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  1. 51
    282114

    The contemporary response of the Brazilian government, the civil society and UNESCO to the HIV / AIDS epidemic. CCO Meeting, New York, New York, October 2003. [Respuesta contemporánea del gobierno brasileño, la sociedad civil y la UNESCO a la epidemia de VIH/SIDA. Reunión del Comité de Organizaciones Copatrocinadoras, Nueva York, Nueva York, octubre de 2003]

    UNESCO

    Brasilia, Brazil, UNESCO / Brazil, 2004. [10] p. (BR/2004/PI/H/1)

    Brazil has handled HIV/AIDS problems with much innovation and effectiveness, thereby creating good practices that other countries can learn from. As a universal organization, with a mandate encompassing the whole world, UNESCO must seek solutions wherever it can. Today, preventive education to fight HIV/AIDS is at the top of its agenda. Hence we must draw lessons from Brazil's experience so that your example can save lives and help development elsewhere: in Latin America, in Asia, in Africa, in Europe. We must learn from Brazil. We must learn fast. And we must apply what we learn quickly and effectively. (excerpt)
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  2. 52
    280139

    One world, one response-needed, but not yet forthcoming [editorial]

    Lancet. 2005 Jan 8; 365:95-96.

    Introducing a series on complex emergencies in The Lancet less than two months ago, we noted that Jan Egeland, the UN’s emergency relief coordinator on disaster reduction, was frustrated by the lack of attention being given to natural disasters by the international community. Now no longer, one presumes. The devastation wreaked by the south- Asian tsunami that struck on Dec 26, 2004, has kick-started an unprecedented global response. Unqualified human empathy has been translated into unrestrained public acts of giving and helping that have caught more cautious politicians unprepared. There are huge lessons here for all heads of state to learn, not least the need for a massive overhaul in the way nations respond to episodes of humanitarian crisis. In addition to those who have died, the numbers of people at risk of disease defy comprehension. WHO estimates that 5 million people are presently without access to basic services. Over 2 million people have been displaced from their homes. And 15 million children are either orphaned or separated from their families. (excerpt)
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  3. 53
    279954
    Peer Reviewed

    Response by Leonard S. Rubenstein.

    Human Rights Quarterly. 2004; 26:879-881.

    This exchange has helped identify common ground and focus questions before us. Kenneth Roth and I agree that strategies for realizing economic, social, and cultural rights must not only include but also go beyond “naming and shaming.” I read his initial article as contending that naming and shaming is “the most productive way” for international human rights organizations to address these rights and criticizing other strategies as ineffective or even counterproductive. He now agrees to the existence of “other important methodologies”;1 I believe discussion of these other methods to achieve economic, social, and cultural rights remains one of the key tasks of the international human rights movement. On the question of allocating resources to realize economic, social, and cultural rights, I agree with Ken Roth that international human rights organizations, using naming and shaming strategies, can and should challenge allocation decisions when they are arbitrary or discriminatory and, as I point out below, when they fail to fulfill obligations for particular rights. Another question, though, also demands our attention: What should these organizations do in the face of the failure, or even resistance, of both national governments and international donors to provide the resources desperately needed to realize economic, social, and cultural rights that are within their capacity to provide. I believe that international human rights organizations should step up their efforts, often in conjunction with partners in effected countries, to increase overall spending on the realization of economic, social, and cultural rights, always seeking to enlarge the pot of resources; doing so, however, will require strategies in addition to naming and shaming. (excerpt)
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  4. 54
    279953
    Peer Reviewed

    Response to Leonard S. Rubenstein.

    Roth K

    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)
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  5. 55
    192364

    Introduction.

    In: Listening to those working with communities in Africa, Asia, and Latin America to achieve the UN goals for water and sanitation, [compiled by] Water Supply and Sanitation Collaborative Council [WSSCC]. Geneva, Switzerland, WSSCC, 2004. 3-16.

    The basics of public health – water, sanitation, and hygiene – are now back on the international agenda. But why have decades of effort and billions of dollars of investment in water and sanitation programmes yielded so little progress? What has been learnt? What are the new approaches that work? Why are they not yet gaining traction? And what can be done to turn the tide of failure and achieve the Millennium Development Goals for water and sanitation? This introduction draws together some of the most commonly held and strongly felt views of the many contributors to this publication who have helped to pioneer the new ways forward. (excerpt)
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  6. 56
    192288

    Aid in community based poverty-environment projects.

