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Are country reputations for good and bad leadership on AIDS deserved? An exploratory quantitative analysis.
Journal of Public Health. 2008 Dec; 30(4):398-406.Some countries (e.g. Brazil) have good reputations on AIDS policy, whereas others, (notably South Africa) have been criticized for inadequate leadership. Cross-country regression analysis reveals that these 'poster children' for AIDS leadership have indeed performed better or worse than expected given their economic and institutional constraints and the demographic and health challenges facing them. Regressions were run on HAART coverage (number on highly active antiretroviral therapy as percentage of total need) and MTCTP coverage (pregnant HIV+ women accessing mother-to-child-transmission prevention services as percentage of total need). Brazil, Cambodia, Thailand and Uganda (all of whom have established reputations for good leadership on AIDS performed consistently better than expected-as did Burkina-Faso, Suriname, Paraguay Costa Rica, Mali and Namibia. South Africa, which has the worst reputation for AIDS leadership, performed significantly below expectations-as did Uruguay and Trinidad and Tobago. The paper thus confirms much of the conventional wisdom on AIDS leadership at country level and suggests new areas for research.
Population Briefs. 2007 Dec; 13(3):5.In April 2007, Mexico City's legislative assembly voted to liberalize abortion law to permit the interruption of pregnancy in the first trimester. The city is a federal district-similar to Washington, DC-and has a state-like autonomy. The law is in place only in Mexico City; Mexico's states still have restrictive abortion laws. The Council's research and collaboration with local nongovernmental organizations, universities, professional associations, and the Mexican government helped bring about this groundbreaking legislation. "The Population Council's research findings on abortion in Latin America have been used by government officials and women's rights advocacy groups to shape evidence-based policies, including the recent change in abortion law in Mexico City," says Sandra G. Garcia, the Council's director of reproductive health for Latin America and the Caribbean. In 2007, Garcia was honored as a recipient of the Guttmacher Institute's Darroch Award for Excellence in Sexual and Reproductive Health Research. She was cited for "research documenting abortion-related knowledge, attitudes, and practices in Mexico" that "played an important role in the...recent decision to legalize first-trimester abortion." (excerpt)
Lancet. 2007 Oct 20; 370(9596):1394.Eradicating poliomyelitis presents many challenges. Financing essential activities can be difficult when donors fail to meet funding targets (a US$60 million funding gap currently exists for the fourth quarter of 2007). Security issues in two of the four polio-endemic countries-Afghanistan and Pakistan-make access to children difficult for immunisation teams. And in Nigeria, low vaccine coverage and an outbreak of disease from vaccine-derived poliovirus (VDPV) could set back global eradication efforts. Over the past 10 years there have been nine outbreaks of poliomyelitis derived from the oral vaccine in nine countries. Nigeria has seen the largest outbreak; 69 children have been paralysed this year. VDPVs are rare but occur when the live virus in an oral polio vaccine mutates and reverts to neurovirulence. This loss of attenuation does not matter so much in populations who are fully immunised with oral vaccine, since they will be protected from wild and vaccine-derived poliovirus, but in Nigeria,where vaccine coverage is 39% (and even lower in some northern states), it is a problem. (excerpt)
Health Affairs. 2007 Mar-Apr; 26(2):345-354.A number of important health policy issues, such as the allocation of flu vaccines during a pandemic, require society to determine priorities across different age groups. Cost-effectiveness analysis (CEA) and related methods of economic evaluation are often useful for determining optimal resource allocations. Using the examples of recently evaluated vaccine interventions, we show that current methods of CEA are likely to undervalue health interventions for young people, relative to societal preferences inferred from research on age preferences and the value of health over time. These findings demonstrate important considerations regarding how society distributes health resources across age groups. (author's)
New York, New York, United Nations Development Programme [UNDP], . 14 p.The deepening of democratic institutions, gains in macroeconomic stability and rapid expansion of prosperity contribute to an overall encouraging context for sustainable development in Brazil. Yet, despite these numerous advances, real poverty has only moderately declined, and inequality persists. In Brazil, economic and social status tends to vary by geography, race and gender, a legacy of the country's history. Imposed and de facto colonial and post-colonial divisions among indigenous peoples and descendents of Portuguese settlers, African slaves and European, Middle Eastern and Asian immigrants created persistent structures of exclusion and inequality. In the 1950s, during the military government, a strategy of import substitution prioritized rapid industrial expansion, and helped to bring about significant, sustained economic growth. Benefits, however, accrued disproportionately to the upper classes at the expense of workers and unions. The industrialization contributed to the expansion of the favelas (urban slums), one of Brazil's greatest contemporary challenges, by promoting urban migration while infrastructure and social support did not expand at the same pace. (excerpt)
