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New York, New York, UNFPA, 2002. x, 103 p.Financial Resource Flows for Population Activities in 2000 is the fourteenth edition of a report previously published by UNFPA under the title of Global Population Assistance Report. The United Nations Population Fund has regularly collected data and reported on flows of international financial assistance to population activities. The Fund’s annual Reports focused on the flow of funds from donors through bilateral, multilateral and non-governmental channels for population assistance to developing countries1 and countries with economies in transition. Also included were grants and loans from development banks for population activities in developing countries. (excerpt)
Bulletin of the World Health Organization. 2003 Nov; 81(11):777.During the last quarter-century or so there has been a revolution in both health and information technology. For the globe as a whole we have seen tremendous strides made in life expectancy and disease control, together with an explosion of information technology and techniques. Humanity now has the potential to make all existing health knowledge available simultaneously to the entire population of the planet. By no means everyone has benefited from the overall trend of increased life expectancy, however, or from that of increased knowledge and its communicability. This gap goes beyond the notion of the “digital divide”. It is a “knowledge divide”, in which large sections of humanity are cut off not just from the information that could help them but from any learning system or community that fosters problem-solving. (excerpt)
Lancet Infectious Diseases. 2003 Sep 1; 3(9):530.According to Raviglione the antituberculosis drugs used with the directly observed therapy short-couse (DOTS) made it possible to cure tuberculosis in over 80 000 Africans living with HIV last year. However more than 200 000 Africans with HIV died from tuberculsosis because they had no access to anti-tuberculosis drugs and DOTS. Tuberculosis was notably absent from the scientific programme at the HIV meeting. “In Africa it strikes us as peculiar how politicians and academics can speak of their ‘AIDS initative’ or ‘their tuberculosis programme’ as if the two diseases are not related,” said Winstone Zulu, a Zambian man infected with HIV, who had been recently cured of tuberculosis. “We see them together conspiring and collaborating to steal away our health.” (excerpt)
POPLINE. 2003 Sep-Oct; 25:4.A $59.6 million grant to improve the health of Afghan women and children in a country where a quarter of all children do not survive beyond their fifth birthday has been approved by the World Bank. The project to develop basic health services and ensure that women and children have access to them will be implemented by Afghanistan’s health ministry. (excerpt)
Cahiers du Médecin. 2002 Dec; 6(58):45-46.This article presents a report from the macroeconomic and health committee to determine the place of health in economic and social development created by the WHO in the year 2000. The main conclusions for all aspects were presented when the report was submitted to the WHO general assembly in 2002. The observations thus raised indicated that economic losses linked to poor health have been underestimated, especially in developing countries and that the role of health in economic growth has been strongly undervalued. Because of this several pathologies are still responsible for a high percentage of avoidable deaths, particularly maternal and perinatal pathologies and infectious diseases in children. It is also noted that the level of health expenses is insufficient and that the recommended financing strategy is based on growth in budgetary credits consecrated to health and to an increase in donor subsidies. The report emphasizes the different essential actions capable of reaching disadvantaged populations and on the correct steering by the public authorities of contributions from donors in the public and private sectors. Other remarks were collected about the various financing mechanisms on the global scale to combat certain endemic infections, specifically AIDS, tuberculosis, and malaria. Efforts to improve access by the populations to essential and indispensable drugs are also being made. The report underlines the need for the signing of a health pact between governments and development agencies in order to increase resources allocated to health. For the development of health in Morocco, the author emphasizes all aspects raised in this report and suggests the creation of a "Health and development" commission as advised by the WHO.
