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RF_PHM _EXCHANGE-I_PART_2_SUDHA
HA-Exchanee> PHM Geneva Report (final)
Subject: PHA-Exchangc> PHM Geneva Report (final)
Date: Tue, 27 Aug 2002 05:30:17 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch" <pha-exchange@kabissa.org >
From:
"Community health coll" <sochara@vsnl.com>
> PEOPLE'S HEALTH MOVEMENT
(PHM)
IN GENEVA
> A short report or the participation of PHM in the Fifty Fifth World
> Health Assembly,
> at Geneva,
13-17th May 2002
> [The Peoples Health Movement (PHM) was invited by the World Health
> Organization to participate in the first Technical Briefing session at
> the World Health Assembly, organised by the WHO-Civil Society Initiative
> and to present the Peoples Health Charter. Over 35 members of PHM from
> different countries attended the World Health Assembly, this year from
> 13-17111 May 2002 and participated in various meetings, lobbying
> initiatives and m the technical briefing.
The initiative was organised
> bv the WHO/WHA Circle of the PHM and this is a short report of the
> salient Features of the PHM related events in Geneva during that week.
> 1. world Health Assembly (WHA)
: An introduction
> ? The Fifty Fifth World Health Assembly organised by WHO, Geneva, took
> place this year from 13th to 18th May 2002.
The assembly is the most
> important annual meeting of the WHO where delegations from member states
> from all over the world gather to discuss a wide range of world health
> concerns and WHO's organisational challenges through formal procedures
> and informal dialogue.
> ? A wide range of topics relevant to world health were covered in the
> agenda during the assembly, including the Report of the Commission on
> Macroeconomic and Health (CMH); Risks to Health (round table);
> Development Goals of the Millennium; Global Fund for
> HIV-AIDS/TB/Malaria; Sustainable Development; HIV-AIDS; Eradication of
> Polio; Quality of Care and Patient Safety; Ageing and Health; Mental
> Health; Diet, Physical Activity and Health; Dengue Prevention and
> Control; Deliberate use of Biological and Chemical agents to cause harm;
> Destruction of Variola stocks; Pan-African Tsetse and Trypanosomiasis
> eradication campaign; Role of contractual arrangements in improving
> health systems performance; Health conditions of Palestinians; Arabs
> under Occupation; Collaboration with UN system and with other
> intergovernmental organizations; International decade of the worlds
>,indigenous people, and a few other topics.
WHO-WHA lobby circle of PHM
? The WHO-WHA circle convened bv Dr. Ravi Narayan of CHC, consisted
initially of Zararullah Chowdhry, David Sanders, Pam Zinkin, K. Bala,
> Claudio Schuftan and grow as the process evolved. It encouraged the
> participation of PHM members from all over the world (especially those
> who were able to find their own support or who were anyway attending the
> WHA as members of NGOs in official status with WHO) to show solidarity
> with PHM and participate in an intense and proactive lobby strategy.
> Six letters were circulated in the process of mobilization on - 7th
> December, 25th February, 25th March, 9th April, 18th April and 29th
> Ppril.
Through active lobbying, WHO was encouraged to formally support
> two PHM resource persons and the NGO forum also supported (2 persons).
> Other members raised their own funds through.various sources.
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IA-Exchsn£s> PHM Geneva Report (final)
3. UHM pa rtlclpantS at HHA
> '? The 35 PHM activists and included Qasem, Zafarullah, Lail-a, Nouman and
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> Andreas from Germany; Sunil from Italy; Prem, Unni, Thelma, Ravi, Nupur
> from India: Satya from Malaysia; Maria from Nicaragua; Ellen from
> Netherlands; David from South Africa; Bala and Joel from Sri Lanka;
> Mwajuma from Tanzania; Pam, Mike, Dorothy from UK; Sarah from USA;
> : ■. FHa r., sric, Manojj, Lday, Garonce, x'aWx.ia, Inez fxoin
> Geneva-Switzerland; and four members from the International Federation
> of Medical Students Associations.
> 4. Registration Challenge
> ? Since WHO-CSI is still to review the mode of linkage and participation
> of NGOs, movements and campaign groups, the 'PHM' which turned out to be
> the largest delegation this year (!) to WHA attended it as members of
> IOCU, World Vision CMC-Action for Health and others. We thank these
> NGOs for their support and solidarity [Next year we should attempt to
> increase the participation of PHM activists and supporters by entering
> as members of country delegations; or getting our specific NGOs to link
> to WHO in official relations and or to persuade WHO to recognise PHM as
> an official movement and the largest health network of ’civil society'
> in the world].
> 5. PHM Community at Mandat
> ? A large number of the PHI-1 participants stayed at Mandat International
> - an NGO reception centre for NGO delegates to meetings in Geneva, which
> is run by a young team of volunteers and residents. With PHM posters,
> photographs and publications ail over the Mandat lobby, and most rooms
> taken bv PHM participants, we converted Mandat International into a
> temporary PHM community.
The accommodation and food was simple and
> computer facilities were available. In addition, the beauty of the
x- residence (inside a small forest and by the side of grassy lands) and
> the enthusiastic hospitality or Ms. Bernadita Gonzales and her team made
> it a memorable experience and our thanks go out to them.
> ? On 13th May 2002, the PHM participants attended the special briefing
> session organised by WHO-CSI for NGO participants. Dr. David Nabarro
> highlighted the main points of concern and initiatives of WHO and its
> corporate strategy; Dr. Andrew Cassels reported on the salient features
> and recommendations of the report of the Commission on Macro-economics
> and Health; Dr. Pekka Pushka spoke on Diet, Physical Activity and Health
> and the 'risks to health’ that would be discussed at the round tables
> sessions, during WHA, this year; Dr. Alex Kalache spoke on the evolving
> policy of Active Ageing and some mention was also made about the Global
> Health Fund and the WHO-CSI initiative.
There was a short discussion
> after each presentation.
The PHM delegation was the largest group in
> the briefing session and among other concerns raised issues (i) the need
> for caution in putting not for profit NGOs and civil society m the same
> group as 'for profit - private sector' in the public-private
> initiatives; and (ii) the need to look at the relevance of WHO's
> concerns and activities including themes for WHO day, in the context of
> the socio-economic-cultural-political-epidemiological situation of the
> poor and marginalised of the world - the social majority (iii) the
> continuing importance of the primary health care approach and framework
> through which technical strategies concerning ageing etc., could be
> channelised. After the briefing, the PHM delegation had its own first
> briefing and strategy planning session at the same venue (this was the
> first of many such meetings throughout the 5 days).
> 6. WHA Inaugural Session
> ? In the afternoon of 13th, the PHM delegation attended the formal
> inauguration of the World Health Assembly with the presentation of the
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> Report of the Director General, WHO for 2001 and a guest speech by Dr.
> Carol Bellamy, Executive Director of UNICEF. We also experienced some
> of the 'politics' of intergovernmental UN agencies by witnessing the
> efforts by Taiwan for recognition as a special member state and the
> spirited and well planned opposition by the head of the Chinese
> delegation supported by the Pakistan delegate.
> ? The DG spoke about the four strategic directions of WHO under her
> leadership (a) to address the burden of ill health among very poor
> populations (b) to track and assess risks to health and to help
> societies to take action to reduce them (c) to improve the performance
> of health systems (d) to encourage national policies which promote
> health.
This report needs to be analysed carefully from the perspective
> of the Peoples Health Charter but two significant shifts in WHO thinking
> were obvious (a) There was no reference to the 'Health for All' goals or
> comprehensive approaches to health and health care development and only
> very marginal mention of the role of people, communities, civic society,
> campaigns and networks to partnership with WHO's efforts to make health
> for all a possibility.
In fact, the so called WHO - civic society
> initiative was conspicuous by absence of any reference to it (b) Except
> perhaps in the Tobacco Free initiative, most of the other initiatives
> supported by International Trusts, funds, etc., were focussed on
> bio-medical determinants of health and showed little concern or
> involvement in tackling the broader determinants of health except for
> passing mentions of poverty and health.
> 7. NGO Forum for Health
> ? Every year, the NGO Forum for Health, based in Geneva, organises a
> special session during the WHA. This year, the theme was 'Partnership in
> Action for Health' and the session was on 14th May from 9-12 noon.
PHM
> had been requested to be part of the panel and Ravi (India) and Sr. Ani
> (Brazil) presented lessons and case studies from the Peoples Health
> Assembly and Movement. Other panelists included Ms. Eva Wallstam
> (WHO-CSI) and her WHO colleagues Dr. Maria Neira (CDS/CPE) and Dr. Hans
> Hogerzail (EDM/PAR) who spoke on WHO perspectives on Partnerships for
> Health. Dr. Bernard Pecoui of Medicins Sans Frontiers spoke about the
> Action Oriented Approach to Partnership - based on MSF experiences. Dr.
> Judith Richter presented a very thought provoking and critical analysis
> of partnerships between UN agencies and the commercial sector. Dr. Eva
> Ombaka spoke on the Ecumenical Pharmaceutical Network for Essential
> Drugs. Ms. Nance Upham presented some provocative thoughts on the need
> for new partnerships in the fight against HIV-AIDS. Dr. Nils Billo of
> the International Union Against ™ and Lung Diseases spoke about
> partnerships between government and NGOs in the DOTS programme. Even
> though the case studies and experiences were very interesting and
> diverse, the presence of too large a number of panelists prevented
> adequate time for discussion.
The meeting was followed by a press
> conference and Ravi and. Sr. Ani attended it as PHM representatives and
> panellists. The press conference highlighted the concerns of NGOs on WHO
> partnership trends with private sector; and the need for greater
> involvement on Civil Society in WHO policy evolution and organisational
> response.
> 8. PHM Media Strategy
>
> ? One of the highlights of the PHM presence at WHA was the two member,
> full time media team, which included Unni from India and Sathya from
> Malaysia (supported by Nupur also from India), who were responsible for
> lobbying with the press and highlighting PHM concerns and PHM responses
> to emerging initiatives of WHO through formal/ informal press briefings,
> interviews and press conferences. A backgrounder on PHM and five press
> releases by them were distributed to the press and many of the delegates
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> as well, (a) Peoples Health Movement - a backgrounder on 13th May, with
> quotes from David Werner, Dr. Ekbal and Halfdan Mahler
(b) Health Care
> - WHO cares? Poverty, War and Debt - greatest threat to world health
> says PHM, - 13th May 20C2 (c) WHO Industry partnership - Who influences
> Who?, 14th May 2002 (d) Global campaign to be launched Revive the vision
> of Alma Ata!, On 15th May 2002 (e) the Peoples Health Movement marches
> on - from Dhaka to Geneva to Porto Alegre, 17th May 2002 (f) Peoples
> Health Movement condemns ongoing attacks on civilians in Palestine and
> the violence in Gujarat- on 17th May 2002.
> ? The advocacy effort provoked the DG and her senior colleagues to find
> the time and interest to attend the formal presentation of the Peoples
> Health Charter and reports from different parts of the world on post PHA
> initiatives, which in the formal invitation and announcement was to be
> chaired by ED - External relations and WHO-CSI only. It also resulted in
> media reports all over the world recognising, quoting and mentioning
> that PHM and civil society were concerned with some of the directions
> and initiatives of the WHO - moving away from the pro-poor Health For
> All goals.
The presence of a pro Health For All goals peoples movement
> was universally acknowledaed in many press releases, the Lancet article,
> 9. Mini PHA at WCC
> ? All the PHM participants attending WHA took time off from WHA on 16th
> May to participate in a full day sharing, reflecting, 'battery charging'
> session on the Peoples Health Movement and post PHA initiatives at World
> Council of Churches on 16th May.
The day started with a symbolic
> gathering of participants in the centi'e of Geneva with Peoples Health
> charters and posters and publications by the side of the special 'broken
> chair' monument dedicated to those people especially children who have
> lost limbs in post-war undetected mine explosions.
This was replete
> with slogan shouting and hand waving that was featured on Star TV in
> India on 20th May 2002 and also resulted in a much needed PHM collective
> public presence. The meeting at WCC which followed was facilitated by a
> four member team of Maria, Pam, Mwajuma and Thelma, animated by
> 'circulation stimulating' breathers and refreshers by Sr. Ani, our
> popular educator from Latin America.
> ? The full day meeting commenced with a self introduction round;
> followed by an exercise to list out through a simple timeline ones
> oncoina involvement in PHM and ones Vision for the PHM and tasks for the
> future.
This was followed by sharing by each parti.cipant which
> included initiatives and processes from all parts of the world.
In the
> afternoon, there was screening of a video 'Hey Ram' on the Gujarat
> violence which lead to great concern and a press statement on 17th
> condemning the attacks in Palestine and Gujarat.
This was followed by a
> brain storming session on plans for the next year, especially as the
> 25th Anniversary of the Alma Ata Declaration of September 1978 was
> nearing. Finally, there was a concluding session on future challenges
> and organisational issues chaired by Qasem and Ravi.
The Indian,
> Banaladesh and Latin American participants contributed to a poster
> exhibition for the event and all the participants also laid our
> publications and other materials for reference as well as takeaways.
>
>
I >
> 10. Some NGO inspired sessions
> The WHA is often interspersed with sessions organised by NGO initiative
> on issues and concerns relevant to Peoples Health.
Two sessions were of
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> particular interest to PHM participants :
> a) Poverty Reduction Strategies and Health: Action £ Roles
> at 5.30 p .m.
on 16th May
>
~> There was a briefinc and a discussion by WHO and Save the Children, UK,
> in collaboration with Medact and Wemos The speakers included Ms. Dr. N.
> Traore (Minister of Health, Mali); Mr. Mike Rowson (Director Medact,
> UK) Mr. Samuel Ocnieng (Chief executive Consumers Information Network,
> Kenya); Ms. Reina Euijs (Senior advisor nutrition and health, Ministry
> of Foreign Affairs, the Netherlands; Mr. Andrew Cassels (Director,
> Strategy Unit at the Director General's Office, WHO).
> b) Consumer improves Quality of Care
> Two short seminars on the above topic in connection with the WHO
> resolution entitled "Quality of Care", "Patient Safety" were organised
> on May 14th and May 15th by KILEN - Consumer Institute for Medicines and
> Health, Sweden, which was part of the IOCU (Consumers International)
> delegation to the 55th WHA. Speakers included : Dr. Mary Couper;
> Professor Ralph Edwards; Dr. Natalia Cebotarenco; Jan Albinson and Lena
> Westin
x* 11. The Technical briefinc on Peoples Health Charter
> ? This was the much awaited highlight of the PHM presence and
> participation in the WHA.
The briefing on the Charter was one of the
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> Diabetes - our failure to deal with a modern epidemic; (b) Guinea worm
> eradication / African trypanosomiasis intensified control; (c)
> Traditional medicine : access, effectiveness, safety and quality; (d)
> Recent developments in access to care of people living with HIV/AIDS;
> (e) Twenty-five years of essential medicines : achievements and
> challenges.
The briefing was announced in the programme, daily journals
> and through notices and handouts.
PHM participants also actively
x" lobbied with WHA delegates and WHO leadership and staff to be present
> and to understand the PHM concerns. (See Appendix 1 for the formal
> announcement).