Sanger File. 2003 Jan 15; (10): p..Every year on the anniversary of Roe v. Wade, I wonder if this will be its last. Roe, decided in 1973, overturned the states' criminal abortion laws as a violation of a citizen's right to privacy. For 30 years the right wing has made the overturn of Roe one if its top priorities. The political goal of the right wing is to get Justices on the Supreme Court who will overturn the decision. The election of George W. Bush combined with a Republican-controlled Senate and House gives the right wing the chance they have been waiting for. Some of the Justices who support Roe are not in the best of health and may step down from the court, leaving a vacancy for President Bush and the Senate to fill. In a political sense, all that stands between the President and Senate doing this is the Democratic minority which could threaten a filibuster, which would take 60 votes out of 100 to defeat. The Republicans only have 51 votes in the Senate. The issue is whether the pro-choice Democrats have the political courage to make this stand. (excerpt)
Africa Today. 2001; 48(3):115-137.This paper discusses the print media’s coverage of crossborder migration in South Africa and how it may affect both public opinion and policymaking on the topic. The paper argues that coverage of international migration by the South African press has been largely anti-immigrant and unanalytical. Not all reportage is negative, and newspaper coverage would appear to be improving over time, but the overwhelming majority of the comprehensive collection of newspaper articles, editorials and letters to the editor surveyed for this research are negative about immigrants and immigration and are extremely unanalytical in nature, uncritically reproducing problematic statistics and assumptions about crossborder migration in the region. Although it is impossible to draw direct causal links between this kind of anti-immigrant media coverage and anti-immigrant policymaking and xenophobia in South Africa, the paper does argue that the two are at least mutually reinforcing and that the print media has a responsibility to be more balanced and factual in its reporting on the issue. (author's)
Seattle, Washington, University of Washington, Seattle Population Research Center, 1997 Jun.  p. (Seattle Population Research Center Working Paper No. 97-9)There have been tremendous changes in congressional debate and federal policy focusing on work, family, and gender since the end of World War II. This paper considers how Congress defined and redefined the "problem" of work, family, and gender; the policies it considered; and how policy changed in response to public opinion and the internal logic of the policy process. Congressional action generally moved together with public opinion, as both became more "liberal" and egalitarian over time. But critical aspects of congressional action depended on how Congress happened to view the problem and possible solutions at times when action of some kind seemed relatively urgent. Congressional action stimulated evaluation of current policies and proposals for policy innovation, by women's organizations, intellectuals, federal bureaucrats, and members of Congress, and these evaluations led to calls for further action. Changing views of pregnancy played a key role in moving policy debates from a focus solely on the workplace to a broader focus on how both men and women can balance the competing obligations of work and family. (author's)
Forum for Development Studies. 2005; 32(1):275-283.The article takes as its point of departure the programmatic point developed in the introduction to Ahead of the Curve – that the UN’s role in producing ideas should be contextualised, that is be seen as not only the source of ideas, but the carrier of ideas originating in some other source. The author finds several of the contributions that he has been able to read very strong analytically and empirically. But on some issues a few of the contributions could have been addressing the programmatic point more consciously; one example is population policy. The author also argues that the position of the UN, for instance in the public opinion, is a matter that could have been addressed more extensively in order to measure the impact and the legitimacy of the world organization in a situation where major reorganization of it is on the international agenda. (author's)
Clinical Medicine. 2005 Jan-Feb; 5(1):62-68.Infectious diseases with high mortality, disability and creating public anxiety are not new, but despite this our initial responses to HIV/AIDS have been primitive and slow. Since the start of the epidemic over 60 million people throughout the world have been infected, with the main focus of the epidemic currently in Sub-Saharan Africa. However, there is every indication that the epidemic will move more towards South-East Asia, with increasing numbers in India and China. Infection with HIV has a profound effect on individuals and their families, and can also lead to destabilisation of societies through its effects on the economy, institutions and security. Considerable emphasis has been placed recently on the widespread use of anti-retroviral therapy. This is a worthwhile initiative but is only part of a balanced array of approaches, which requires building a political consensus, social economic interventions and modifying the biology. Strong political leadership is still required, with an approach that recognises that the socioeconomic drivers of this epidemic. (author's)