Washington, D.C., National Academies Press, 2003. xii, 57 p.The present monograph--on rebuilding the health sector in East Timor following the nation's struggle for independence--is the second in this series. It provides an overview of the state of the health system before, during, and after reconstruction and discusses achievements and failures in the rebuilding process, using an informative case study to draw conclusions for potential improvements to the process in other post-conflict settings. Other topics under consideration in the series include reviews of current knowledge on psychosocial issues, reproductive health, malnutrition, and diarrheal diseases, as well as other case studies. (excerpt)
Social Science and Medicine. 2003 Nov; 57(9):1547-1557.Spurred on by donors, a number of developing countries are in the midst of fundamental health and population sector reform. Focused on the performance-oriented norms of efficiency and effectiveness, reformers have paid insufficient attention to the process-oriented norms of sovereignty and democracy. As a result, citizens of sovereign states have been largely excluded from the deliberative process. This paper draws on political science and public administration theory to evaluate the Bangladeshi reform experience. It does so with reference to the norms of efficiency, effectiveness, sovereignty and democracy as a means of making explicit the values that need to be considered in order to make health and population sector reform a fair process. (author's)
Guttmacher Report on Public Policy. 2003 Aug; 6(3):4-5, 14.In the United States and other developed countries, where Pap tests are widely available and easily accessible, deaths from cervical cancer have plunged in recent decades, even in the presence of high HPV rates. Death rates remain high in developing countries because women lack access to Pap tests or other effective screening programs. The evidence strongly suggests, then, that while keeping the focus on HPV and its sexual transmission may be politically useful in advancing a morality-based, abstinence-until- marriage agenda, a more realistic campaign against cervical cancer deaths would focus on increasing access to cervical cancer screening among women around the world. (excerpt)
New York, New York, Ford Foundation, 2003.  p.The connections between globalization and women’s reproductive health and rights are not straightforward, and as yet, there is little systematic evidence exploring these linkages. The following paper will examine more closely what is meant by globalization and attempt to analyze its broad implications for women’s health and well-being, albeit largely from first principles. (excerpt)
The new lepers. HIV-positive people are treated as social outcasts while the government fails to cope.
London, England, Institute for War and Peace Reporting [IWPR], 2003 Aug 8. 3 p. (Belarus Reporting Service No. 28)More and more people in Belarus are finding themselves in her position – 50 or 60 new HIV cases are recorded every month. At the beginning of August, the number of people carrying the virus reached 5,150, and experts fear that the figure will be more than double that in 2005. More worryingly, some say the recorded figures should be multiplied by a factor of three or more since they fail to capture drug users who have not been seen by the health authorities. Although HIV and AIDS are advancing rapidly, neither the government nor society in general appear able to come to terms with it. A survey conducted jointly by the United Nations and the Centre for Sociological and Political Research in Minsk found that three quarters of the people polled thought people with HIV should not be allowed to care for their own children, and more than 40 per cent said they should not be allowed to travel around the country or choose where they want to live. (excerpt)
POPLINE. 2003 May-Jun; 25:3, 4.The president of the Population Institute contends that it would be "not only unacceptable but also morally reprehensible for the United States to back away" from commitments toward universal access to family planning and reproductive health. In testimony submitted to the foreign operations subcommittee of the House of Representatives Appropriations Committee, Werner Fornos, president of the Population Institute, was referring to apparent efforts by the Bush administration to reverse United States support of the Cairo Program of Action from the 1994 International Conference on Population and Development. (excerpt)
Civil-Military Alliance Newsletter. 1997 Oct; 3(4):3-4.The Alliance held its first Regional Seminar in Central America July 2-5,1997, in Tegucigalpa, Honduras. This was the first meeting held within the framework of the two- year Alliance program in Latin America supported by the Commission of the European Union. The theme was "Civil- Military Intervention Strategies for the Prevention and Control of HIV/AIDS in Latin America and the Caribbean." (excerpt)
Summary measures of population health in the context of the WHO framework for health system performance assessment.
In: Summary measures of population health: concepts, ethics, measurement and applications, edited by C.J.L. Murray, J.A. Salomon, C.D. Mathers and A.D. Lopez. Geneva, Switzerland, World Health Organization [WHO], 2002. 1-11.This volume addresses the conceptual, ethical, empirical and technical challenges in summarizing the health of populations. This is critical for monitoring whether levels of population health are improving over time and for understanding why health differs across settings. At the same time, it is also important to recognize that improving population health is not the only goal of health policy and to understand the way health improvements interact with these other goals. For that reason, we briefly review the World Health Organization (WHO) framework for assessing the performance of health systems and the role of summary measures of population health (SMPH) in this framework. Following the recent peer review of the methodology used for health system performance by WHO (Anand et al. 2002), this framework will continue to evolve in response to the detailed recommendations of the scientific peer review group and to ongoing scientific debates and research. (excerpt)
Lancet. 2003 Jul 19; 362(9379):249.These positive results from the new community-based therapeutic care (CTC) model of intervention call for a change in the way that we classify acute malnutrition. The WHO classification consists of moderate and severe categories, defined according to anthropometry and the presence of bilateral pitting oedema. This classification was appropriate and operationally relevant when the modes of treatment involved inpatient therapeutic feeding centres for severe acute malnutrition, and outpatient supplementary feeding for moderate acute malnutrition. This new era of community-based care, however, has three treatment modes. To be operationally relevant, a new system of classification must, therefore, include complicated malnutrition as well as severe and moderate malnutrition. (excerpt)
Population assistance and family planning programs: issues for Congress. Updated February 13, 2003. Programas de asistencia a la población y de planificación familiar: temas para el Congreso. Actualización al 13 de febrero de 2003.