    Sullivan M

    Development Bulletin. 2002 Jul; (58):16-19.

    It is commonly accepted among development agencies that poverty and environmental degradation are intricately linked. All donor or development agencies have recently made that link explicit, and accepted a concept of poverty that is more than simply cash-based or economically defined. Like other development banks and development assistance agencies, the World Bank and AusAID have a policy focus on reducing poverty, which they define in terms of income generation, vulnerability and other aspects of livelihood or well-being. Marjorie Sullivan (2001) undertook a brief analysis of how the links between poverty and environment can be addressed through development assistance. She concluded that it is not possible to undertake an adequate poverty analysis as a basis for identifying project interventions without considering long term (post project) sustainability, nor without fully considering resource use. That analysis must include the explicit links between poverty and environment, and the more contentious issue of ecological sustainability (to address ecosystem services concepts), and how these can be incorporated into the management of development assistance programs. (excerpt)
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  7. 57
    190177
    Peer Reviewed

    Polio-endemic countries pledge to boost eradication efforts in 2004.

    Zarocostas J

    Lancet. 2004 Jan 17; 363(9404):215.

    Health ministers from the world’s six remaining polio-endemic countries— Afghanistan, Egypt, India, Niger, Nigeria, and Pakistan —pledged in a declaration signed in Geneva on Jan 15 to boost their polio-eradication activities in a bid to wipe out the disease. The commitment came amid growing fears that the ongoing outbreak in west Africa—centred in Nigeria and Niger—and the importation of cases to neighbouring countries could derail the 15-year global effort to eradicate the disease. (excerpt)
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  8. 58
    185608

    Against all odds: Bolivia's water war. [En pos del agua: la dura lucha de Bolivia]

    Duciaume N

    Monday Developments. 2003 Sep 22; 21(17):1, 5.

    Unlike many regions that pit nations against each other in wars over water and sanitation, Bolivia's story tells of the government against its own people, the people against a multinational corporation and ultimately the corporation against the government. The battle over the water supply of Cochabamba, Bolivia's third largest city, has raged from countryside to the courts and is now being waged before the International Center for Settlement of Investment Disputes (ICSID), an arbitration body created by the World Bank. (excerpt)
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  9. 59
    093362

    Better health in Africa.

    World Bank. Africa Technical Department. Human Resources and Poverty Division

    [Unpublished] 1993 Dec. xii, 217, [2] p. (Report No. 12577-AFR)

    The World Bank has recommended a blueprint for health improvement in sub-Saharan Africa. African countries and their external partners need to reconsider current health strategies. The underlying message is that many African countries can achieve great improvements in health despite financial pressure. The document focuses on the significance of enhancing the ability of households and communities to identify and respond to health problems. Promotion of poverty-centered development strategies, more educational opportunities for females, strengthening of community monitoring and supervision of health services, and provision of information on health conditions and services to the public are also important. Community-based action is vital. The report greatly encourages African governments to reform their health care systems. It advocates basic packages of health services available to everyone through health centers and first referral hospitals. Health care system reform also includes improving management of health care inputs (e.g., drugs) and new partnerships between public agencies and nongovernmental health care providers. Ministries of Health should concentrate more on policy formulation and public health activities, encourage private voluntary organizations, and establish an environment conducive to the private sector. African countries need more efficient allocation and management of public financial resources for health to boost their effect on critical health indicators (e.g., child mortality). Public resources should also be reallocated from less productive activities to health activities. More commitment from governments and domestic sources and an increase of external assistance are needed for low income African countries. The first action step should be a national agenda for health followed by action planning and setting goals to measure progress.
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  10. 60
    166726

    The belated global response to AIDS in Africa.

    Gellman B

    Washington Post. 2000 Jul 5; A1.