Population Studies. 1961 Nov; 15(2):102-109.A marked awakening is taking place in Asia to the need and desirability of fertility control. One might even say that a revolution in the public and private attitudes toward family planning has occurred in Asia during the past decade. This paper will describe family planning in the Orient, the term "family planning" being interpreted in a broad sense. It will deal with government policies and with government action in this field, as well as the activities of private associations which are promoting fertility control by voluntary and private efforts. In the terms of this report, Asia includes the countries of Asia and South Asia that extend from Japan to Pakistan. Specific reference will be made only to countries that I have visited during the past six months, namely Japan, the Philippines, Taiwan, the Colony of Hong Kong, the State of Singapore, Indonesia, Thailand, Ceylon, India, and Pakistan. Visits have been made to this region more or less annually since World War II, and my contact with some of these countries dates back to 1939. Recent developments, in contrast to the earlier conditions, will be interpreted; obviously this report covers personal impressions and judgments, without facts and figures to support all the statements. (excerpt)
Talking points for Bill Gates, UN Media Leaders Summit on HIV / AIDS, January 15, 2004. 8-10 minute remarks.
[Unpublished] 2004. 4 p.The media have played a crucial role in highlighting the most important issues of our time—civil rights, apartheid, political oppression. Yet HIV/AIDS may be the greatest challenge of all. You have played a remarkable role already. In fact, the media had a great influence on my own commitment to fight diseases in the developing world. Early on, when my wife, Melinda, and I were thinking about our philanthropy and how we could have the greatest impact with our resources, my father sent me a clip from a newspaper about preventable deaths in poor countries. I remember reading a chart that listed the world’s deadliest diseases. One disease I had never even heard of— rotavirus—was killing literally half a million kids each year. I thought: That can’t be true, that’s got to be a typo. If a single disease was killing that many kids, we would have heard about it—it’d be front-page news. But it isn’t. As Melinda and I have become more engaged in global health issues over the past decade, one thing has become clear: not enough is being done about the millions of preventable deaths each year from diseases like AIDS or malaria. In part, that’s because people aren’t aware of what is happening. We don’t see these issues covered enough in newspapers, radio and television. (excerpt)
Kaiser Family Foundation Survey of Americans on HIV / AIDS. Part One -- Global HIV / AIDS. Summary and chartpack.
Menlo Park, California, Henry J. Kaiser Family Foundation, 2004 Jun.  p.The broad foreign policy context within which Americans view the global HIV epidemic hasn’t changed much in the past few years. Most Americans think the U.S. currently spends too much on foreign aid in general, and a strong majority believes the U.S. should address problems at home first rather than spending more money on the global HIV/AIDS epidemic. In discussing Americans’ views of the global HIV/AIDS epidemic, and what they think about the role of the U.S. in helping solve this global problem, it’s important to set the context with their views on foreign aid in general. More than six in ten adults (62%) think the U.S. currently spends too much on foreign aid, while about one in five (18%) say it spends about the right amount, and one in ten (10%) say the U.S. spends too little on foreign aid (Chart 1). Responses to this question have been similar since 2000. When asked about the largest areas of spending by the federal government, half the public (49%) incorrectly identifies foreign aid as one of the two largest areas of federal spending (Chart 1). Half the public (53%) agrees with the statement that the U.S. is a global leader and has a responsibility to spend more money to fight HIV/AIDS in developing countries. However, when forced to choose, three in ten (30%) say they agree more strongly with this statement, while, perhaps not surprisingly, six in ten (62%) say they agree more with the statement that the U.S. should address problems at home first rather than spending more money to fight HIV/AIDS in developing countries (Chart 2). (excerpt)
Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS [UNAIDS], 2001 Feb. 42 p. (UNAIDS Best Practice Collection Key Material; UNAIDS/01.05E)This handbook aims to equip scientists especially with ideas, skills, and knowledge on how to relate to the media and thereby reach both the general public and some specific groups. The handbook is not a communication strategy and does not address all aspects of communication and audiences that must be included in effective communication about vaccine trials. Many vaccine development and vaccine trials in humans have to be carried out with the expressed support and cooperation of national governments. Such cooperation usually manifests itself through regulations and monitoring by organizations such as the Food and Drug Administration (FDA) in the USA or equivalent national institutions. Consequently, there is a necessary collaboration between government and medicine (science) in the interests of public health. Ordinarily, that would be a good thing. But, ironically, in many countries, this is a collaboration between two 'institutions' whose popularity and public confidence have dwindled over the years, and their support for HIV vaccine trials does not readily translate into public confidence in those trials. (excerpt)
Situation analysis of the knowledge, attitudes and behavior of stakeholders and key target groups regarding the family planning program in the Philippines.