> ? It had been decided earlier that Zafarullah and Ravi would present
> the PHA background and the Charter and Maria, Mwajuma and Ellen would
> share about post PHM concerns and initiatives from Latin America, Africa
> and Europe. -At the suggestion of WHO-CSI and after considering the
> Venezuelan Health Minister and then the WHO-DG as potential
> chairpersons, some of us from PHM invited Dr. Manuel Dayrit, the
> Secretary of Health of Philippines to chair the session. A briefing
> session was held with Manuel on 14th May in which many PHM participants
He patiently listened to
> and the WHO-CSI team were actively involved.
> all our concerns about WHO initiatives and its loss of focus, which he
> understood well from his initial experiences and participation in ACHAN
> (Asian Community Health Action Network) and other civil society
> initiatives. Among other things, the need for an urgent Joint
> Commission on Poverty and Health between WHO and PHM was felt necessary
> to complete the unfinished agenda of the CMH (Commission on
> Macroeconomic £ Health) which had totally ignored efforts of
> macro-economic and trade policies on the lives and health of people.
> ? As a result of effective lobbying, including the media strategy and
> the choice of a relevant chairperson, the WHO leadership changed its
> mind on 16th May and we were glad that the DG - Dr. Brundtland and Dr.
> David Nabarro, both decided to get away from their busy schedule and
> appointments ana attend the briefing. Dr. Brundtland welcomed the group
> and presented WHO's key concerns and her interest in Civil Society
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> partnerships and attended the whole briefing session including the five
> presentations. Dr. David Nabarro stayed back to answer questions and
> comments after the briefing. The chairperson managed the active
> discussion and comments, that followed the presentations, very well.
> ? Zafarullah started the briefing by narrating his early morning dream
> in which "WHO along with other agencies had become totally privatised
> with mergers and many staff retrenched. He ended with the hope that as
> in the Bangladesh folk tradition early morning dreams may not come
> true".
> ? Ravi presented the background of the PHA mobilization and the key
> elements and concerns of the charter using OHPs that has already been
x' widely circulated. With the assistance of David Sander’s OHPs — he
> snowed evidence about tne dismal performance even m the area of
> immunization in the last few years based on WHO and other data. He
> listed out 5 key messages to WHO that emerged both from the charter and
> the PHI' and highlighted 14 specific action points (see Appendix 2).
> These had been discussed in a meeting of some PHbi participants on 17th
> morning.
> ? Maria then presented, what was happening in Latin America since PHA.;
> followed by Mwajuma who described the concerns and initiatives in the
> African region; followed by Ellen who shared the concerns and
> initiatives from the European region.
The chairperson then allowed some
> questions, comments and discussions, which was lively in spite of a time
> constraint .
There were two rather supportive comments from a
> Venezuelan delegate and another from a delegate from francophone
> Africa. Someone also asked WHO about what they were planning for The
> Silver Jubilee Alma Ata Declaration in 2003, next WHA. Dr. Nabarro
> answered on behair of WHO though he was somewhat guarded in his
> reactions about the Alma Ata Jubilee celebrations; the issue of broader
> determinants, the need for a poverty commission, etc.
s.
> ? However, tile scheduling of another briefing simultaneously and that
> too on the theme.
'Twenty five years of Essential Medicine :
> Achievements, Challenges', which was a tonic of great interest to the
k> delegates and to NGOs including the PHM, meant that many had t.o choose
between the two sessions. Also Friday afternoon was late in the
> Assembly schedule.
in spite of these constraints, there was a larger
> group of participants at the briefing session perhaps partly because of
> the presence of the DG.
> 12. Final Strategy and Follow up Meeting
> ? After the Technical briefing session, the PHM participants met for the
> last time on 17th late afternoon for an informal final meeting chaired
> by Qasem to identify specific action strategies and volunteers to
> convene or follow up on these strategies and initiatives.
There was
> discussion and suggestions on a Communications / Media Circle (to be
> convened by Andy, UK;) some ideas to celebrate the 25th anniversary of
> Alma Ata with reflections by PHM groups including a joint Health
> convention at the next World Social Forum at Porto Alegre in February
> 2003; follow up on special issues of Contact magazine and Development
> Dialogue on Post PHA initiatives; and matters of strategy and
> clarification of procedures for representing PHM at meetings; the need
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A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A
> for further mobilization and regional meetings to identify the members
of the evolving Peoples Health Movement Council; need to support the PHM
Secretariat etc. Further details will be circulated from the
Secretariat.
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13.
PHM Dialogue with UNAIDS
? At the special request of Dr. Peter Plot, Executive Director of
UNAIDS, a dialogue with a small group of PHM participants was held on
17th May at 10 a.m. in the office of UNAIDS in the Palais Des Nations.
A team of seven resource persons from PHM - Maria, Sr. Ani, David
(Sanders), Thelma, Mwajuma, Dorothy and Ravi met Dr. Peter Plot and some
of his colleagues to understand the concerns and initiatives of UNAIDS
and also share the concerns and suggestions of PHM participants on the
H1V/A1DS problem in their own countries and regions.
It was decided.
that since UNAIDS and PHM had many similar concerns and perceptions of
the problem, such a dialogue should continue.
It was decided that a
'Poverty and .AIDS' circle would be convened as an issue circle that
could continue Lilis dialogue with UNAIDS. Dorothy volunteered to
facilitate this circle and the continuing dialogue with UNAIDS. Others
interested in the AIDS oroblem could join the circle. Dorothy , Thelma,
Maria and ohbere met with some of the UNATDS team after the technical
briefing as well and further details will be circulated.
14.
PHM dialogue with GFHR
? The Global Forum for Health Research (Louis Currat, Executive
Secretary and Andres de Francisco, Senior public Health Specialist)
contacted some of the PHM participants to explore how PHM could
participate in the next Forum 6 at Arusha, Tanzania in November 2002.
They appreciated greatly Ravi's input on behalf of PHM (presentation of
research challenges from Charter) at Forum 5 at Geneva in October 2001.
This had been included in the 10/90 Report on Health Research 2001-20u2
(see A.ppendix 3) .
The GFHR team and a few PHM researchers met for a short dialogue and it
was decided that PHM, as a start would participate in the final plenary;
in the session on TB and on Access to Drugs and also coordinate a
parallel workshop on Research by CSUs. David from South Africa agreed
to be the contact point of PHM for GFHR and Forum 6 and follow up on
these and further ideas of collaboration.
These were just a few
possibilities. As more researchers in the PHM Circle were identified
the participation possibilities in Forum 6 sessions could be enlarged.
15.
New Contacts and Opportunities for presenting PH Charter
? During the week in Geneva, apart from UNAIDS and GFHR mentioned
earlier many other organisations met up with some of the PHM
participants and discussed possibilities of dialogue, working together
or informed about meetings at which the Charter could be presented.
All of them were requested to keep in touch with the PHM Secretariat and
wavs and means to follow up on the requests would be evolved by the
secretariat and its support group.
These included :
1. World Civil Society Forum, Geneva, 2002 - 14-19th July
(http://www/worldcivilsociety.org
Email : forum@mandint.org)
2. World
Organisation of Family Doctors Ltd.
(contact person : Dr. Use
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}> 3. NGO Cornyn rrp° on the Status of Women, Geneva (Email ■
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> 4. Asia Civil society Forum, 2002 - UN/NGO Partnership for Democratic
> Governance, Bangkok, 24-29 November 2002 (Email : congo.gva0congo.org)
> (Website : www.congo.crg)
>
> 5. The AIDS Network - an international network to formulate an
> alternative public health approach to AIDS
> (aidsmanifestow club-internet!r)
> 6. NGO Adhoc Advisory Group on Health Promotion (contact person : Joanna
> Koch. Email : bhgljibo.org Website : www.ibo.org)
>
>16. In Conclusion
> ? In the final analysis the first, proactive, PHM participation and
> presence in WHA went better than our initial expectations.
Tt was a
> good opportunity for PHM participants to understand some of the dynamics
of discussion, policy evolution and dialogue in WHO as an
intergovernmental, UN organisation and the need for more effective
> lobbying with our own government delegates and WHO leadership.
The
> enthusiasm of participants was ver; infectious and the media team very
> provocative and effective. However, we also understood the complexities
> of rhe situation both within and without WHO and the need for a more
> planned, better analysed and researched collective strategy to counter
> the 'market economy’ trends and the overdose of selective bio-medically
> oriented responses in WHO policy planning and initiatives.
> ? Much more needs to be done and in a much more rigorous and strategic
> way.
> ? But the week in Geneva was a good beginning and a good 'battery
> charger' for all those who made it. A word of thanks to Eric of NGO
> forum, Manoj of WCC, Eva and Margareta of WHO-CSI, Fawzia of UNAIDS, who
> in addition to so many others played key supportive role in arranging
> the local logistics for the events.
Appendix
" Room XVI
1:- Technical Briefing Friday, 17th May 2002,
1300-1400 Hrs.
>
> "CIVIL SOCIETY PERSPECTIVES ON HEALTH : THE PEOPLE'S CHARTER FOR HEALTH
> (there will be interpretation in Arabic, Chinese, English, French
> Russian and Spanish)
> During the last 20 years, there has been a dramatic growth of civil
> society organizations and a significant increase in their involvement in
> health, both at national and at global level. WHO recognizes that it is
> only by working with a broad range of partners including civil society
> organizations that a lasting difference can be made to improve health.
> The purpose of the briefing is to share the experience of the People's
> Health Assembly, an example of civil society involvement in health in
> recent vears, and to offer a forum where issues related to people's
> involvement in health can be debated. Representatives from the People's
> Health Movement will present the processes surrounding the Assembly that
> took place in December 2000 in Bangladesh which brought together
> participants from over 92 countries. One important outcome of the
> Assembiv was the endorsement of the People's Health Charter.
The main
> concerns and themes outlined in the Charter will be presented at the
oflO
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briefing and a panel of speakers representing different regions of the
> world will briefly highlight developments in the People’s Health
> Movement since the Assembly”.
> Source : WHA Journal
> Appendix 2. Call to World Health Organization
> Be a strong advocate for poverty eradication, eg.,
> - Greater equity (in WTO/WB/IMF)
> - Debt cancellation (in WB/IMF)
> - Fairer trade (in WTO/TRIPS)
> - Poverty and Health Commission (WHO £ PHM)
> Promote comprehensive approaches, eg.,
> - Avoid vertical wholly technical initiatives (eg., GAVI)
> - Ensure greater intersectorality (like Thailand-Basic Minimum Needs
> Programme)
> - Involve community and people’s organizations in ’evidence and action’
> Strengthen public sector for health, since
> - No evidence that privatisation leads to equity
> - Prevent agenda setting by corporate interests (be like Tobacco Free
/ Initiate not Roll Back Malaria Programme)
> Involve people’s organizations in WHO work, eg.,
>>
—
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> — At regional levels
> - At WHO level (beyond Civil Society Initiative and World Health
> Assembly)
> Promote more participatory, relevant transparent public health policy
> processes and initiatives eg.,
> - From ’DOTS’ to ’Community Oriented TB Services (COTS)’
> - From micronutrients to ’food’
> Source : Technical Briefing by PHM at WHA, May 2002
> Appendix 3. : — ’’But there is a more devastating, more direct and
> self-reinforcing effect of poor health on poverty, through the vicious
> circle of poverty, i.e., malnutrition, disease, unemployment or
> underemployment, low income, poor housing, low level of education, low
> productivity, no access to drinking water, no access to health care
> services, larger number of children, unwanted pregnancies, substance
> abuse.
In addition, poor people are more likely to suffer from the
> degradar-i r>n of the environment and from discrimination. Once trapped in
> this vicious circle, the chain of causality is very difficult to break,
> as pointed out by numerous reports, including the People's Charter for
> Health*
"
> *Ravi Narayan, Community Health Adviser, Community Health Cell, PHM,
> India.
Paper presented at Forum 5, Global Forum for Health Research,
> October 2001
>
> Source: The 10/90 Report on Health Research 2001-2002, Global Forum for
> Health Research,
p4
>
>
8/29/02 2:23 PM
bVExchange> PHM Geneva Report (final)
AAAAAAAAAAA
5th June 2002
Pavi Naravan
BcngcTlore
Convenor, WHO-WHA Circle of Peoples Health Movement
PHA—Exchange is hosted onKabissa - Space for change in Africa
To post, write to z PIIA~Exchange@kabissa.org
Website: http://www.lists.kabissa.org/maiIman/listinfo/pha-exchange
lOofio
8/29/02 2:23 PM
i iic missionary positions NGOs
cevckpmcnt in Africa
Subject: l’HA-Exchangc> The missionary position: ?<GOs anti development in-Africa
Date: Ihu. 15 Aug 2002 21'36:59 -0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch'1 <-pha~exchan2e/i?'kabissa.org>
U v~
•
tt ” - y
_ — — . C.W
'* —
.
-t 4 tl
_
y—
v
'z ■r q
i'
-N Vo v'
— V.*C*-.CA
Published in In Lerna Lioi-dl Affairs,
73:3
C* n v" 1
(2002)
/A t r"*
»_z
4 1 1
— _-i_
567-33.
Excerpts:
NGOs “odav cor-ribute marginally to “he relief of
pover~y/ii1 ?.?.a^-th/maInutri_ionr but oignificantly to undermining the
struggle of trie people to emancipate themselves from oppression...Programs
delivered by these NGOs do not really seek to redress the social
circumstances that cause impoverishment/preventable ill-health and
malnutrition....
The development discourse is framed not in the language
expertise, neutrality and paternalism....
Development as a whole has worked to undermine popular mobilization....
NGOs accept or do not comment on the manner in which the state exercises
tricks rather than seeking justice and standing up against violations of
Human Rights (HRs; . . .
Many NGOs were co-opted by funders to taking up such a role (a typical
sxamole is work to set un ssfst’’ nets for the noor' . . . Development NGOs have
oecome an integral part or a system that sacrifices respect for justice and
rights, instead taking a missionary position...
If NGOs stand in favor of emancipation, then the focus of their work has
invariably r.o be in rhe equi r.y/HRs/poi i ti cal domain, supporting those social
movements that seek to ohallonco a social system that benefits a few and
impoverishes the many.