    This article describes the political infighting, quiet racism, and overall neglect that have impeded the industrialized world’s reaction to the AIDS epidemic. It is noted that less than 20 years after physicians first described its symptoms, HIV has now infected 53 million people and has claimed the lives of 19 million people. In wealthy nations, effective drug therapies against AIDS became available, such as zidovudine in 1987 and then combinations of antiretroviral agents in 1996. But according to AIDS experts, combating the disease requires governments to interpose themselves into controversies of sex, injected drugs, and other taboos. It also requires people in the developed world to make Africa and Africans a priority. Even the WHO has had trouble confronting such realities. In addition, combating AIDS requires costly change in economies and national cultures. In this perspective, the US government, African governments, the World Bank, WHO, and the Joint UN Programme on HIV/AIDS (UNAIDS) are still struggling to agree on, and implement a prevention program in sub-Saharan Africa that would include hundreds of million of dollars in youth- focused education, intensive counseling of sex workers, provision and "social marketing" of condoms and much more aggressive treatment of lesser venereal disease. Some are waiting for a vaccine, but it is noted that it took 183 years between the discovery of a smallpox vaccine and the disease’s eradication.
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  11. 61
    166082

    In Angola, supporting a grassroots path to peace and democracy.

    Hudock A

    Monday Developments. 2002 Apr 8; 20(7):10, 15.

    With the death of rebellion leader Jonas Savimbi in February 2002, Angola now faces a challenge to put itself on the road to peace, prosperity, and democracy. The country's hope depends on grassroots organizations, which hold the key to citizen participation and attaining a transparent and accountable government. Angola confronts a critical stage that needs the support of the international community for its emerging organizations to advance towards democracy and prosperity. One of the small grassroots organizations to exemplify action against the government is the Coalition for Boavista Homeless. The coalition was established in July 2001 as a response to the government's policy of demolishing homes and taking over the land in Boavista. It distributed pamphlets about the government's action and circulated a petition in request to stop demolition. The coalition and other civil society groups were supported by international organizations like World Learning, which is committed in upholding democracy and human rights worldwide. Changes in Angola will not happen overnight, but are taking place with the effort of the civil society and with help of international community.
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  12. 62
    162880
    Peer Reviewed

    Governance, good governance and global governance: conceptual and actual challenges.

    Weiss TG

    Third World Quarterly. 2000; 21(5):795-814.

    This article takes seriously the proposition that ideas and concepts, both good and bad, have an impact on international public policy. It situates the emergence of governance, good governance and global governance, as well as the UN's role in the conceptual process. Although `governance' is as old as human history, this essay concentrates on the intellectual debates of the 1980s and 1990s but explores such earlier UN-related ideas as decolonization, localization and human rights, against which more recent thinking has been played out. A central analytical perspective is the tension between many academics and international practitioners who employ `governance' to connote a complex set of structures and processes, both public and private, while more popular writers tend to use it synonymously with `government'. (author's)
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  13. 63
    144376

    Church or state? The Holy See at the United Nations.

    Rahman A

    CONSCIENCE. 1999 Summer; 20(2):2-5.

    This article provides an information on the role and position of the Roman Catholic Church in the UN. The Roman Catholic Church was elected to participate in the UN as the "Holy See". The "Holy See" is the supreme organ of government of the Catholic Church with the pope designated as its head under the Code of Canon Law, with the Vatican City regarded as its "vassal" territory. Unlike any other modern nation, the Vatican City does not support its citizen; rather it provides a base for the central administration of the Roman Catholic Church. The "Holy See" was regarded as a "nonmember state" in the UN. Pope Paul VI established the first Holy See "permanent observer mission" on March 21, 1964. When the Holy See was admitted as a nonmember state permanent observer, it maintained delegates at specialized agencies such as the International Atomic Energy Agency and the Council for Cultural Cooperation of the Council of Europe. The status of the Holy See as a state under the International Law was uncertain because it has not satisfied the modern definition of a nation, which has: 1) a permanent population; 2) a defined territory; 3) a government; and 4) the capacity to enter into relations with the other states.
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  14. 64
    083274

    The preventive-curative conflict in primary health care.

    De Sa C

    HEALTH FOR THE MILLIONS. 1993 Apr; 1(2):14-7.