[Manila, Philippines], Academy for Educational Development [AED], Social Acceptance Project, 2003 Jan.  p. (Academy for Educational Development, Social Acceptance Project Working Paper)The initiative for this research study came from the Social Acceptance Project of the Academy for Education and Development (AED) which has been launched by USAID as part of the continuing reexamination of the Philippine Population Management Program (PPMP) and in response to the Cairo Declaration calling for fresh initiatives and approaches not only for women but also other key stakeholders such as men and youth. The re-focusing of the country’s population program calls for no less than the creation of a climate of public opinion that supports and encourages couples to practice effective family planning methods in vast enough numbers that will impact the country’s runaway population growth that is considered to be the highest in Southeast Asia. In the light of these social communication issues and concerns, the Social Acceptance Project had come up with the following approaches to “internalize” the small family norm and use of modern contraceptive methods among Filipinos through: a) Increase health literacy and improve the flow of accurate information about family planning; b) Increase dialogue about family planning and the credibility of health providers and the medical profession as sources of information; c) Raise the cultural legitimacy of family planning practice; and d) Build local capacities. This report in turn, was designed to: provide a basic review of the psychological, sociological and cultural factors that may result in the practice or non-practice of family planning; briefly analyze the issues and concerns that explain how communication interventions can lead to behavioral change, client satisfaction, and other desired results for the Social Acceptance Project; come up with a list of recommendations that can be used for future researches and/ or monitoring and evaluation of proposed IEC interventions. (excerpt)
In: Handbook of health communication, edited by Teresa L. Thompson, Alicia M. Dorsey, Katherine I. Miller, Roxanne Parrott. Mahwah, New Jersey, Lawrence Erlbaum Associates, 2003. 403-422.In this chapter we enter into the quagmire that is U.S. healthcare policymaking. In doing so, we have three goals in mind: (a) to summarize contemporary models of the policymaking process, including the role that organizational discourse plays in it; (b) to examine the distinctive complexities of healthcare policymaking; and (c) to briefly illustrate those processes and complexities in an analysis of the development of Medicare. In the process we argue that the fragmented and incoherent nature of U.S. healthcare policy is not "accidental," as Reagan's title suggests, but instead is inherent in a complex interaction between the structure and processes of policymaking, the ideological bases of health discourse, and the rhetoric of healthcare reform. (excerpt)
Creating awareness of the issues and problems of the elderly: among planners and policy makers; in the local community.
In: Implications of Asia's population future for older people in the family. Report and selected background papers from the Expert Group Meeting on the Implications of Asia's Population Future for Family and the Elderly, 25-28 November 1996, Bangkok, compiled by United Nations. Economic and Social Commission for Asia and the Pacific [ESCAP]. New York, New York, United Nations, 1996. 104-16. (Asian Population Studies Series No. 145; ST/ESCAP/1736)Asians have long held their elderly in high esteem as being both wise and the focal points of family and community unity, especially in rural areas. Asian societies, however, are undergoing rapid technological advancement, modernization, rapid demographic changes, and rapid national economic growth amid persistent mass poverty which have led to the ongoing decline in the status of the aged and very old in Asia. As their lifespans and numbers increase, old people are also becoming more poor and marginalized, and increasingly seen as burdens by contemporary families. Asian families need to establish a sustainable balance between the old and basic Asian family values and current modernization. Future aging in Asia, the Asian response to aging, raising awareness of aging, the need for a new philosophy of aging, an agenda for research and policy awareness, legislating the consequences of population aging, what can be done about aging in the region, public awareness and action, families, institutional support systems, and the mass media's role in changing public perception are discussed. Asian families and communities need to change how they perceive the elderly, giving priority to empowering older people and the organizations which fight for their interests. Such efforts should not, however, provoke a move away from the focus upon keeping families strong, healthy, and stable.