^..'.-.iiange is hosted on Nao-issa
Space for change in Azrica
To post, write to: PHA-Exchange@Jcabissa.org
Website: http: //www. lists . kabissa. org/mailman/listinfo/pha-exchange
p l-> £i
i of i
8 u 9/02 1.51 P.vl
.VuTSCS b"alu drain
Subject: l’HA-Exchange> iSurses brain drain
Date: Wed 14 Aug 2002 23'03 04 4-0700
From: "Aviva" <aviva,%netnani.vn>
To* "pho-cxch' <pho”oxchon2cfiz},kobissci.org>
rei-z quai
for qualified nurses.
mounds ar hour and just one dav's
tags by increasing the number of
7-Qlleges from 1 000
000 this wear,- and has
nurses trained every year
28 July 2002)
stea
1 ofl
Kabassa - Space for change in Africa
:hange@kabissa.org
kdbis5a.org/ in a ilman/listinfo/pha-exchange
8/16Z02 7,15 Pm
■ ^uisnge> v fluid Health.v-.t
Research Initiative (C HNRI)
Subject: PHA-Exchange> Child Health and Nutrition Research Initiative (CHNRI)
Date: Wed. 14 Aug 2002 22:55:31 +0700
Prom: "Aviva"' <aviva@netnam.vn>
To: "Le Thi Hop" <hopnin(tt:hn.vnii.vn>
CC: "pha-exch" <pha-exchange@kabissa.org >
Frc~: "Salter Gulbinat" <gulbinatw@who.int>
> child
and Nutrition Research Initiative (CHNRI)
at - Global Forum for Health
> Health research is essential to improve the design of health inter> ventions, policies and service delivery. Every year more than US$ 70
> billion is spent on health research and development by the public and
> nrivate sectors. An estimated 10% of this is used for research into
O/l Jr
r r-.’•> o '.r<~ r ' X r <? r> o n ' + n ^'"OblemS . Th S IS What 1S Called f
10/90
h* car.'. The Global Forum for Health Research is an independent interna> tional foundation established in 1998 in Geneva, Switzerland. Its
> central objective is to help correct the 10/90 qap by focusing re> search efforts on diseases, determinants and risk factors represent.> ing the heaviest burden on the world's health and by facilitating
> collaboration between partners in both the public and private sec-
The Global Forum is supported financially by the Rockefeller Founda
tion, World Hank, World Health Organization and the governments of
Canada, the Netherlands, Norway, Sweden and Switzerland. The Global
Forum supports networks in health research bringing together a wide
range of partners in a concerted effort to find solutions to priority
heal th probl OZP.S .
The Child Health and Nutrition Research Initiative (CHNRI) is a re~
centi'’ formed n—c?.ro27.< ot interested oartners swooorted bv the Global
rr«
j. Ou. uZi.
—^.-v-
j. ou-
rr—. ' — u
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-
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<2 0 l. j.
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ivut. A-iiiw
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kiclhvuu'J.uu j.
ca‘. jssues of priority string on Child Health, Nutrition and uevelopment research, and on a life -cycle approach to child health and nu
trition research, it aims at increasing the level of communication
and discussion amoncst ^la^e^s wo1" kino on "research on child health
and nutrition, sucn as nutritionists, child health specialist, and
child development specialists. it further stimulates research and
supports the expansion of research into priority child health and nu
trition problems on a global basis, especially in lov/ and middle in-
> The need for a global initiative on child health and nutrition re> search (CHNRI) is based on the requirement of increased communication
among disciplines working on research on child health, nutrition and
development. CHNR.I provides a platform to initiate and maintain de
bate on the IrnpoLtance and direction of Che leseaich. IL blings Loaether scientists and implementing bodies to discuss issues relevant
to the current status of knowledge and the requirements for the fu
ture, Further, CHNRI allows communication with donors and potential
> contributors, tnereny nelping direct funds to the cause. The initia
> tive, therefore, makes an effort, to ensure that identified gaps are
b&mg nj.ghl^.gh^cd an-» addressed•
.fcU-b
> w.h^r. CHNRI was initiated, the view on its governance was that the Se-
S/16/02 7; 10 Pivi
anu
iliid
the meantime,
last two
the Global Fos Reouesr.
Proposa1s
yea rs
ive ror
erlo ci
or t h
jo
promote
cussions within a broadened ap
developing countrv institutions and
res cooroma
e oroaoest ano mos
usrve
working to reduce the 10/90 gap in
alread.v partners in the process. The
■e
gn rrequenc excnange or rnrormation .
ween
However, the CHNRI Secretariat is the operaGovernance is the main function of the
tow/miaaie
the Global Eorum,
reports to the Board.
e CH1\
ma enta
and the secretary
collaboration and communication amona diffe.
stituents through the CHNRI
uocta te
err orcs
or can
8/16/02 7.10 PM
? A- Cxchan
Health 2Tid NutriuCii R.escarch Initiative (CHNR.I)
DrCO0
3 ■' *"
?.'3CT S” " ■'
3 7_£■ 3 , C? '"CT3n Z3 ~
**
''instil ; Les/ayenc-ies will be considered lor hosting CHNRI Secre>
tncc o^r. der.c.’Tssr^uo tneir capacity to
> " maintain International communication, including easy e-mail access
> * organize and manace .'.r.temat ior.al health programmes
i-i . . C. A-'J-- '~ <-• u —'
> "■' manage interr. ~ t ■~.r.al health research, preferably in the .fields of
> * develop a v:ork.~vlan for proposed activities to be carried out by
>
t-h& ■--------------------yot-^ r 7 A f"- b'/zr
yc,; rx----------n — r i bri
■ — — a— "yj------—
' ceveoop ano manage a oucget rcr the Secretariat and its activities
> r support workshops, meetings and symposia to promote research and
>
networking of CHNRI
> * maintain the infrastructure necessary for providing support to the
>
Board.
> The institution should have a public health mandate from any public,
> private or academic sector in a low- or middle-income country.
> Support for tne functioning and activities of the CHNB.1 Secretariat
> is expected to tie avaid.abd.e nor some staff costs, administrative
> helpr communications, and small meetings. The support will come from
> * from the rest organization as a sign of their commitment
(funds,
> * seed support for core functions from the budget of CHNRI, approved
>
by the Board and managed bv the Secretariat and the host
> * ether partners or ~und raising efforts initiated by the secretariat
>
under guidance of the Board.
> Schedule of '.'.Torh
The deadline for letters of intent is 30 September 2001. Review and
> selection of groups will take eight weeks and results will be an> nounced by late November 2002. To aid the transfer of knowledge and
>■ enable the Secretariat to become functional as soon as possible after
> the transfer, it is envisaged that the current.Secretariat will work
> with the newly elected Secretariat for a 2-3 month time period. Ap> plication process Applicants are requested to send in a proposal of
> no more than 10 pages (excluding appendices which should also nor. ex> cocd 10 additional pages) covering the following sections:
> * Leiter of Intent (detailing mailing and email address)
>
Description ci tne organization/institute/agency, including its nationaj. and international roles
> x Descript ion of internal management processes (e. g, governing bod>
ies or processes, financial control, reporting and approval
>
requireme.'its)
>
Capacity and e:-perienoe of the institution vis-a-vis the stated re>
qulrem.ents
>
Proooseo method of work
x * T^stitutional/covernment support for the functions of the Secre
' 0-1.
PHA-Exchanae> Child Health and Nutrition Research Initiative (CHNRI)
8/16/02 7.10 PM
•> Propose' s
s
'
hs
? v’aq1
by .30 September 2002 at. the
»-
> G-ZVbdi Fcxur. 2m HealLh Research
> (Attention iva-cer Rmdnat)
> c/o WHO
> 20 A.venue Aooia
n. 12^1
'‘’e'"' -’’’■■■'
S”' tZ'~-1 a'''2
> Te3 : +4'-22-2^1
> Ra:.: r41 -22-2m -'i3?s
> ^21 Lc:gulblnaL^&who. inc
pj.eass note' zns^ztu-j.ozs a^rs caut2.onec4 chat tnene v/j-H ste no exten —
>
rr-a
r. .applicants should carefully
> consJ.dcr their capacity tc deliver the products on time.
PHA-Exchange is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-Exchange@kabissa.org
PllA-E
1
job announce
c" li^\-xSXC*iuIle£C'* jvb mHUGUIiCvillClli, A xlO
Bate: Fri. 16 Aus 2902 08:17:01 -0700
From: ‘ Aviva:; <avivafanctnom.vn>
nhn-pvr
h1 <T?h3"£>Lcli3ii2€7? k<ibissa.ort’->
r*“*
** .’.■“ nave .>.■.ss L -Leri:. pauFessj-unal ooslLlons aL Lhe Would Health OrganlzaLion
> in zne Department ci Health Financing and Stewardship WHO Geneva
> e-mail: emerycGwho.inc
Short-Term Professional Positions at WHO:
Programme of Work on Health Systems Performance and Poverty Reduction
-~-5 part oz its wcrK
support countries m improving the performance
their health systems, "HO is:
? developing a programme of work on health and poverty reduction. The main
hzbiective of this ’.•.’?r.< is analysis
formulation implementation menitorinc*
ana evaluation oz z~z.'_ .zea^zn policies and poverty reduction strategies.
f developing a orocramme of work on rhe function of stewardship. it will
cover a wide spectrum of activities: more detailed characterization of the
concept of stewardship, the development of practical methods to assess
stewardshin and work to " i^k a^al’,c?es o^
>*r<cb i *-> t-q
t-o
strengthen it.
? working with .temn-r States to generate, synthetize, present and
disseminate a suostantia^. amount oz new information on different aspects of
nar.ionai and sun-rar. i nna . naa : th systems performance,
qua 1.1 LaLxve dala
heallh sysLern. inputs,
including health
fuiicll'ji:s and goals in individual
? developing a prograrm.-e of work to increase WHO capacity for health policy
and systems swoon to countries, in order to strengthen the desion and
1 Several positions are likely to be available requiring a range of
different sfiiis ana different levels of experience. The Department of
Health Financing and Stewardship (HFS) is more specifically looking for
Professionals with a background in political and/or development economics
questionnaire development and techniques for cross-population research, to
contribute to instrument analysis and development.
A background in Political and/or development economics sciences public
health or sociology, who possess excellent analytical and writing skills, to
contribute to the development of policy briefs and country reports on health
systems ana poverty reduction. A first degree in one of the social
sciences, with strong quantitative skills in multi-variate statistics and
experience with analysing larce data setsf as well as usinc psychometric and
zaczcr analysis, zz soZiZtibute zo the analysis of information on aealth
systems performance. Ability to work in STATA would be an advantage. A
background in health policy and systems analysis, especially in less
developed countries; experience in organizing cross-country capacity
bui'dinc *^r ocramm.es fo1” a wide
technical excerts and
decision-makers, and e'<cellent organizational and manager1a± ski±1s.
Preference '..'ill be given to applicants who have excellent knowledge of
JZnglisn or rrencn >.wj.zr. a wording knowledge of the other) , and good
1 nr. erne r son a 1 ski I; s wir.n a proven ability to work in a team. Initial
app^ ’ ^"mor t s
' be
" 1 »/■. ■- >-> x g <•,
shorter, depending on a va lability and
experience. The s-jcesstul appllca^ils will work under the guidance of a team
cecrcinazcr.
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. kacissa ■ crgZr.;ailii:ar./list inf o/pha-exchange
Ttost
2 oi 2
8/19/02 i.22 PM
Subject: PUA-Excfaange> Correction in the stated Aepali month yesterday - The Kathmandu Rally
Sy oMj soi%?1 't?s for ■’Tcmecracv
Date: Wed. 21 Aug 2002 04:30:31 -0530
Froiiiz "yirdhiirn P Sin*csth?/’ <xnrithur2?zP.ienltluiel.ors np>
Io:
mmumty Radio” <woit@terracom.net>, ”VHAI” <vhai@sify.com>5
’’Thomas Achard” <lhomas.achard@bluewin.ch>.
rtc.
—t- --- o - A .!C.’■'SiUVZ.U ......
______
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"Souiii-Sou'ih Solidarity" <south'tf giasdl01.vsnl.net.in>. "Sophie Beach" <SBeach®cpj.org>.
’^HANei'.vork'' <;.?ha-exchanae?? kabissa.ors'' "N'laiv De: Chene" <:mdesch€'ri.'emo’v edtA
dpshiia (HE)" <ipshita'S:intoday.com>, "Ian Harper" <ian harper2000 ayahoo.com>.
"ek"
ciTechco.net>. "Edelina de lo. Paz" <bdelapaz/??uplink.com.ph>.
■ opton1ine.net>, "anna dehavenon" <adeliavenon@iiuiidspriiig.coin
rarr
PlM
a-ioiC OU TiiC \
PcSiuCh i2'
Subject: PH A-Exchanged* More on the Missionary Position (2)
Date: Sun, 18 Aus 2902 06:36:18 -0700
From: "Aviva" <aviva'a netnam.vn>
> Development NGCs operating in Africa have inadvertently become part of the
and
an riches in much the same way as their missionary predecessors, argues
In
till 5
benefits a few and impoverishes the majority; or they can
continue
in
’The Mi s si on a ry Po s i t ion: NGOs a nd De ve 1 oomen t 7 n Africa r , and
> authored by Flroze IKanjl and Carl OrColli, the paper traces the emergence
missionary beginnings through
programmes and globalisation.
1 Af
argues that
at supported toe
> In some cases, charitable organisations "actively" helped to suppress
> colonial struggles, as was the case in Kenya, where the Women's
Association,
> i-'iaer.del eo Ya Wanawak-^ (MYWO) and the Christian Council of 'Kenya
(CCK) were
> 1:. jcl.^ec 1:. go-/er indent-1 ^nded schemes designed to subvert black resistance
> curing tne rMau itau’ uprising.
8/19/0
t dying a
and
■ha ri i~a'r> 1 e
ostj-oor oy appropriating
it
cause non-liestern people vrere defined by th
ural standards
more tn an a
i*72tn the
~ u n a < ci n e a u a n
tn
pment ana create
economic
The rest, c
trey
ga ve
mpQse
demands, somethina that was not always popular wi
ay lending
'Vha~ em~rfieri rac
8/19/0:
1 CO S-J-JOi . =-r.'71Cc?3 “C tf.e 7 ui i'l&rabl <5 ’ ai'id became the
> ^er.a-icianes of fords intended co mitigace the inequalities of adjustment
> P°^icfes. This Add d "profound" impact on the sector and together with an
> increase - r
as a conduit for government aid led to dramatic
S r-r x~ -. - - - ..
7 C<- •-/c* —•' »i iAX^7—>-—•»’ z- □ .
■-- -
>
n z.ior cr.arofore
so to a 'foss or authority" by African states
over
> social dc"e_. cement and policy, ,.^r rhe same time,- Mandi and O’do.lll ooint
S/19/02 2.57 PM
chc about the down.
readme
the
PEA Exchange is hosted on Kabissa
Space for change in Africa
- : PHA-Exc . ; ?] bissa.org
cs s i o e : no op : ■' r.?.-.;. .isos . kabissa . org/r.:Qi l^an/1 ist inf o/pha-cxchange
HA-Exchange> Earth Summit - PRESS RELE...INTERNATIONAL- ON DISASTERS AND WOMEN 2
Subject: PHA-Exchange> Earth Summit - PRESS RELEASE from the HUA1ROU COMMISSION
AND GROOTS INTERNATIONAL- ON DISASTERS AND WOMEN 2
Date: Thu, 22 Aug 2002 20:58:11 +0530
From: "UNN1KRISHNAN P V (Dr)" <unnikru@yahoo.com>
To: <unnikru@liotmail.com>
^Part 1.1
Type: Plain Text (text/plain)
Encoding: quoted-printable
8/28/02 12:14 PM
IIUAIROU COMMISSION
Women. Homes and Community
Email- huairou(fi!earthlink.net
New York:
lele: 718-388-8915
www.huairou.org
Fax: 718-388-0285
URGENT
PRESS RELEASE
Istanbul, Turkey; August 21st 2002 "PLACE WOMEN AT THE CENTRE OF
DISASTER RESPONSE STRATEGIES", Huairou Commission urges (he planners and
the international community to do a 'reality check'.