Washington, D.C., Library of Congress, Congressional Research Service, 2003 Feb 13.  p. (Issue Brief for Congress)Since 1965, United States policy has supported international population planning based on principles of voluntarism and informed choice that gives participants access to information on all methods of birth control. This policy, however, has generated contentious debate for over two decades, resulting in frequent clarification and modification of U.S. international family planning programs. In the mid-1980s, U.S. population aid policy became especially controversial when the Reagan Administration introduced restrictions. Critics viewed this policy as a major and unwise departure from U.S. population efforts of the previous 20 years. The “Mexico City policy” further denied U.S. funds to foreign non-governmental organizations (NGOs) that perform or promote abortion as a method of family planning, regardless of whether the source of money was the U.S. government Presidents Reagan and Bush also banned grants to the U.N. Population Fund (UNFPA) because of its program in China, where coercion has been used. During the Bush Administration, a slight majority in Congress favored funding UNFPA and overturning the Mexico City policy but failed to alter policy because of presidential vetoes or the threat of a veto. President Clinton repealed Mexico City policy restrictions and resumed UNFPA funding, but these decisions were frequently challenged by some Members of Congress. On January 22, 2001, President Bush revoked the Clinton Administration population policy position and restored in full the terms of the Mexico City restrictions that were in effect on January 19, 1993. Foreign NGOs and international organizations, as a condition for receipt of U.S. funds, now must agree not to perform or actively promote abortions as a method of family planning in other countries. Subsequently, in January 2002, the White House placed a hold on the transfer of $34 million appropriated by Congress for UNFPA and launched a review of the organization’s program in China. Following the visit by a State Department assessment team in May, Secretary of State Powell announced on July 22 that UNFPA was in violation of the “Kemp-Kasten” amendment that bans U.S. assistance to organizations that support or participate in the management of coercive family planning programs. For FY2003, the President proposes no UNFPA funding, although there is a “reserve” of $25 million that could be used if the White House determines that UNFPA is eligible for U.S. support in FY2003. The Administration further requests $425 million for bilateral family planning programs, a reduction from the $446.5 million provided in FY2002. H.J.Res. 2, as passed by the Senate on January 23, 2003, includes the FY2003 Foreign Operations Appropriations. It provides $435 million for bilateral family planning aid and $35 million for UNFPA. Last year, the Senate Appropriations Committee (S. 2779) had recommended $450 million for bilateral activities and $50 million for UNFPA. The Senate bill further would have modified the Kemp-Kasten amendment and partially reversed the President’s Mexico City policy for some organizations. The House bill (H.R. 5410) last year provided $425 million for family planning and $25 million for UNFPA, but made no modifications to Kemp-Kasten or to the Mexico City policy. (excerpt)
Bulletin of the World Health Organization. 2003 Jul; 81(7):539-545.Those concerned with poverty and health have sometimes viewed equity and human rights as abstract concepts with little practical application, and links between health, equity and human rights have not been examined systematically. Examination of the concepts of poverty, equity, and human rights in relation to health and to each other demonstrates that they are closely linked conceptually and operationally and that each provides valuable, unique guidance for health institutions’ work. Equity and human rights perspectives can contribute concretely to health institutions’ efforts to tackle poverty and health, and focusing on poverty is essential to operationalizing those commitments. Both equity and human rights principles dictate the necessity to strive for equal opportunity for health for groups of people who have suffered marginalization or discrimination. Health institutions can deal with poverty and health within a framework encompassing equity and human rights concerns in five general ways: (1) institutionalizing the systematic and routine application of equity and human rights perspectives to all health sector actions; (2) strengthening and extending the public health functions, other than health care, that create the conditions necessary for health; (3) implementing equitable health care financing, which should help reduce poverty while increasing access for the poor; (4) ensuring that health services respond effectively to the major causes of preventable ill-health among the poor and disadvantaged; and (5) monitoring, advocating and taking action to address the potential health equity and human rights implications of policies in all sectors affecting health, not only the health sector. (author's)
Fees-for-services, cost recovery, and equity in a district of Burkina Faso operating the Bamako Initiative. [Prestation de services, couverture des coûts et équité dans une région au Burkina-Faso exploitant l'Initiative de Bamako]
Bulletin of the World Health Organization. 2003 Jul; 81(7):532-538.Objective: To gauge the effects of operating the Bamako Initiative in Kongoussi district, Burkina Faso. Methods: Qualitative and quasi-experimental quantitative methodologies were used. Findings: Following the introduction of fees-for-services in July 1997, the number of consultations for curative care fell over a period of three years by an average of 15.4% at ‘‘case’’ health centres but increased by 30.5% at ‘‘control’’ health centres. Moreover, although the operational results for essential drugs depots were not known, expenditure increased on average 2.7 times more than income and did not keep pace with the decline in the utilization of services. Persons in charge of the management committees had difficulties in releasing funds to ensure access to care for the poor. Conclusion: The introduction of fees-for-services had an adverse effect on service utilization. The study district is in a position to bear the financial cost of taking care of the poor and the community is able to identify such people. Incentivesmust be introduced by the state and be swiftly applied so that the communities agree to a more equitable system and thereby allow access to care for those excluded from services because they are unable to pay. (author's)
Unintended consequences: drug policies fuel the HIV epidemic in Russia and Ukraine. A policy report prepared for the UN Commission on Narcotic Drugs and national governments.
