNICEF but important for the health and survival of children are a government system of welfare for the care of the aged to partially solve the need for children and the equal valuation of male and female children. Concerned Australians are urged to spread the word about the UNICEF report, provide funds, and influence the Australian government to offer help through UNICEF to developing countries. Technically qualified people can go to Third World countries and work for better conditions. It should be noted, however, that Australia has its own Third World sector. The Aboriginal population is severely disadvantaged in terms of all the major indicators of quality of life. The infant mortality rate among Aboriginals is 25/1000 live births, which is 2.5 times the Australian national average. Life expectancy at birth is 53 years, or 20 years less than the national average. 80% of Aboriginals have no educational qualifications, and 80% are unemployed. Aboriginal households have less than 60% the average income available to non-Aboriginal households and the housing of the majority of the Aboriginal population is substandard.