"Place women at the centre of any initiative to respond to the devastating impacts of
natural disasters. The experiences of women in Turkey and India in responding to a series
of earthquakes that shook these two countries last decade show that women-centred
initiatives alone will help to put the lives of the affected communities back in place." This
is the key demand coming out of an international consultation held at Istanbul on the eve
of the World Summit on Sustainable Development at Johannesburg (26 Aug -4 Sep,
2002).
The consultation at Istanbul was facilitated by the Huairou Commission and GROOTS
International, two international coalitions who have been actively involved in facilitating
women-centred disaster response strategies. The consultation brought together a group of
disaster-affected communities, grass root women groups, non-governmental
organizations, relief agencies, academicians and international experts.
"We need to think differently and act differently. The international community has a
collective responsibility to place women at the center-stage of disaster response
strategies," said Ms. Jan Peterson, Chair- Person of Huairou Commission.
Disasters, despite their devastating nature also provide opportunities for new community
equations. " It was only after the earthquake that we came together to take collective
action and now we feel more powerfill," said Ms.Hamiye, a grassroots leader from
Women's Cooperative in Tzmit, the industrial province of Turkey.
In 1999, two devastating earthquakes killed over 20,000 people in Turkey. Over 340,000
houses were damaged or destroyed and the industrial province of Izmit was shattered.
Another earthquake reconfigured the landscape in Gujarat (India) in 2001 killing over
15,000, leaving a long trail of mortality and morbidity.
"Programmes such as Disaster Watch' and 'Community to Community' exchanges have
energised women's groups of Izmil (Turkey) and Gujarat (India). I earning from practice
is a tool for empowering communities. It further helps to transform a crisis into an
opportunity for rebuilding. For better results, International agencies need to invest in
building local capacities and community-based disaster reduction initiatives," said Ms.
Prema Gopalan, director of Swayam Shikshan Prayog (SSP), India.
"Disaster response and rehabilitation is not just about efficiency. It is also about a better
governance and the use of disaster aid in which women can play a critical role. Their
experience can help to formulate more pragmatic disaster management policies," said Ms.
Sengul Akcar of the Istanbul based Foundation for the Support of Women's Work
(FSWW).
The call to place women at the centre of disaster response initiatives comes at the most
appropriate time. In the last decade, the total number of people affected by disasters has
tripled to 2 billion. There has been a live-time increase in the total direct economic loss
during the same period.
These grim statistics remind us about the difficult road the world has travelled since the
Rio Summit in 1992. The United Nations' International Strategy for Disaster Reduction is
expected to boost its efforts alter the Johannesburg Summit. However, (he UN strategy
needs support and synergy of different constituencies, especially women and grassroots
groups.
The World Bank estimates that 97% of the natural disaster related deaths each year occur
in developing countries. The percentage of economic loss in relation to the GNP in
developing countries far exceeds that in developed countries. The devastation that each
disaster causes reverses the social development in these countries by decades. Perennial
poverty, bad planning and lack of community-driven strategies further neutralize the
recovery.
"It is true that the devastating impacts of disasters have gained visibility since the Rio
Summit. But the challenge is to place the affected communities and the most vulnerable,
especially women, at the centre stage" said Ms. Sandra Schilen, Global facilitator of
Groots International, a coalition of grassroots groups. Schilen and her coalition network
partners from Asia, Africa and South America will moot this concept during the Global
Summit al Johannesburg.
On the eve of the Johannesburg summit, grassroots groups make 3 key demands;
. Be innovative: Initiate disaster response strategies in consultation with the
a.
community in general and women in particular.
. Invest with vision: The donor agencies and the UN must make a long-term
b.
commitment to disaster response programmes.
. Ensure synergy: The UN, Government, Non- governmental and private sectors must
c.
find common grounds for collaboration. This will help to optimize the scarce resources
that often miss the target.
Jan Peterson
Prema Gopalan
For media enquiries : India : +91 (0) 98450 91319 & New York: +1 9175327055
During the Earth summit, the Huairou Commission and GROOTS International
representatives can be contacted at Johannesburg :
Mobile phone : 027.82.858.9440 (Sandra Schilen or Prema Gopalan);
Phone - 011-615-9744
Message forwarded by :
:
Email: GROOTSss@aol.com
Dr. Unnikrishnan PV
Co-ordinator: Emergencies & Humanitarian Action, OXFAM INDIA
E-mail: unnikni@yahoo.com
Mobile: + 91 (0)~98450 91319
++++++++++++++++++++++++++++++
CONTACT
DETAILS
OXFAM INDIA
Vijaya Shree. 4th A Main. Near Baptist Hospital, (off) Bellarv Rd, Hebbal, Bangalore560 024 - INDIA
Ph: 91 (80) 363 2964, 363 3274 ; Fax : 91 (80) 391 4508 (attn: Oxfam India)
E-mail: oxfamindia@vsnl.com Web-site: www.oxfamindia.org
HA-Exchangc> Earth Summit - PRESS RELE...INTERNATIONAL- ON DISASTERS AND WOMEN 2
Subject: PHA-Exchange> Earth Summit - PRESS RELEASE from the HUA1ROU COMMISSION
AND GROOTS INTERNATIONAL- ON DISASTERS AND WOMEN 2
Date: Thu, 22 Aug 2002 20:58:11 +0530
From: "UNNTKRISHNAN P V (Dr)" <unnikru@yahoo.com>
To: <unnikru@hotmail.com>
iE>part ] j ;
Type: Plain Text (text/plain)
“
~ : Encoding: quoted-printable
P M 0 -Eye ci^
ofl
~2>
8/27/02 1:58 PM
HUAIROU COMMISSION
Women, Homes and Community
Email: huairou@earthlink.net
New York:
Tele: 718-388-8915
www.huairou.org
Fax: 718-388-0285
URGENT
PRESS RELEASE
Istanbul, Turkey; August 21st 2002
"PLACE WOMEN AT THE CENTRE OF DISASTER RESPONSE
STRATEGIES", Iluairou Commission urges the planners and
the international community to do a 'reality' check'.
"Place women at the centre of any initiative to respond to the devastating impacts of
natural disasters. The experiences of women in Turkey and India in responding to a series
of earthquakes that shook these two countries last decade show that women-centred
initiatives alone will help to put the lives of the affected communities back in place." This
is the key demand coming out of an international consultation held at Istanbul on the eve
of the World Summit on Sustainable Development at Johannesburg (26 Aug -4 Sep,
2002).
The consultation at Istanbul was facilitated by the Huairou Commission and GROOTS
International, two international coalitions who have been actively involved in facilitating
women-centred disaster response strategies. The consultation brought together a group of
disaster-affected communities, grass root women groups, non-governmental
organizations, relief agencies, academicians and international experts.
"We need to think differently and act differently. The international community has a
collective responsibility to place women at the center-stage of disaster response
strategies," said Ms. Jan Peterson, Chair Person of Huairou Commission.
Disasters, despite their devastating nature also provide opportunities for new community
equations. " It was only after the earthquake that we came together to take collective
action and now we feel more powerful," said Ms.Hamiye, a grassroots leader from
Women's Cooperative in Izmit, the industrial province of Turkey.
In 1999, two devastating earthquakes killed over 20,000 people in Turkey. Over 340,000
houses were damaged or destroyed and the industrial province of Izmit was shattered.
Another earthquake reconfigured the landscape in Gujarat (India) in 2001 killing over
15,000, leaving a long trail of mortality and morbidity.
"Programmes such as Disaster Watch' and 'Community to Community' exchanges have
energised women's groups of Izmit (Turkey) and Gujarat (India). Learning from practice
is a tool for empowering communities. It further helps to transform a crisis into an
opportunity for rebuilding. For better results, International agencies need to invest in
building local capacities and community-based disaster reduction initiatives," said Ms.
Prema Gopalan, director of Swayam Shikshan Prayog (SSP), India.
"Disaster response and rehabilitation is not just about efficiency. It is also about a better
governance and the use of disaster aid in which women can play a critical role. Their
experience can help to formulate more pragmatic disaster management policies," said Ms.
Sengul Akcar of the Istanbul based Foundation for the Support of Women's Work
(FSWW).
i'he call to place women at the centre of disaster response initiatives comes at the most
appropriate time. In the last decade, the total number of people affected by disasters has
tripled to 2 billion. There has been a five-time increase in the total direct economic loss
during the same period.
These grim statistics remind us about the difficult road the world has travelled since the
Rio Summit in 1992. The United Nations' International Strategy for Disaster Reduction is
expected to boost its efforts after the Johannesburg Summit. However, the UN strategy
needs support and synergy of different constituencies, especially women and grassroots
groups.
The World Bank estimates that 97% of the natural disaster related deaths each year occur
in developing countries. The percentage of economic loss in relation to the GNP in
developing countries far exceeds that in developed countries. The devastation that each
disaster causes reverses the social development in these countries by decades. Perennial
poverty, bad planning and lack of community-driven strategies further neutralize the
recovery.
"It is true that the devastating impacts of disasters have gained visibility since the Rio
Summit. But the challenge is ro place the affected communities and the most vulnerable,
especially women, al the centre stage" said Ms. Sandra Schilen, Global facilitator of
Groots International, a coalition of grassroots groups. Schilen and her coalition network
partners from Asia, Africa and South America will moot this concept during the Global
Summit at Johannesburg.
On the eve of the Johannesburg summit, grassroots groups make 3 key demands;
. Be innovative: Initiate disaster response strategies in consultation with the
a.
community in general and women in particular.
. Invest with vision: Tire donor agencies and the UN must make a long-term
b.
commitment to disaster response programmes.
. Ensure synergy: The UN, Government, Non- governmental and private sectors must
c.
find common grounds for collaboration. This will help to optimize the scarce resources
that often miss the target.
Jan Peterson
Prema Gopalan
For media enquiries : India : +91 (0) 98450 91319 & New York: +1 9175327055
During the Earth summit, the Huairou Commission and GROOTS International
representatives can be contacted at Johannesburg :
Mobile phone : 027.82.858.9440 (Sandra Schilen or Prema Gopalan);
Phone-011-615-9744
Email: GROOTSss@aol.com
Message forwarded by :
Dr. Unnikrishnan PV
Co-ordinator: Emergencies & Humanitarian Action, OXFAM INDIA
E-mail: unnikru@yahoo.com
Mobile: + 91 (0) 98450 91319
CONTACT
DETAILS
++++++++++++++++++++++++++++++++++++++++
OXFAM INDIA
Vijaya Shree. 4th A Main, Near Baptist Hospital, (off) Bellary Rd, Hebbal, Bangalore560 024 - INDIA
Ph: 91 (80) 363 2964, 363 3274 ; Fax : 91 (80) 391 4508 (attn: Oxfam India)
E-mail: oxfamindia@vsnl.com Web-site: www.oxfamindia.org
?HA-Exchange> R.A.P. (Rita - Action - Philippines)
Subject*!; PHA-Exchange> R.A.P. (Rita - Action - Philippines)
Date: Fri, 23 Aug 2002 04:56:49 -1200
From: "Bert De Beider" <bert.debelder@wanadoo.be>
To: "Nederlands-Filippijnse Solidariteitsbeweging (NFS)" <n.f.s@hetnet.nl>
ii b^Part 1.1.1
Type: Plain Text (text/plain) :j
Encoding: quoted-printable
;j
I INo Philippine organizations on EU list of terrorist organizations.eml
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■;
Name: No Philippine
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Encoding: 7bit
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.
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lettre a la nresidence danoise de lEU.doc ■=—------------ -~
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ton
8/28/02 1:45 PM
Rita Vanobberghen
Huisarts bij Geneeskunde voor het Volk. Schaarbeek (Brussel)
English:
Dear,
May I invite you to join us in our action against the criminalisation of the Philippines
liberation struggle. Last August 9, US President Bush added the Communist Party of the
Philippines (CPP) and the New People's Army(NPA) to the list of terrorist organisations.
The US has requested the European Union to do the same and enact repressive measures
against progressive Filipino's and their supporters in Europe. I propose that together,
through this E-mail campaign, we demand from the Council of Justice and Home Affairs
of the European Union not to push through with said measures.
I have been a doctor in the squatter areas of Manila for some eight years. At present, as a
doctor in Brussels with Medicine for the People, I daily have Filipino patients. They have
a job as nanny or maid, as cook or driver, they are often undocumented and deprived of
rights. A big chunk of their meager earnings is sent to their family in the Philippines. For
the majority there, poverty, exploitation and injustice is daily fare. But there is also a
growing people's movement, fighting for 'another world'.
In (he Philippines I had several friends who belonged (o (hat movement. Individuals who
gave their utmost in the people's struggle for national liberation and democracy, even to
the extent of putting their lives at stake. Bush now wants to make us believe that those are
all terrrorists.
This is sheer hypocrisy. The US is the real terrorist. I know wat I am talking about. In
1985, as a doctor active in a guerilla area in El Salvador, I had been seriously wounded
after a helicopter attack of the Salvadoran Army. That was trained, armed and
commanded by the US. And who bombed and strafed a marriage banquet in Afghanistan?
Who announces without blinking the next war against Iraq? Who supports and finances
Israel's terror against tire Palestinians?
Together we can prevent that the CPP and NPA land on the list of "terrorist
organisations" of the European Union. Mail to Mrs. Lene Espersen (jm@jm.dk) and Mr.
Bertel Haarder (info@inm.dk),
the Danish minislers who preside (he Council of Justice and Home Affairs of the
European Union. May I ask to forward me a copy (ritaphilippines@hotmail.com, so that I
can better keep track of our common campaign.
In solidarity', accept my thanks,
Dr. Rita Vanobberghen
Medecine for the People, Brussels
Fran^ais:
Cher(e) Ami(e),
iA-Exchange> Report tr^ a dKgde
of sustainable development in six countries
Subject: PHA-Exchange> Report tracks a decade of sustainable development in six countries
Date: Fri, 23 Aug 2002 09:07:52 -0500
From: "George(s) Lessard" <media@web.net>
Organization: http://mediamentor.ca
To: creative-radio@yahoogroups.com, devmedia@listserv.uoguelph.ca,
pha-exchange@kabissa.org
CC: cyberculture@zacha.org
:
:
Type: Plain Text (text/plain)
; iSjPart 1.1 ;■ Encoding: Quoted-priniable
•
Description: Mail message body
ofl
8/27/02 2.03 PM
Reports from six countries
on progress towards
Sustainable development
India Japan South Africa Tanzania Uganda United States
The Report is available online only. Visit the Panos London™s website htlp:/7www.panos.org.uk/environment/roads_to_the_summit_cover.htm
The Report
http://www.panos.org.uk/Earth%20Summit%202002%20Report.pdf
This requires Adobe Acrobat Reader to be installed on your computer,
which can be downloaded here.
http://www.adobe.com/products/acrobaVreadstep2.html
For online version clickhere.
http://wvvvv.panos.org.uk/environment/roads_to_the_sununit.htm
For a "text-only" [Actually a 343 kb MS Word... ed.] version clickhere.
http://www.panos.org.uk/environment/Earth%20Summit%202002%20Roads?/o2 Oto%2 0the%20stimmit. doc
[Please copy & past all lines of the URL into your browser
[rather than double-clicking for access]
if you are having problems accessing the site, ed]
Click here for News Release.
http://www.panos.org.uk /environmentT>R_roads_to_the_summit.htm
------ Forwarded message follows-------
For immediate release
Newspeg:
World Summit on Sustainable Development, Johannesburg, South
Africa
26 August “ 4 September 2002
Roads to the Summit
Panos London and LEAD international have published a joint new
report, which explores what six countries have achieved in sustainable
development since the 1992 Earth Summit in Rio. The report, called
Roads to the Summit, also looks at their preparations for the upcoming
World Summit in Johannesburg. The countries in focus are: India,
Japan, South Africa, Tanzania, Uganda, and the United States.