New York, New York, Open Society Institute, International Harm Reduction Development program, 2003. 16 p.Taking action now to reduce HIV transmission rates and treat those already infected is critical. With the goal of avoiding adverse effects on social welfare and public health, the Russian and Ukrainian governments should reconsider how they interpret international treaties. Policy changes should be made in the following areas: Harm reduction. The governments should play an active role in establishing and supporting a large, strategically located network of harm reduction programs that provide services for IDUs, including needle exchange, HIV transmission education, condom distribution, and access to viable treatment programs such as methadone substitution. Similar services should be available in all prisons. Education. Simple, direct, and dear information about HIV transmission should be made available to all citizens-especially those most at risk. Similarly, society at large should be educated about the realities of drug use and addiction as part of an effort to reduce stigma. Discrimination and law enforcement abuse. Public health and law enforcement authorities should take the lead in eliminating discrimination, official and de facto, toward people with HIV and marginalized risk groups such as drug users. Authorities must no longer condone or ignore harassing and abusive behavior, including physical attacks, arrest quotas, arbitrary searches, detainment without charges, and other violations of due process. HIV-positive people, including IDUs, should be included in all policy discussions related to them in the public health and legal spheres. Legislation. Laws that violate the human rights of people with HIV and at-risk groups should be repealed or restructured to better reflect public health concerns. Moving forward with the above strategies may make it appear that the governments are backing away from the goals and guidelines of the UN drug conventions. They may be criti- cized severely by those who are unable or unwilling to understand that meeting the goals of the conventions, some of which were promulgated more than 40 years ago, is far too great a price to bear for countries in the midst of drug use and HIV epidemics. Governments ultimately have no choice, though, if they hope to maintain any semblance of moral legitimacy among their own people. (excerpt)
Human development report 2003. Millennium Development Goals: a compact among nations to end human poverty.
New York, New York, Oxford University Press, 2003. xv, 367 p.The central part of this Report is devoted to assessing where the greatest problems are, analysing what needs to be done to reverse these setbacks and offering concrete proposals on how to accelerate progress everywhere towards achieving all the Goals. In doing so, it provides a persuasive argument for why, even in the poorest countries, there is still hope that the Goals can be met. But though the Goals provide a new framework for development that demands results and increases accountability, they are not a programmatic instrument. The political will and good policy ideas underpinning any attempt to meet the Goals can work only if they are translated into nationally owned, nationally driven development strategies guided by sound science, good economics and transparent, accountable governance. That is why this Report also sets out a Millennium Development Compact. Building on the commitment that world leaders made at the 2002 Monterrey Conference on Financing for Development to forge a “new partnership between developed and developing countries”—a partnership aimed squarely at implementing the Millennium Declaration—the Compact provides a broad framework for how national development strategies and international support from donors, international agencies and others can be both better aligned and commensurate with the scale of the challenge of the Goals. And the Compact puts responsibilities squarely on both sides: requiring bold reforms from poor countries and obliging donor countries to step forward and support those efforts. (excerpt)
RNIS. Report on the Nutrition Situation of Refugees and Displaced Populations. 2003 Jan; (40):43-48.The nutrition situation seemed mixed. Whilst the situation is under-control in some regions where nutrition surveys have been done (category III), the nutrition situation was not satisfactory in Shamali plain and in some of the IDP/refugee settlements (category II). Winter is challenging, especially for the returnees. (excerpt)
RNIS. Report on the Nutrition Situation of Refugees and Displaced Populations. 2003 Jan; (40):29-30.The nutrition situation of the Liberian refugees in south Sierra Leone was precarious in August 2002 (category II/III). However, it is hoped that stabilization in the number of refugees has allowed an improvement in their living conditions since that time. (excerpt)
Liberia. Report on the nutrition situation of refugees and displaced populations. [Libéria : Rapport sur l'état de nutrition des réfugiés et des populations déplacées]
RNIS. Report on the Nutrition Situation of Refugees and Displaced Populations. 2003 Jan; (40):27-28.The situation of IDPs, returnees and newly-created refugees in Liberia is of concern (category II). The large new influx of vulnerable people, adding further to the already high number of IDPs and refugees, will be a difficult challenge for humanitarian agencies to respond to. (excerpt)
Have you integrated STI / HIV prevention into your sexual and reproductive health services? Use IPPF / WHR's STI / HIV Integration Checklist to find out.