    Approximately 80% of the rural population in developing countries do not have access to appropriate curative care. The primary health care (PHC) approach emphasizes promotive and preventive services. Yet most people in developing countries consider curative care to be more important. Thus, PHC should include curative and rehabilitative care along with preventive and promotive care. The conflict between preventive and curative care is apparent at the community level, among health workers from all levels of the health system, and among policy makers. Community members are sometimes willing to pay for curative services but not preventive services. Further, they believe that they already know enough to prevent illness. Community health workers (CHWs), the mainstays of most PHC projects are trained in preventive efforts, but this hinders their effectiveness, since the community expects curative care. Besides, 66% of villagers' health problems require curative care. Further, CHWs are isolated from health professionals, adding to their inability to effect positive change. Health professionals are often unable to set up a relationship of trust with the community, largely due to their urban-based medical education. They tend not to explain treatment to patients or to simplify explanations in a condescending manner. They also mystify diseases, preventing people from understanding their own bodies and managing their illnesses. National governments often misinterpret national health policies promoting PHC and implement them from a top-down approach rather than from the bottom-up PHC-advocated approach. Nongovernmental organizations (NGOs) and international agencies also interpret PHC in different ways. Still, strong partnerships between government, NGOs, private sector, and international agencies are needed for effective implementation of PHC. Yet, many countries continue to have complex hierarchical social structures, inequitable distribution, and inadequate resources, making it difficult to implement effective PHC.
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  15. 65
    068966

    Why Nicaraguan children survive. Moving beyond scenario thinking.

    Sandiford P; Coyle E; Smith GD

    LINKS. HEALTH AND DEVELOPMENT REPORT. 1991 Fall; 8(3):11-2.

    The authors respond to Tony Dajer's critique of their study concerning the trend in Nicaraguan infant mortality and its possible explanations. It is pointed out that the sharp decline in Nicaragua's infant mortality in the mid-1970s is an intriguing phenomenon, since it began to occur at a time of economic slump, civil disturbance, and under a government that gave low priority to the social sector. It is contended that a number of factors (among them the Managua earthquake) prompted the government to shift its allocation of resources from hospital-based health care in the capital city to ambulatory health care throughout the country. After the revolution, the Sandinista government continued this process. Dajer's characterization of USAID-funded clinics as "notoriously ineffective" is rejected; arguing that although operating under overt political guidelines, these projects are well-advised by experts. Dajer's question as to the importance of health care within the Sandinista government is considered. It is maintained that the revolution was not fought in order to reduce infant mortality, and that health was not the primary concern of the Government of National Reconstruction. It was the international solidarity movement, not the Sandinista government, which focused so intently on infant mortality, hoping to find good news to report. The issue of health care had the added advantage of being politically noncontroversial. It is also maintained that since the mid-70s, the country's health policy has remained stable, despite the radical changes in government because the international arena helps determine national health policy.
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  16. 66
    071345

    Africa 2000: looking at development afresh.

    Sai F

    PEOPLE. 1992; 19(1):32-4.

    The IPPF President asks his fellow Africans to look inward to find sources and solutions to the continent's problems. They can no longer blame colonialism and the international community for its problems, but should realize the governments of African countries which had little regard for their own people have misused government resources and not invested in people. Further the 1 party state is no longer effective at solving Africa's problems and people in many countries are beginning to prefer a multiparty democracy. In addition, 11% of the world's population inhabit Africa but Africa takes part in only 2% of the international trade. Africa's population growth rate is >3%/year and in 1992 it had almost 500 million people, yet the gross national product of the continent equals that of Belgium, a country of 10 million people. Development will need to come from Africans so governments must 1st develop its human resources base such as implementing policies that releases the entrepreneurial spirit, providing universal education, and training high levels professionals including planners, engineers, and entrepreneurs. In fact, military expenditures should be curtailed to make room for the much need development efforts. Further African governments must give priority to developing effective population and family planning programs. African population and family planning experts should convince government officials of the need to appropriate funds to these programs. Governments must also confront the problem of AIDS, but not at the expense of investment and general health programs. The 1990s are the last opportunity for Africa to mobilize its people, especially women and children, to pull itself out of poverty and despair.
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  17. 67
    068711

    Exporting abortion politics: the battle over international family planning assistance.

    Lasher C

    CONSCIENCE. 1991 Sep-Oct; 12(5):22-3.