The report shows that each country has enacted an array of new mainly
environmental legislation, but has largely failed to go the extra mile to
integrate environmental protection with development. Most of the
countries being reviewed, moreover, do not appear convinced by the
concept of sustainable development.
The report shows that the poorer countries lack the physical
infrastructure, ideas and human capacity to integrate sustainability into
their development planning. Richer countries, on the other hand,
perceive sustainability to be expensive to implement.
However, most of (he countries analysed in this report have established
environment ministries and signed or ratified the main Rio environment
conventions. And many “ particularly the US “ have successful local
authority initiatives in sustainability.
In addition, the decade since the Rio summit has seen a flowering of
new environmental NGOs and new business initiatives in sustainable
development. Both business and NGO groups - who were new to Rio -are now more mature and play an important role in their countries™
sustainable development policymaking.
Agendas for Johannesburg
Poor countries and development organizations want to put poverty
reduction at the top of the summit agenda, according to the report. 1'he
richer governments on the other hand, are pushing for the Summit to
focus on concrete results on a broader range of issues, which they see
as urgent and dangerously neglected “ such as water, energy, health,
agriculture and biodiversity.
Predictably, Japan and the US are more lukewarm about the Summit
than the other countries. The US, in particular, does not want the
summit to encroach upon other international initiatives, such as climate
change, biodiversity, desertification, international trade and
development finance, which are all discussed in separate and
comprehensive international meetings.
Environmental organisations will ruse the summit to call countries to
account; to praise positive initiatives, and to shame those that have
taken little action. Other issues that some governments want to see
discussed include insecurity, the failure of some states, the underlying
causes of terrorism, technological progress in communications, and the
role of science and technology in sustainable development.
- ends The Report is available online only. Visit the Panos London™s website
www.panos.org.uk/environment/roads_to_the_summit_cover.htm
<http://www.panos.org.uk/environment/roads_to_the_summit_cover.htm >
Notes Panos-London™s mission is to work with media and other
information actors to enable developing countries to shape and
communicate their own development agendas through informed public
debate. Panos particularly focuses on amplifying the voices of the poor
and marginalized.
Leadership for Environment and Development (LEAD) is a global
network of 1200 professionals and 14 NGOs committed to sustainable
development. I.EAD™s mission is to create, strengthen and support
networks of people and institutions promoting change towards
sustainable development. More from www.lead.org
<http://www.lead.org/>
*** Via / From / Thanks to the following :
$$*********♦**♦♦*$♦* *#*«❖#$**:£ $^** $ »*##❖❖❖ ❖*«***❖*❖**
****❖❖❖****❖*
&AAAAA&
To get on or off this listserve, please email wuscnet@wusc.ca with
SUBSCRIBE or UNSUBSCRIBE in the subject field. For more
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4A-Exchange>
oPSource - IntciTiSuoni' Information Sunoort Centre
Subject: PHA-Exchangc> Launch of Source - International information Support Centre
Bate: Tue, 27 Aus 2002 05:04:41 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch" <pha-exchange@kabissa.org>
om
> Launch of Source
<richardson.v@hcalthlink.org.uk>
International Information Support Centre
> A unique resource centre, designed to meet the information needs of
> those working in health, disability and development worldwide, opens
> in London in September 2002.
> Source is an innovative collaboration between two international NGOs,
> Healthlink Worldwide (formerly AHRTAG) and Handicap International UK
> and an academia institution, the Centre for International Child
> Health (at the Institute of Child Health, UCL).
> Source is aimed at health workers, researchers, rehabilitation workers, non-govezrnzr.entsl and governmental organisations and. disabled.
P peoples' organisations worldwide and has a unique collection of over
> 20,000 health and disability related information resources. These in> elude books, manuals, reports, newsletters, posters, videos, and CD> ROMS. It also links to an increasing number of electronic resources
> including on-line databases and full-text documents on the Internet.
> Source has a valuable collection of both published and unpublished
> materials documenting a wealth of practical experience from develop> ing countries. Subject areas include adolescent and child health,
> d~.
1
evaluation, health communication, HIV/A.IDS, information
> management, primary health care, reproductive & sexual health and
> more. SOURCE is the only regular outlet in London where books and
> other teaching materials published and distributed by TALC (Teaching> aids at Low Cost) are sold.
> Materials in Source are fully referenced on the Source database which
> can easily be searched from the website, http://www.asksource■info
> Source is different from other databases because the majority of ma> terials are relevant to developing countries and not recorded elsevrhere. The database also gives details of how to get hold of materials including price, publisher and distributor.
> Soon to be available from the website are a Contacts database of international health and disability organisations, and a Newsletters
irbohnd Journals database describing over 150 free of low-cost newsletters and how to subscribe.
‘
> Oona King, Member of Parliament in the UK, said "the launch of Source
> is welcome news for the thousands of campaigners like myself who have
> been engaged in the fight against poverty".
> For further information, contact:
> Marina Waddington
> Assistant Librarian - Source
> Tel: +44-20-7242-9789 (ext. 8698)
> mailto:sourceaich.uel.ac.uk
> Victoria Richardson
> Source Coordinator (Information Systems)
> Healthlink Worldwide
>40 Adler Street
> London El 1EE, UK
of 2
8/29/02 2:25 PM
'tA-Exchanse* Launch
? - intci iiativrial Inforination Support Centre
Tel: +44-20-7539-1576 (direct line)
: +44-20-7539-1570(reception)
> Fax: +44-20-7539-1580
> ma+lto: -ichardson. v@healthlink. org. uk
-> http://www.healthiink.org.uk
' http: //www. asksource. info
-
fHA-Exchange is hosted on Kabissa - Space for change in Africa
To pest, write to: PHA Exchange@kabissa.org
Website: http: ,/,/wwk. lists, kabissa.orq/mai 1 man/1 istinfo/pha-exchange
HA-Exchange> AFRICA: POORER COUNTRIES PRESS FOR CHANGES TO AIDS FUND
Subject: PHA-ExchangO AFRICA: POORER COUNTRIES PRESS FOR CHANGES TO AIDS
FUND
Date: Thu, 30 May 2002 21:20:14 -0500
From: "George(s) Lessard" <media@web.net>
Organization: http://mediamentor.ca
To: creative-railio@yahoogroups.com
CC: pha-exchange@iabissa.org
AFRICA: POORER COUNTRIES PRESS FOR CHANGES TO AIDS FUND
Several developing countries on Wednesday urged changes to the newly
launched Global Fund against AIDS, malaria and tuberculosis to give states
with the most patients more of a voice in its activities. Further details:
http://www.pambazuka.orq/newsletter,php?id=7771
:-) Message Ends; George(s) Lessard's Keywords Begin (-:
Freelance Media Arts, Management, Training, Mentoring & Consulting
On line: Internet / Workshops / Research / Presence I Content /
on location: TV / Radio / Production / ENG / EFP / Editing
Interests: Access / Activism / Communities / Cultures / Arts
fctesume and more @ http: / /members■ tripod.com/-mediaO02
Queries / Offers / Patronage /
Commissions should be sent to
media@_no_spam_web.net
Rostered Volunteer UNV# 120983 & CESO/SACO VA# 11799
-Caveat Lector- Disclaimers, NOTES TO EDITORS
£
(c) information may be found 0
http://members.tripod.com/-media002/disclaimer.htm
Because of the nature of email & the WWW,
please check all sources & subjects.
- 30 -
PHA-Exchange is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-Exchange@kabissa.org
Website: http://www.lists■kabissa.org/mailman/listinfo/pha-exchange
6/4/02 11:32 AM
PHM website teinbly behind...
Subject: PHM website terribly behind...
Date: Wed, 19 Jun 2002 15:55:07 +0700
From: "Aviva" <aviva@netnam.vn>
To: "Community health cell" <sochara@vsnl.com>
De 31? R.3V7
I went in again.... Last update was 21 Sept 01.,..Cannot wox’k like this.
Any suggestions?
Clau
P.lLs don't forget to resend those attachments of last week in Word.
$
,__.c
Claudio
Subject: Claudio
Date: Mon. 17 Jun 2002 11:10:15 -0700
From: “/.viva; <aviva:<?netnam.vn>
J o: "Cominunitv health cel!” ^socharaiZFvsnl.coirP*
Ravi, I read Dr Bancrji's ppr. Is long. Found it irregular m its aicssag
.
reuelilive. I would onl> excerpt a few pieces of if fox the
send r.e again in Word or text those attachments I could not read Fri.
10:59 AM
1 of 1
r
'XY'
> Ravi Narayan,
> CHC / PHM.
From:
To:
Copies to:
Subject:
Date sent:
"Aviva" <aviva@netnam.vir5>
"pha-exch" <pha-exchange@kabissa.org>
"afro-nets" <afro-neis@i3sa.heaithnet.org>,
"idea!" <ideal@iists.ccs.carieton.ca >
PHA-Exchange> A foiiow-up on Giobaiization
Wed, 19 Jun 2002 15:51:21 -5-O7QO
i his is a quote from Fidei Castro's opening address to the South Summit, Havana, April
14-20, 2000. It is excellent to use in your debates:
Underlying Globalization is the fact that we are al! passengers on the same ship. But
passengers on this vessel are traveling in very different conditions. A tiny minority
travels in luxurious cabins; the overwhelming distressed majority travel In conditions
that resemble the terrible slave trade... This vesei is carrying too much injustice to
remain afloat and it pursues such an irrational and senseless course that it cannot cal!
on a safe port. Heads of state have not only the right, but the obligation to take the
helm and correct this catastrophic course. Neoliberalism has put Globalization in a
straight jacket, globalizing poverty rather than development.; it has been applied
dogmatically. World trade continues to be a means of domination by the rich countries.
The world economic order worksto the advantage of 20% of the population, but leaves out,
demeans and degrades the remainig 80%. The world could be globalized under the rule of
neoiiberaiism, but it is impossible to govern billions of people who are hungry for bread
and justice...
Either we unite and cooperate closely, or we die!
In the same meeting, President Mahatir Mohamad of Malaysia added these interesting
insights: While it is easy to meet, it is not so easy to act together. Therein lies our
weakness. The rich are apparently more united; they close ranks very rapidly if their
dominance is challenged. (Since money equals force in the market, those with money
dominate). The South mostly reacts. But reacting limits the choices and is less rewarding
and less effective. The rich interpret Globalization as the right of capital to cross and
re-cross borders at will. Why should not workers move across borders freely as well? If
money is capital for the rich, labor is the capital of the poor.
From:
To:
Subject:
Date sent:
"Aviva" <aviva@memam.vr8>
"pha-exch" <pha-excharsge@kabissa=org>
PHA-Exchange> Critique ©n Macroeconomic Commission! on Heali
Tue, IS Jun 2002 16:12:49 +0700
From: Prof D Banerji <nhpp@bol.net.in>
April 14, 2002
THE MACROECONOMIC COMMISSION ON HEALTH
A Critique
Debabar Banerji,
Professor Emeritus,
Centre of Social Medicine and Community Health
Jawaharial Nehru University,
B-43 Panchsheel Enclave,
New Delhi 110017
Abstract
WHO has been able to interest some of the top economists of the world to
join the MCH to study macroeconomics of health services for the poor people
of the world, who account for more than two-thirds of the population. The
approach followed by the CMH is disturbing. They have been ahistoricai,
apolitical and atheoretical. They have not succeeded in making
contributions from economics to enrich the interdisciplinary method of
health service development to ensure optimal use of the very scarce
resources. They have adopted a selective approach to conform to a
preconceived ideology. They have ignored the earlier work done in this
field. They have pointedly ignored such major developments in the health
services as the Alma Ata Declaration, failure of the Universal Programme of
Immunization and the numerous WHO Resolutions, promising Health for All by
AD2000, using the approach of Primary Health Care. They have made frequent
references to the relevance of what they call ' operational research', but
they made different interpretations of this approach in different patrs of
the Report. The experience of application of this method in other countries
from as early as 1951 were simply ignored. This attitude of developing
massive blindspots in their vision has brought the quality scholastic work
to almost the rock-bottom level. It is not surprising that the CMH has
developed a tube vision in making recommendations on so important a sublect.
Ciose to Client (CTC) institutions, a 100-bedded with a single doctor and
some paramedical staff institution, undertaking a wide range of
responsibilities to attend to the requirements of the patients, putting in
place organisational and management superstructure to lend support to the
CTC-Hospital complex, are the major recommendations for action. The lack of
understanding in conceptualising such a plan of action is startling. Even
more starling is the emphatic assertion by the CMH to perpetuate vertical or
categorical programmes against major communicable diseases like
Tuberculosis, AIDS and Malaria. That the CMH justifies such already
discredited approaches on the grounds that vertical programmes have proved
to be convenient in a number of ways to the ' donors' lets out the real
motivations for undertaking such an
almost openly ideological driven agenda. This is a serious danger signal for
scholars of the world who would like to have a scientific attitude towards
programme formulations for the poor to get the maximum returns from the
limited resources. The concept of DALYs is rife with gross infirmities. The
WHO generated data used for DALY calculation and convert them into dollars
terms are patently invalid, unreliable and not comparable between and even
within countries. The figures churned out from the patently defective modeis
and mathematical discourses are obviously meaningless.
There appears to be a nexus between WHO and the type of scholars represented
in the MCH. A hint of this link up emerged when the WHO was impelled to ask
for consultative advice to examine the managerial process through which the
organisation has planned and monitored its performance. The consultants
eveaied a shocking state of affairs within the organisation. ' Cruelty and
nflexibility of senior managers and policymakers' and ' a range of
igh-profiie actions and interventions that are clearly not sustainable' and
short-term results are justifiable at any cost to satisfy' external
takeholders1, are some the indictments made by the consultants. These
idictmentsalso apply to the MCH.
If you want a full copy of this 18 pp document order it directly from Prof
Banerji at email adress above.
PHA-Exchange is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-Exchange@kabissa.org
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meSS82.C to Pn A-Exchsnsc swsits moucrj’i’" spurovsl
Subject: Your message to PHA-Exchange awaits moderator approval
Date: Fri, 28 Jun 2002 13:39:53 +0530 (1ST)
From: plia-exchange-admin@kabissa.org
To: socbara@vsnl.com
Support to Campaign for Justice in Bhopal
Post to moderated list
Either the message will get posted to 'the list, or you will receive
notification of tiio mo do mt or ’ s decision.
■10/
1 ofi
6/28'02 2.29 PM
The following come from several issues ofUNRISD News and the South Letter: Use
them!
1. Globalization is a non- territorial form of imperialism, imposed by legally binding
obligations of compliance with rules favoring capital, enforced by trade sanctions and by
a denial of access to finance.