New York, New York, IPPF, WHR, 2002.  p.Participants at the 1994 International Conference on Population and Development (ICPD) in Cairo called for the global increase in the availability of a broad range of sexual and reproductive health (SRH) services for women, men and young people. This call reflected a continuing shift away from the narrow family planning model of service provision that shaped the field in its early years toward a more encompassing practice of sexual and reproductive health care. Rather than focusing on the provision of contraception for controlling pregnancy, the SRH model frames the contraceptive choices available to women within a larger paradigm of women’s health: their health rights, needs, concerns and constraints. In theory, SRH care incorporates the prevention, detection and treatment of sexually transmitted infections (STIs) – including and perhaps most pressingly, HIV – into other SRH services. In practice, however, many organizations that work in SRH service provision fail to incorporate STI/HIV prevention or treatment into their roster of services and programs, or they provide these services separately from other SRH services. Therefore, making explicit the connection between sexuality, contraceptive choice and STI/HIV prevention and harnessing the inherent synergy between preventing unwanted pregnancy and preventing STI/HIV remain fertile areas for action. In support of this effort, IPPF/WHR has developed this self-administered checklist to be used by organizations to explore their degree of integration. (excerpt)
BMC International Health and Human Rights. 2003; 3(1): p..Background: Although a grossly disproportionate burden of disease from HIV/AIDS, TB and malaria remains in the Global South, these infectious diseases have finally risen to the top of the international agenda in recent years. Ideal strategies for combating these diseases must balance the advantages and disadvantages of 'vertical' disease control programs and 'horizontal' capacity-building approaches. Discussion: The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) represents an important step forward in the struggle against these pathogens. While its goals are laudable, significant barriers persist. Most significant is the pitiful lack of funds committed by world governments, particularly those of the very G8 countries whose discussions gave rise to the Fund. A drastic scaling up of resources is the first clear requirement for the GFATM to live up to the international community's lofty intentions. A directly related issue is that of maintaining a strong commitment to the treatment of the three diseases along with traditional prevention approaches, with the ensuing debates over providing affordable access to medications in the face of the pharmaceutical industry's vigorous protection of patent rights. Summary: At this early point in the Fund's history, it remains to be seen how these issues will be resolved at the programming level. Nevertheless, it is clear that significant structural changes are required in such domains as global spending priorities, debt relief, trade policy, and corporate responsibility. HIV/AIDS, tuberculosis and malaria are global problems borne of gross socioeconomic inequality, and their solutions require correspondingly geopolitical solutions. (author's)
Ottawa, Canada, CARE Canada, 2002.  p. (AIDS Briefing Paper: Giving Communities the Tools to Respond)CARE is focusing efforts both in HIV/AIDS prevention and impact mitigation programming. Mitigating sectoral and development threats of HIV/AIDS requires assessing its impact- and planning and implementing appropriate responses. The most direct impact of HIV/AIDS mortality and morbidity is on families and communities. This extends to reduced sectoral output and gross domestic product. Actions to break the vicious cycle are required at all levels, but actions at the sectoral level may have the most effect, because they provide services to households and generate output for the economy. Therefore, CARE is expanding community-based HIV/AIDS programming and capacity building in sectors such as agriculture, food security, basic and girls' education, emergency programs, economic development and health. (excerpt)