    Congressional legislation seeking to overturn US government restrictions on international family planning assistance face a possible presidential veto. Dating back to the Reagan years, the 1984 Mexico City Policy prohibits foreign nongovernmental organizations (NGO) receiving US money from performing or actively promoting abortion as a family planning method. Even if abortion is legal in that particular country, the agency involved may not even discuss abortion as one of the medical options of a pregnant woman. In line with the Mexico City Policy, the US has withdrawn funding from both the International Planned Parenthood Federation, the largest NGO in the population field, and the Family Planning International Assistance, the international division of the Planned Parenthood federation of America. One of the effects of the Mexico City Policy has been to make family planning more controversial, and to increase opposition to birth control. In addition to the Mexico City Policy, the Reagan years also saw the implementation of a policy that denies funding to the UNFPA, charged by the US of "co-managing" China's population program that engages in coercive abortion and involuntary sterilization. The UNFPA has denied such charges. So far, President George Bush -- previously a supporter of family planning programs -- has sided with opponents of abortion, and has threatened a veto threat may soon be tested, since Congress has drafted a foreign aid appropriations bill that has includes a measure saying that NGOs should be treated in the same manner as their governments, which are exempt from the Mexico City Policy so long as US funds are not used to support abortions.
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  18. 68
    066491

    Foreword.

    Bush GH Jr

    In: World population crisis: the United States response, by Phyllis T. Piotrow. New York, New York, Praeger, 1973. vii-ix. (Law and Population Book Series No. 4)

    In this article, George H. Bush, Jr., the US Representative to the UN, expresses his support for family planning and fertility control at both the national and international level. Long aware of birth control as a public policy issue, Bush recalls how in 1950 his father lost a US Senate race when his opponent disclosed that the elder Bush supported Planned Parenthood, a family planning organization. But the previously taboo subject of birth control now demands public discussion, says Bush. With a 2% annual increase, the world's population of 4 billion is increasing by 80 million every year. Higher birth rates in poor countries have widened the income gap between developed and developing countries. While a member of the US House of Representative during the 1960s, Bush faced such disturbing issues as famine, unwanted pregnancies, and poverty. Finding it ridiculous that clinics and hospitals were prohibited from discussing birth control, Bush and other members of the House Ways and Means Committee took the lead in Congress to make family planning available to all women. Bush also helped repeal a law barring the mailing of birth control information and birth control devices. And when he moved to the UN, Bush saw that though the population issue was high on the agenda, it lacked some of the urgency it deserved. But having planned the 1974 World Population Conference, the UN is ready to tackle the population problem. Individual choice and responsible government represent the framework within which individuals and organizations must work. This work will be difficult, considering the large number of countries, races, and religions around the world. But addressing the population problem may help resolve such issues as peace, prosperity, and individual rights.
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  19. 69
    262747

    Government intervention on fertility: what is ethical?

    Berelson B; Lieberson J

    New York, Population Council, 1979 Oct. 68 p. (Center for Policy Studies Working Papers No. 48)

    After outlining various problems posed by the growth or decline of population and the class of feasible means available to governments for dealing with them, the authors pose the question of whether important ethical issues are raised by interventionist policies actually in use today. These policy options are surveyed in detail and shown to fall into 3 categories of government intervention: 1) Limitations imposed on access to modern methods of fertility control. 2) Incentives and disincentives of various kinds. 3) Politically organized peer pressure. With regard to ethical issues raised by these policies, the authors invert the traditional procedure in the ethical literature of first providing an overarching ethical theory and then deducing consequences pertaining to particular issues -- in this case population controversies. Instead, they adopt a contextual and piecemeal approach to the ethical concerns which views ethics as a species of decision making, resting on agreed-upon premises and proceeding to substantive conclusions as to what sort of action should be taken in particular situations. Proceeding to examine the 3 sets of policies from this perspective, they find limitations on access and incentive programs ethically permissible provided certain safeguards and intuitive conditions are satisfied. The 2nd category -- politically organized peer pressure -- is found unethical except under stringent conditions and where other approaches have been tried first. In the final section of the paper, the authors clarify aspects of the ethical framework underlying their judgments on the policy and raise and discuss a number of subsidiary problems. (Author's)
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