2. We need to be absolutely clear: through the Globalization process, the quest of the
North is for control of global space; and when we talk about financing development, we
are talking about furthering the capitalist model that furthers such a quest —for it is the
only model accepted by the financers.
3. Globalization and its companion structural adjustment leave behind poor economies
and weaker strata in strong economies. This has fueled a rise in income inequality both
across and within countries thus making the reduction of poverty difficult to achieve.
4. When engaging in structural adjustment measures, fiscal deficit reductions can be
achieved through higher taxation rather than expenditure cuts in the social sector!! Yet
the former approach is rarely espoused by the IMF. Rather, with Globalization, the non
poor benefit disproportionately from public spending, their benefits far exceeding the
taxes they pay.
5. Pro-poor structural reforms we so much talk about are yet off-limits for the macro
policy establishment.
6. At the macro level, 'the social' continues to be an afterthought. But macroeconomic
policies should add on to social policies if they are to achieve poverty’ reduction. But the
macroeconomic agenda is not open for such a debate... Ironically, 'open' capital markets
lead to an ‘absence of openness' in socioeconomic policy discussions. Therefore,
macroeconomic policies tend to be quite unsound in human terms: Globalization treats
social welfare as an optional extra.
7. The discovery of'the social' by international financial institutions is happening mainly
at the micro level. At the macro level, attention to social questions is still very much an
afterthought: 'sound' macroeconomic policies are designed and then social "band-aids' are
applied in order to achieve acceptable outcomes.
8. Resulting targeting policies suggest that the social exclusion inherent in neoliberal
growth models should simply be attenuated, not rejected. Amelioration of exclusion is
nol inclusion. We should accept nothing less than social inclusion of the poor.
9. With Globalization, the trend is thus toward a drastic reduction of state-based
entitlements and their replacement by market-based, individualized entitlements... But the
invisible hand of the market has no capacity' to create a decent society' for all. lite law of
supply and demand can fix the market price of bread, but it does nothing to alleviate
hunger, famine and ill-health.
10. Moreover, with Globalization priority is granted to efficiency over other values such
as social justice or environmental sustainability.
11 local level participation, while important in building communities' organizational
and individuals' personal capacities, should not be overemphasized as the major strategy
for change.
Often, local participation begins to challenge the status-quo at the macro level and those
in power tend to react strongly. This forces the experience back into the micro level and
sometimes even threatens any gains that had been made. We no have to think globally
and act both locally and globally.
12. Following the Globalization orthodoxy, recommendations are made these days to
privatize social protection (but privatizing basic social services and social insurance is
antithetical to redistribution and equity... With increasing vulnerability to global
economic forces, the development of adequate social insurance mechanisms is a must).
The idea that any pivatization is better than no privatization should be rejected.
13. Effective redistribution involves gaining the support of the middle class: services
have to be paid for. made accessible and used by all citizen -not only the poor. The
current emphasis on targeting and privatization goes in exactly the opposite direction; it
makes the needed solidarity' with the middle class more difficult.
14. In sum. Globalization is reversing some of the social gains already made; it is
lessening the likelihood that developing countries will have the necessary policy
autonomy and fiscal capacity to carry out and finance comprehensive social policies.
15. Developing countries cannot afford to remain in a reactive mode less they lose
strategic ground. They need to fight for a different system of trade-offs where market
access is exchanged for concrete market access and not for 'policy space' and promises.
16. Although NGOs have enjoyed a high profile in recent years they have mostly
remained in the reactive mode. There are signals that their heyday is over. Many stand
accused of complacency and self-interest on the one hand, and of being ineffectual and
irrelevant on the other.
Claudio
■ AVjiange> BA i A prows: rath .. -is: BA ■ S programme
Subject: PUA-Exchange> BATA protest rally against BAI’S programme
Date: Mon 22 Jul 2002 18:39:35 +0600
Front: wbb <wbb.'«'.pradeshta.net>
OrganizalioH: Work for a Better Bangladesh (WBB)
To: Pha-exchange 'a kabissa. org
;!' a Pari l.l.i
Tvne: Plain Text (text/piain) .
Encoding: Tbit
: (jl coffin.ina
Name: coffin.mg
Tvpe: JPEG Image (image/jpeg)
Encoding: base64
against B’.T'S programme
Anti-Tobacco Alliance (BATA) with symbolic coffin and
Bangladesh
ar
in the Dhaka 21 july Sunday
Brillsh-Auiericari Tobacco
Bangladesh.
The alliance leaders urged intellectuals and policy planners to boycott
BAT’S farcical crograrame like
"
Corporate
Social
Responsibility Dialogue Between British
American
Tobacco, Bangladesh
and Stakeholders.” "That issues can be discussed with a business
organisation, which deals in death-commodity?" they asked.
The leaders ~ e f e rred to various diseases caused by smokinci and tobacco
leading t’.any ’oetp_e to ueatn every day and said tne tooacco coiuoames
with no care for that were pursuing their efforts for more and more
business.
R.
E - ma i 1 - vb b <3 p r ade s ?i t a . n e t
websire i http: / / bb. g ?baJ lnk.org
P Pi E y
IA-c.xchange> from moderator, in Cambodia
Subject: l’HA-I£xchangc> from moderator, in Cambodia
Date: Thu 18 Ju! 2002 08:23:45 +0700
From: "aviva" <aviva@:netnam.vn>
Toz pha-cxchance^Jcabisss.ors
Was in the interior without email for 2 weeks. Now, back in Phnom Penh
- have crciolr-F.s accessing kohisso. That is why Quite a tew messages
have accu.uU —a ceo anc* are _ate.
Goro.ia 11 v,
PHA-Exchange is hosted on Kabissa - Space for change in Africa
To post write to: PHA-rxchano—T.Ta'oissa. orci
ebs11e: ntl~c : / /w. is?5 . ,<ao i s sa. o r cr/rnailr~tan/113mnro/ pha~e2<chanc<e
P /4A
22.)7
7/22/02 11.3 i AM
HA-Excliaise> Generics.crices atu access to .AIDS medicines
l’UA-l£xchangc> Generics,prices and access to AIDS medicines
Wed. 17 Jul 2002 15:23:54+0700
t>ha-exchanse'2!kabissa. ora
10 July, 2002
Gsnsr/LC competition leads co Graitatic crop m price of AIDS medicines
Research published today by Oxfam clearly shows that the availability
of
cheat Generic medicines in developing countries plays a significant
ro i c i n
cutting the price of patented antiretrovirals (ARVs) and in increasing
the
number of patients who have access to the lifesaving medicines.
fc’he research tracks the price of brand name drucs in Uganda from May
co April 2002 . Despite the fact rhe big five pharmaceutical companies
had
agreed under the -Accelerated Access Initiative to reduce the prices of
ARVs, it was the introduction of generic equivalents from India in
October
2000 that led to an dramatic fall in the price of the brand name
me u i c i n e s
in the country.
"Wo had been promised price cuts since May 2000 and didn?t see them
until
we started to import generics in October", says Dr Cissy Kityo, Deputy
Director of the Joint Clinical Research Council in Uganda.
Prices fell bv as much as 78% within a couple of months and up to 97%
over
the two years. The largest decreases were for Stavudine/ D4T. A. 40mg
monthly dose fell from $173 in May 2000 to $23 in February 2001 and
then
eventually to $6 in -April 2002.
the same time, the numbers of patients taking ARVs at one treatment
centre alone increased by 200 per cent within a year.
”28 million people in the developing world are HIV positive and 6
million
need treatment with ARVs now.
This research shows that with Generic
medicines,
more people can atrord tne life-line that antiretrovirals
already provide to AIDS sufferers in richer countries. Any plans to
combat
AIDS in some of the worldrs poorest countries must include the use of
Generics and we must ensure that countries are allowed to continue to
import them”, says Dr Mohga Kamal Smith of Oxfam.
Under WTO rules, Uganda will no longer be able to import generic
versions
of newly patented medicines after 2005 because countries that
manufacture
generics such as India will no longer be allowed to export them. Rich
country trade ministers committed themselves at Doha in November last
year
to find a solution r.o this problem by rhe end of 2002 bur. they are
P /-/ r~t
c
2^1?
backsliding on this pledge by putting forward temporary, impracticable
and
Ends
7/22/02 11:25 AM
r>^.e
•j- \Cnaji2c-'' vjchci iC5.pi .ccs and access to AIDS medicines
-Or r;.e;ia enomres and copies of the report in Barcelona contact Adela
tarre, -34 626 992 057, or Dr. Mohga Kamal Smith, + 44 77762 55884. in
oonracr. Tricia O?Rcnrke on 01908 233 273 or 07989 965 359.
Oxiar. Briefing Paper No. 26: Generic compel!Lion, price and access Lo
medicines ? The case of antiretrovirals in Uganda available on :
.~;C cp : > t
. l
ar.ce lna ~ ona x. orq
PHA-Exchange is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-Exchaiige&kabissa,org
?. ebsi re: hr co: / / '.'”'."'7 .lists, kabissa. org/iuai liuan/ list info /pha~ exchange
:>f2
7/22/02 11:25 AM
" tn,n-,-.xchai;ie> PHM 8t. NewsBriif
Subject: Re: PHA-Exchange> PH.VI 8th Mews Brief
Date: t-.,c_ 23 Jul 2002 17:34:04 -0700
From: : uTnNIKRISI4NAN P V (Dr)" <unnikru(®.yahoo.com>
To: "Qascm Chowdhun" <2ksavar;l^citechco.p..et>
CC: 'Community Realm Ceil” <sochara@vsni.com >, ’’Satya Sivaraman” <satyasagar@yahoo.com>
ust t
seed ist
:
ay be required in the news brief.
Please delete Nuc-ur's name from the media team. She came representing WHO
and not PHA.
Of course, sne neaped a ict. But it may be counter productive if we profile
_hailand and not Malaysia.
It is jk
li'
vhat (where) ever the news brief has been circulated tixl now.
But nlease make this correction in future communications.
correccicn m trie rBr version of tne newsletter as well.
W-iTl
Please make this
hr
:rr11vV^xr
again on August 3rd for a week..
for processing the travel claim.
- r
iator: Emergencies & Humanit rian Action, OXFAM IND1A.
E-mail: unnikru@yahoo.com
Mobile: 91 (0) 98450 91319
; i I : ! 1 i I :
Near Baptist Hospital,
3274 ; Fax :
91
(off) Bellary Rd, Hebbal,
(80) 391 4503 (attn: Oxfam India)
www. oxfamindia. org
--------- Original Message --------Frc . Qasem Chowdhury <gksavar@citechco.net>
io: pha-exchangerkacissa.erg <pha-exchange@kabissa.org>
Sent: Thursdev, July 11, 2002 3:02 AM
Subject: PHA-F,xchange> PHM 8r.h News Brief
PHM at the World Health Assembly
P14
7--s>
(PHM) was invited by the World Health
of 6
7/24/02 10.44 AM
Or cani zati ■■■ * ”
~ £p the
* irst Technical briez.ino session at th©
WHO
P'rz.eono -r2 lioulzs -ealth Charter.
al h A s-=
ly,
Society Initiative and to
Over 35 members of PHM attended the
this year from 13-17th May 2002 and participated in
-- - nas ana lobbyina inir.iar.ivfis and also participated in the
tocr.nicai briofinc. The initiative was organised by the WHO/WHA Circle of
zne - HM.
Tn 13c?. Ma-- 2002, the PHM participants attended the special briefing
session organised bv WHO-CSI for NGO participants. The PHM delegation was
%.ns ^.creese croco in the orzezzno session and among omer concerns razsea
two issues
i. the need for caution in putting not for profit l\GOs and
civic society in the same group as 'for profit - private sector' in the
■- .■ lie-private initiatives; and (ii) the need co look at the relevance of
some of l/HO’s concerns including themes from WHO day from the
300 z o—econCiT.z c—cu u. t u r a 1—po 1111 ca 1 — epi aemz o log 1 ca 1 situation of the poor and
marginalised of the world - the larger majority. After the briefing, the
PHM delegation had its own first briefing and strategy planning session at
the same venue 'this was the first of many such meetings throughout the 5
~
Ss-.-c;'
aj-ho
PPM
He I hnt b i/hr
a r b a rt H «= d
i"V>.=>
r.nrmal
znauouration or me .vorlo health Assembly.
|On 14th May 2002 from 9-12 noon, PHM delegates participated in NGO Forum
Bor Health Session at WHA on ’Partnership for Action in Health’ and
presented z'Ae People’s Charter for Health as an alternative approach to
health. Tne main messages from the PHA event were shared including that
Health for All and Comprehensive Primary Health Care should be the
fundamental principles which guide international health policy and that
‘.:.= s great, concern about the ability of WHO to respond to the forces
ecvnoc.lc _'?:a.rige and in terms of the role of WHO in relation lo other global
institutions such as WTO, the World Bank and International Monetary Fund.
The meeting was followed by a press conference and Ravi and Sr. Ani
attended it as PHM representatives.
One of the highlights of the PHM presence at WHA was the presence of a
three member, full time media team, which included Unni and Nupur from
India and Sathya from Malaysia, who were responsible for lobbying with the
press arc hid.2ichiino PHM concerns and PHM responses co emerging
znzzzsc.ives or Zj'iiO through loriudi/ informal press briefings, intGrvisws ana
press conferences. As a PHM media strategy a backgrounder on PHM and five
press releases were distributed to the press and many of the delegates as
■jell. (a. Peoples Health Movement - a backgrounder on 13th May, with quotes
David Werner, Dr. Ekbai and Halfdan Mahler
(b) Health Care - WHO
cares? r'overty, War and Debt — greatest threat to world health says PHM, —
13th May 2002 (c) WHO Industry partnership - Who influences Who?, 14th May
2002 (d) Global campaign to be launched Revive the vision of Alma Ata!, On
15th May 2002 !e) the Peoples Health Movement marches on - from Dhaka to
Qo-ngrrsi to Por’’r. Ai ^ecro, l^th ^ay 2002 (f) Peoples Health Movement condemns
oizgcmg attacks on civilians in Palestine duel th© violence in Gujarat— on
17th May 2002.
A"? the PHM parr.i ci pants attending WHA took time off from WHA on 16th May
to participate in a full day sharing, reflecting,
session
’battery charging’
Peoples Health Movement and post PHA initiatives at World
Council or Churches on 16th May.
The day startea with a symbolic gathering
of carzicipants in the centre of Geneva with Peoples Health Charters and
posters and publications by the side of rhe special ’broken chair’ monument
dedicated z: those people especially children who have lost limbs in
posz-war unde
led -zine explosions. The full day meeting including a self
introduction round; followed by an exercise to list out ones ongoing
involvement in PHM and ones contribution to a Vision of PHM and some tasks
for sharina b*’ each participant which included
from all parts of the world.
In the afternoon,
! of 6
<c: PHA-Exdiaiige> PHM 8ui News Brief
7/24/02 10.44 AM
-■
: s >: ■ videos including 'Hey Ram' on
Gujarat
:: great ttt.tem and the press statement on 17th
condemr :
atta :
in E; Lestine and Gujarat,
finally, there was a
concluding session on future challenges and organisational issues chaired
Save .::e Children, UK, In collaboration with MedacL and
sn ‘Poverty Reduction Strategies and Health: Action & Roles'
ano the
one was on 'Consumer improves quality of care'
organised by KlLEN -ns'.'i'tr 1 n5ti~u~e for Medicines and Health, swedon, which w?.s cart of
-.to - - ■
__ U»--- C-.c..--------------------- Cii L«J c. X * -C JUbli VYHtX •
Thi Technical briefing on Peoples Health Charter was the much awaited
highlight of .he PHM presence and participation in WHO. The session was
her interest in Civil Society partnerships. Dr. David Nabarro stayed back
to answer all the questions and comments after the briefing. Zafarullah and
P.svi oresented me ba a.-isround of tne PHA mobilisation and ke'7 elements 3.nd
concern o_ i.'.t Cnarzer and kc.i'ifi, Mw’ajuma and Ellen snarec ac-out post
concerns and inioiaoives from Latin America, Africa and Europe.
After the Technical briefing session, the PHM participants met for the last
up on these strategies and initiatives. There was discussion and
suggestions on a Communications / Media Circle (to be convened by Andrew,
i"K'
some ' -jeas ~ - celebrate r.he 25r.h anniversary of Alma Ata with
World Social Forum a^ Porto- Allegro in February 2003; .follow up on special
issues of Contact magazine and Development Dialogue on Post PHA
initiatives; and matters of strategy and clarification of procedures for
representing PHM at meetings, the need for further mobilization and
regiona. meetings o idem—xV the members of me evoi zmg x ecpies Health
Movement Council; need to support, the PHM Secretariat etc.
During the HHA several contacts were made with individual and
organizations.
team ot seven resource persons from PHM - Maria Sr. Ani
mavid (cancers, , .neima, .•■.wa~uma, Dorothy and Ravi met Dr. Peter Plot and
some of b?s r-r’loAguAs to undorsfand the concerns and initiatives of UNAIDS
and the concerns and suggestions of PHM participants on the HIV/AIDS
problem in their own countries and regions.
o a a. romm _cr neaita r.esearcn (Louis Curran, Executive Secretary and
Bidres de Francisco, Senior public Health Specialist) contacted some of the
Dili participants to explore how PHM could participate in the next Forum 6
at Arusha, Tanzania in November 2002.
Many other organisations met up
Qia.b jgue, wo rxmg togetner or inrormeci about meetings at which the Charter
could be presented.
All of them were requested to keep in touch with the
PHM Secretariat and ways and means to follow up on the requests would be
evo'-'en by rhe secretariat. and •its support group. (Detail report on WHA-2002
',•.'2.j
oc available or request shorti ’’ ^^'cm PHM Secretariat'
AS
In Philippines, Health Workers Dav was celebrated
May 7 and they had a
nio cored de irom die Lung Cenuex of the Philippines up to the House of
R.epresentatives where a Congresswoman who supports campaign tor people’s
healt’n gave a privilege speech cn the plight of health workers and how they
are also very much affected by the onslaught of globalization. The PCH and
tne iwas aiso higniignted.
7-24/02 10:44 AM
:e: PH. v-Exctage> PHM 8th News Brief
Nepal, HA participants met and formed the National Circle. They call it
as People’s Health National Coordinating Committee. rhe Executive Board
meeting of the Peedes’ health National Coordinating Committee unanimously
e! ecr.ed Pref.
Prasaci Shresr.ha and Mr. Shanta T.all Mulmi as link
person of N n o ~ ' 1\ °"" ~ "**"*a cc' c fo** ph.a .
c B o a v'd also constituted a
programme planning c'osuuiliee under the convenorship of Mr. Shanta Lail
:ed that PHA is a concept, a movement. Hence
PHA should not be involved in short term project. They also translated the
Charter in Nepalese lanouaca and brought tut a beautiful poster on the
In Bangladesh 2nd National conference of People’ Health Movement was
oraganisfed on the theme ’’Towards implementation of People’s Charter for
Haa 1 r
"
Rocj'n —-V -
parr i T’rai— :Ar» «
srronriad
hv Mini=;'’‘or
of Health and State Minister tor environment
Bangladesh. This meeting
was preceded by six Hi visional meetings in Bangladesh. Besides discussion
alisation and Poverty Reduction
In Iran PHA. participant Dr. Mcriar.ad A.li Barzgar arranged meeting with like
minded people and discussed the content of the Charter. All of them are in
agreement with its content and support it. The participants requested Dr.
Barzgar to act. as cnntact nersnn of PHM in Tran till they elect a link
and grass root levels. Dr. Barzgar met with the Minister of Health of Iran
and brieiea him about PHM witn relevant papers. They also translated ana
printed the Charter in Farsi language for wider distribution through
discussion meetinas at various* levels.
EUkOhE
In Europe, PHA participants from the region met on 4th and 5th December
2001. On 4th they arranged a conference on ’Health for All: A Question of
C'Ccis. justice . „ 1 was woncierm oecause or me diversity or speakers and
^he breadth of experience, knowledge, energy and clear commitment to
Achieving ’Health for All’ by the participants. It was a great opportunity
to share ideas, network and galvanize more support for the PHM. The day was
h 1' vi ded rOucb ’■r ' n t^
rc — "'“'—as ■ co kin z at both domes t i c and 1 ob a '
perspectives.
1. the impact
2. ths impact of privatisation of health services
3. Democracy, civil participation and influence in shaping health.
Usefully tire UK press w—re interested with deliberations and a wider
audience was introduced
PHM which is vital if PHM is to continue raise
its profile to strenqiluen the work.
On the second lay the participants had in depth discussion on the Proposed
structure of PHM arid welcomed the document. They also developed some joint
action plan witn Internationa. Federation of Medical Students Association
(IFMSA), MEMOS- Netherlands and Public Service International Research Unit
(PSIP.U) on various issues. Par“icir:?.ncs from different countries and
organizations expressed their interest to initiate and coordinate issue
based circles.
In Italy, more than 6000 persons have signed the Charter and more
signatures are pouring in. The Charter was translated in Italian and
printed m 10OO copies. A s.ight.y editea '/emion of tne Charter was
7/2-1.02 10:53 Aivl
(Adi?
Chai
Si
n 10,000 copi
ke as annex to the
m on t h "> v m a crazine
emo er
forums
rations and movement
as part or tne
involved like
camoaicin, healthy
ernational workshop on Poverty &
was also presented to persons coming
wnicn
biannual A.iFO
jed on PHA Charter
nar ce
ns.
rKsnops ano events.
uuno monsaivo rrom
iring report that is being translated into
be available verv soon.
region, PHM participants from the region organized a
People’s Health Assembly activity. The focus
those who
preparations)
with
others
were not
globa1 People
HeaI th
a nioveiiieni
7-2-t 02 10.53 AM
\eg
circle
.■ ' ’
he
4
Saidd r Masaiganah as their link person to PHM..
:-.-o
t c.a
—“5 T-“.T 7 5 rjr'incj to be represented
-- ■•’•ABA AAA ?'_•£ ••.*: ■. Il - Arusha, Tanzania - 23-27 SepLeiuber 2002. Contact
>’-ABA 2_i.o=_ 7?yxrr 2, FABA. Secretariat, PC Box 1200, 10850 Penang,
Malaysia
Tel: 604-6584816 1 Fax: 604-6572655 ,
- r:. -11 • s e ? r i -<■a h = , p ? , r y,
• ■ vj 3.. i e : : •*»•". ■’. > -'Ci c a . c rc . c r _
.r. :■.*ao a . o rg. mV
2. The Global Forcm for Health P.esearoh
Tanzania ll-lacli lAnerAeil 2002.
next Forum 6 meeting at Arusha,
>. Asia Civi- society Forum, 2002 - i.i'i/ixriO Partnership zor oemocratic
vna-r--s
zzi-zG rvovember 2002 (Fmai > : cor.go.gva^congo.org)
January 2003 at Hyderabad India
ariat, corking 'comen’s Hostel,
s,
1 in February zOOJ; Contact: David
Western Cape, P Bag X17, Belville
-2309
‘HA exchange is 'nested on Kabissa
Space for change in Africa
c post, write to: PHA-Exchange(«kabissa.org
X3bsi ' r : hetp : / /wrw. lists . kafcissa .org/raailman/ listinf o/pha-oichange
7/24/02 10.53 AM
Subject: PHA-Exchange> Hum:
I evelopment Report 2002
Date: 1'hu. 25 Jul 2002 07:30:26 -0700
rom:
NN1KRISHN <?: P V (Dr)" <unnikru@yahoo.com>
1 oc
ci Vuiioo.coni^*
P hl C) - /rs-yc
■3J7
c.
'
. -.
...........
. - , . -•
CZ Z. 3-Z‘. 2 Z Z 3 C - .2 Z 2_ _ V 71'3'30'30
ra
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1' 1_-Mil'll
■.
. • ,
’
era L ions Office,
backburr
S^veloo.'r.eiiL Goals
,
HDP
jfj
c .
i
7'26'02 i0.45 AM
1A-Exchange> from your moderator
Subject: PHA-Exchange> from your moderator
Date: Mon. 29 Jul 2002 08:35:43 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch" <pha-exchange@kabissa.org>
Dear PHM colleagues,
Some of you have slanted gosling on pha-exchange, but only very few (we are
over bOO). Few ot you react to pieces posted. That is the spirit ot a list!
The easiest way is to forward to the list interesting pieces you get in the
email:
you just push 'forward' and address to pha-exchange@kabissa.org and
that' s all....
Letting us know what your organizations are doing, what is happening in your
country, calls for people's solidarity, upcoming meetings... all that would
interest us. So, get active, OK?
Cordially,
Claudio
PHA-Exchanae is hosted on Kabissa - Space for change in Africa
jjo post, write to: PHA-Exchange@kabissa.org
Website: http://www.lists■kabissa.orq/mailman/listinfo/pha-exchange
Pl-I H - 2. to c. I
of 1
2*
7/30/02 10:20 AM
PHA-Exchange> global fund again
Subject: PHA-Exchange> global fund again
Date: Mon, 29 Jul 2002 08:26:46 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch" <pha-exchange@kabissa.org>
Lancet
Editorial
> Time to make the Global Fund global
http://www.thelancet.com/journal/vol360/iss9328/full/llan.360.9328.editorial
_and_review.218 61.1
/
r
0
'
of2
> Since the first International AIDS Conference in 1985, researchers have
> come to accept that there is no "magic bullet" to combat this modern
> plague. But as the fifteenth AIDS conference drew to a close in
> Barcelona, Spain, last week, it was clear that there is something akin
k5, to a magic bullet--money. How to finance the response to AIDS turned out
'> to be one of the main themes at this meeting. The fiscal atmosphere in
> Barcelona was thus an appropriate backdrop to Richard Feachem's first
> speech as Executive Director of the Global Fund to Fight AIDS,
> Tuberculosis, and Malaria, since he used this opportunity to announce
> the development of the Fund's long-awaited financial plan. In October,
> the Fund's board will publish and widely disseminate the Fund's
> financial projection estimates and resources needed over the next
> several years. Pledges to the Fund--almost all of which are from the
> public, sector—current! y total just over US$2 billion. The US Government
> has given $500 million, and Japan, Italy, and the UK have pledged $200
> million each. The total amount Is, of course, derisory in view of the
> task in hand. Jeffrey Sachs, chairman of WHO's Commission on
> Macroeconomics and Health, estimates that the Fund requires $5.5 billion
> in 2003, with $2.5 billion coming from rhe USA alone. Feachem promised
> that the Fund's financial projections will be open to public scrutiny.
> While this pledge towards transparency and openness in the Fund's
> activities is welcome, it seems odd that the topic chosen tor public
> dissection is financial planning. To be sure, the resource requirements
> of the Fund are important issues, .but surely they are of less immediate
public interest than the way in which the resources are to be spent? The
call for the second round of proposals is already well underway, but, as
> the Fund's guidelines make clear, only limited information on successful
> proposals will be disclosed, contrary to earlier statements from the
> Fund. The Fund states that proposal-specific deliberations will be
> confidential and information on the reasoning behind the different
> decisions taken on proposals will be shared only with the authors.
> Details of the review process may be shared with some other
> "stakeholders". It is unclear whether these stakeholders include the
> management consultancy firm who might eventually be charged with
Pli P> hryc +>
overseeing the Fund's disbursements, McKinsey i Company, whose Managing
> Director Rajat Gupta is the private-sector member of the Fund's board.
> It is clear, however, that the public, who have provided almost all the
> money so far, will not be able to see how it is to be spent. Is there a
> chance that the Fund will embody a genuinely new approach to health
> financing? It certainly seems likely that, with its focus on AIDS and
> the high profile of its supporters, the Fund exists within the right
> 'conditions to have some degree of success. Ironically, this may work
> against the wider range of Millennium Development Goals that the world
> has set itself to achieve by 2015. Although AIDS has pushed health up
> the international political agenda, it risks eclipsing the
> poverty-related health, issues that needed to be tackled long before AIDS
> appeared. For example, the United Nation's Economic and Social Council
7/30/02 10:16 AM
’HA-Exchange> global fond again
- h’as recently told of deep concern at the slow progress towards the
> Millennium Goals, notably in reducing child mortality. Maybe it is time
> to accept that AIDS is a special case and as such should have a single,
> separate fund. Many of the interventions likely to be successful in AIDS
> prevent)on--such as education--have little tn dn directly with medicine
> or public health. Sectioning off AIDS would allow another fund—a truly
> Global (and transparent) Fund--Lo finance all other health-related
> aspects of the Millennium Development Goals. There is a further issue.
> Whatever happened to the proposal from last year's Commission on
> Macroeconomics and Health to establish a Global Health Research Fund?
> Without supporting biomedical and health sciences research on the
> problems facing the world's poor, the long-term value of these global
> funds will be severely compromised.
> The Lsncet.
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7/30/02 10:16 AM
X x.i.-vL\diu is 1 C^ xiCCCaii cii’nCiCS ii viil tilO Uel 1X1 islix
Date: Mon 5 Aik ?W2 08:11:56 “0200
From: ’’ixiaria Hamlin Zunigat: <iphc@cablenet.com.m>
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8'8-02 10.55 AM
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Subject: l?ItA-Excli:isigc> International intervention needed: humanitarian crisis
Date: Mon, 5 Aug 2002 21:50:55 -0700
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Hollo Commardcaticfl (Fwd) SAMPLE The Drum Beat -157-
Subject: l’liA-Exchange> Polio Communication (Fwd) SAMPLE The Drum Beat -157 Date: Wed 7 Au" 2002 09:14:15 -0500
From: George(s) Lessard" <mediafa’web.net>
iinrx nicdisnicnior.CG
Toz r?hci-cxch?.iioC’iZ k2biss2.0rG
CC: cr-india ff mail .sarai n.ei, creative-radio@yalioogroiips.comj wscnet@wusc.ca,
deViTied i 3 @ i iS tServ. UOglic 1 ph. C3
------------- Forwarded message follows---------------Daze sent:
~Fri, 2 Aug 2002 19:19:28 -0700
Subject:
—-i-_.....
The Drum Beat - 157 - Polio Communication
T>>ea
gsk^commir*it. com>
The Drum Beat - Issue 157
- Communication for Polio Eradication
!rc-m The Communication Initiative... global forces... local choices ... critical
Trust, The CHANGE
Hopkins University
Soul City, The Synergy
Chair of Partners Group: Denise Gray-relder, Rockefeller Foundation dgrayfeldercrec.<rou2d.org Director: ’barren w’£Qi<f wfeektscomminit.com Website:
1.
Prc-cramme Communication for Immunization Plus — a summary presentation from
me <.NiCz£.-c -'..mnization Plus Reoreat, May 20u2. Includes current status, goals,
activities, challenges, and proposed solutions.
http: / /wvzv.-. conm-init. com/st2002/sld-4922 .html Contact Waithira Gikonyo
w g i ko n ycr- unicef.org
Pud £
11$
2.
Guidelines for Interpersonal Communication Training for 'vaccinators &
Supervisors A training module developed by partners in Nigeria to enable
vafj'c’natnrs
-rive the correct response to common questions, to help them in
ad'tbting a respectful and patient approach and to encourage vaccinators to sc
assistance z.hei: needed. Rule-pldys and additional resources axe provided.
nttp : //www.coagaxnit ■ ccm/st2U02/sld-'i929 - html Contact Steve Stewart
znc48cdc.gov, Jonathan Veitch veicchj@who.int, Thilly De Bodt
3.
Vaccinator Information Sheet and Q&A In India and Nigeria, the polio
partners have deveL.peci this information sheet that provides Q&A. on the most
8/9/02 10.07 AM
st During the Nigerian Sub National
use these checklists, developed
d£lQ
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(sunice f. org
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i2“ Au s~
2 include vour events, workshops oublications or services
Ireland, Nigeria, Pakistan. In English, i-rench, Portuguese or Spanish.
'^r.r.n: / /win:. m~ te~ . -m/my/ q ?’ z / nr A.hrh! Contact Thilly De Poor.
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against 5 deadly diseases with 1 new vaccine. The campaign was launched at the
Sport & Immunisation festival, whose purpose was to highlight the fact that
children's right to play cannot be exercised without good health. Olympic Aid
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cma i?n rrp i ca i d . n rg
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.r, regional and global e?.perleiiues were discussed in order Lo assess
regress made zrorr. 11'-jJ on communication in endemic countries. [PDF]
hefc : / /•.-.riAT:.-.;. citjuinit. cem/pdf/mid-year meeting reportlOOQ .pdf Contact Thilly De
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8/9/02 10:13 Aivi
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find out he?. fax one can go." T.S. Eliot...
"It you think you are too small to make a difference,
try sleeping in a closed room with a mosquito..." African Proverb
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XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX*X**X*XXX
Life is whao happens while you are busy making other olans.
?HA-Exchange is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-Exchange9kabissa.org
". e;Site; .: T ~ 0 . / / '.-.".•.W. 1 515 -
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'■ / m all l'iia H / 1151IV ~ .7 / p It a-exchange
8/9 02 10:13 Alvi
IA-Exuhanae> Military versus health expenditures: a response
Subject: PHA-Exchange> Military versus health expenditures: a response
Bate: Sat, 10 Aug 2002 11:41:08 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch” <pha-exchange@kabissa.org>
From: ‘'Msreel. 3 • DoSmocitQcm. be r*
Dear Mr. Malachi Opule Orondo,
Congratulations for the good article you made about different African
countries.
If you agree I will use it in meetings of the European Union !....
Marcella De Smedt
Member of the .AIM (=association internationale de la mutualite)
pharmaceutical expert group
Clinical pharmacist § Adviser
Medical Direction
Kaussea d'Haecht 579 1031 Bruxelles
^^1. 00—32—2 2464477
Fax 00-32-2 2464649
E marl marcella.desmedt@mc.oe
PHA-Exchange is hosted on Kabissa - Space for change in A.frica
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I of 1
8/12/02 11:04 AM
PHA-Exchange> Global Fund Stalls
Subject: P11A-I£xchange> Global bund stalls
Date: Tue. 13 zAae 2002 22:36:16 +0700
From: "Aviva" <aviva@netnam.vn>
Tn; "pha-exch" <pha-cxcliangc@lcabissa.org>
> Politics and Folj.cy; Infectious-Disease Fund Stalls Amid U.S. Rules
> tor Disbursal
> Wall Street: Journal
5 August, 2002
> By MICHAEL M. PHILLIPS, Staff Reporter of THE WALL STREET JOURNAL
> A highly publicized fund set up at the behest of the United Nations has
> raised $2.1 billion to fight AIDS and other infectious diseases in the
c/svs-Zxczld. IL has announced 11. 6 billion in grants aimed at
/ J. 2LZ S ~ SaVing OZCJSCtS in 40 COUFltriQS .
> But it has yet to give away a single penny.
> That is largely because of demands led by the Bush administration that
th.e new fu^d set uo a world~wids aid~dolivQry system from scratch —
> instead of relying on established agencies the administration distrusts,
> such as the U.?;. and World Bank.
> The Global Fund r.o Fight. ATDS, Tuberculosis & Malaria was created in
> January in response to U.K. Sccrctary-Gcnoral Kofi Annan's call. Its
> establishment stirred gzeat hope that rich countries would finally spend
> enough money to defeat diseases that together kill six million people a
> year, mostly in developing countries in Africa and elsewhere. Now,
> however, it is caught in a dilemma between poor nations' need for
> iTiimedzane help and donors ' antipathy toward agencies set up to provide
it the zastest.
> Tanzania, for example, was promised $25 million for AIDS and malaria
> projects in April when the first round of grants was announced. "We're
now awaiting a reply from them as to when we can have these funds," says
> Maj. Gen. Herman Lupogo, head of the Tanzanian Commission for AIDS. "We
> needed them yesterday."
0
> It is a quandary that exemplifies the pros and cons of the Bush
> admmistra ticn's war on what it considers wasteful foreign aid. The
> administration is openly dubious that past aid funneled through
> established agencies has had any positive effect -- a topic Treasury
> Secretary Paul O'Neill has repeatedly stressed, including during his
> much —ballyhooed African jaunt with Bono the rock star.
> The administration vows to resist any efforts to increase foreign
> assistance unless it can deliver quick, measurable improvements in the
> lives of the poor and sick, and it repeatedly has placed conditions on
> U.S. largess toward that end. The Treasury Department promised $300
> million in extra funds for the World Bank's loan program for the poorest
^nations, but only if it can demonstrate results. President Bush proposed
.> a $5 billion-a-year aid fund aimed strictly at countries that can meet
> objective standards for economic and political reforms.
Pl) P
yi.c
> And the U.S. pledged $500 million to the global AIDS fund. But the
> administration insistea — joined by Britain and some other donors —
> that the fund shun existing aid agencies and build its own system. That
1 of3
8/16/02 9.45 AM
PHA-Exchango Global Fund stalls
JL S t2T5 t ?* VS
auditing
each. country for each grant.
>
I can't tell you how much resistance we've had to this" from some
■> g 1 o'na : - fund re.n/p / ants and donors, said one senior U.S. official. "We're
> anxious for quick victories, [but] better that it be done right and
■r rater, than early and wrong. "
> me fund and its backers face mounting pressure to get the money
> blowing. Some 40 million people world-wide carry the virus that causes
> AIDS; an additional 20 million have died of the disease since it first
> surfaced in the 1930s, and a quarter million more are dying each month.
> “he spread of the AIDS virus has made vast numbers of people in the
> developing world and former East Bloc nations more vulnerable to TB,
> which claims two million lives a year. And as many as 500 million people
> corit.j-3ct. io.3J.32?J.3 snnusJ.lv.
>
> The fund approved 58 project applications in its first round. Among the
> winners are a Nigerian campaign to widen access to AIDS drug cocktails
> and a Tanzanian project to increase the use of bed nets impregnated with
> insecticide to combat malaria. Another approved oroiect is an effort in
k Madagascar to promote the use of condoms, mosquito nets and other
> health-related items by using marketing techniques and local retailers
k> such as street vendors and market stalls.
k Although the fund has a new executive director, Richard Feachem, it is
> still advertising for many senior positions — another holdup in
> distributing funds.
> "Of course the recipients are imnatient — they want to get started,"
> says Dr. Fcachcm, on leave from his post as director of the Institute
> lox Global Health at the University of California.
> "Equally, the countries are understanding that we have to put new
> arrangements in place."
> Dr. Feachem hopes to get money to a handful of projects by the time his
> board next meets in October. But even that goal remains up in the air.
> And the vast majority of grant winners probably won't see any funds
> until the end of the year, if not later.
k 'i don't see any justification for that kind of excess precaution," says
> Milly Katana, a Ugandan AIDS activist who represents private charities
> on the fund's board. "Personally I don't want to just light the money on
fire and burn IL, but at the same time lives are being lost."
k Dr. Feachem and U.S. , British and many other donors say the fund is
> making quick progress for a brand-new aid program. Nonetheless, tension
> has emerged among donors and recipients over how fast to go, versus how
> careful to be. "There's simply a higher level of attention being paid,
> and it's [angering people] who are used to having large amounts of money
k given to them,” said the U.S. official. "Some of the Europeans don't
> feel as strongly about that -- they just dish the money out."
k The fund was set up as a Swiss foundation after a spat among donors
k early on; Italy and others were aligned against the U.S. and those who
> didn't want It run by either the U.K. ox World Bank. "We would have
> tavoreo a stronger roie tor the World Bank in the whole disbursement
> procedure," says Claudio Spinedi, a senior aid official in the Italian
> Ministry of Foreign Affairs.
> Initially, despite the U.S. 's discomfort, the fund tiled to negotiate
> with the Woria Bank, the wand's largest economic-development lender, to
> take responsibility for the money and its use.
> Bank officials, however, refused to accept that role unless they also
of 3
rlA-Exchaiigc> Global Fund stalls
8/16/02 9:45 AM
-input; mto nci'.T the projects were selecteci snd imclemented — s
conaition unacceptable to the fund and the U.S. The issue is still in
^limbo, but for the ~.oaent the bank has agreed only to hold the fund's
uiGnsy and i-;ire grants tc the recipients the fund designates.
quickly set up a panel of technical experts who reviewed
> 300-plus applications and chose the first recipients. But the fund still
> has only a vague outline of how it will distribute money, monitor its
> use, and judge its effectiveness. Dr. Feachem promises that the fund's
> staff will number no more than 50, meaning it likely will have to hire
> outsiders to monitor projects in what could ultimately be 100 or more
> countries.
> According to the current plan, each project will involve:
> o A principal recipient — perhaps a foreign health ministry, local
> government, company or private charity -- that will implement the
> project, assess its success and report its conclusions to the fund.
_> 0 _3. locsl fund scent — such ss sn sccountinc firm Josnk on chsritv —
> that 1’72x2 aUdlt ZnS iQOFi&yr S US&. The a2cht viOn'Z eXdiuj.ne whether the
> project succeeds.
> o A third independent agent that will periodically verify the principal
recipientr s assessment of the projectrs im^set on ^ubJ. i.c be si. th.
> U.S. officials acknowledge that their approach means somewhat slower
> delivery of the aid, and risks a crescendo of criticism. But, they say,
> if the fund doesn't. Drove ir.s merits by financing effective health
2* oro"'cctS/ the doo~^~s xor t
s11 the hi tty
02*
t runs dry •
> Write to liichaei !•!. Phillips at michael .phillips&wsj. comB
T-1TT 7\
P-.
1 —
V
«4- —
T/-— V,
~
■! y.
—
To post, write to: PHA-Exchange@kabissa.org
Website: hrtp://www.lists.kabissa.org/mailman/listinfo/pha-oxchango
of 3
8/16/02 9.45 AN!
HA-Excliangc> UGANDA: HOW BEHAVIOUR MODIFICATION HELPED STEM HIV/AIDS INFECTION
Subject: PHA-Exchange> UGANDA: HOW BEHAVIOUR MODIFICATION HELPED STEM
HIV/AIDS INFECTION
Date: Thu, 30 May 2002 21:20:14 -0500
From: "George(s) Lessard" <media@web.net>
Organization: http://mediamentor.ca
To: creaLive-nwlio@yahixjgroups.com
CC: pha-exchange@kabissa.org
UGANDA: HOW BEHAVIOUR MODIFICATION HELPED STEM HIV/AIDS INFECTION
http://www.kaisernetwork.org/daily reports/rep index■cfm?DR ID=11323
The May 27 issue of the New Republic examines how Uganda's "ABC" HIV/AIDS
prevention program has primarily used behaviour modification to lower HIV
infection rates and how that model could be applied to the rest of Africa.
ABC, which began in 1987 after President Yoweri Museveni became aware that
many soldiers in the army were Hlv-positive, stands for "Abstain, Be
Faithful, or wear a Condom." The program focuses primarily on abstinence
before marriage and fidelity inside of marriage, and has "little to do"
with condoms.
:-) Message Ends; George(s) Lessard's Keywords Begin (-:
jTreelance Media Arts, Management, Training, Mentoring S Consulting
T)n line: Internet / Workshops I Research / Presence / Content /
un location: tv / Radio / Production / eng / EFB / Editing
Interests: Access / Activism I Communities / Cultures / Arts
Resume and more @ http://members■tripod.com/~media002
Queries I Offers / Patronage /
Commissions should be sent to
media@_no_spam_web.net
Rostered Volunteer UNV# 120983 s CESO/SACO VA# 11799
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&
(c) information may be found @
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please check ALL sources s subjects.
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oil
6/4/02 11:31 AM
HA-l .<0131.3..-- OktH 2002 Gene
As*. :.iNs.. si th and Justice: For All er "Just US"?
Subject: f’llA-Exchange> DGH 2002 General Assembly August 2-4: Health and Justice: For All or
"Just US"?
Date: Fri, 07 Jun 2002 19:47:09 -0400
From: DGH info <dghinfo(<^dghonline.org>
t o: DGH Info <d£hinio<tzds>hoiiline.or2>
Doctors for Global Health
2002 General Assembly
Health and Justice: For All or JUST US?
Doctors for Global Health is pleased to invite you to the 2002 General
Assembly.
This annual event is a chance to come together and meet others
working to advance health and human rights, to learn, to support one
another, and to have run.
Come participate in lively discussions, listen to
world-renowned speakers, and re-energize yourself to continue working for
The General Assembly will include a keynote address by Dr. Jack Geiger, a
champion of health and human rights over the past five decades and a
hounding member of both Physicians for Human Rights and Physicians for
Jocial Responsibility.
This year's featured Social Justice Speaker is Dr.
Juan Romagoza.
A Salvadoran torture survivor and Director of La Clinica del
Pueblo in Washington, DC, he will motivate and inspire everyone.
Friday night will feature a special musical celebration and fundraiser with
local Afro-Latin ensembles sol y canto and Sumaj chasquis.
Tickets will be
available at the ueneral Assembly.
WHEN: August 2-4, 2002
wuvnr•
Taqisv Collece in
Hqa
Massachusetts
HOW MUCH:
Doctors for Global Health offers a sliding scale. Higher amounts
will help others who cannot afford the full amount.
Please pay what you can
**On Campus: $100 - $200 (Anything above $200 would be a much appreciated
tax-deductible donation to DGH)
Includes all conference fees, 2 nights accommodations in a shared double
room at Lesley Colieoe, meaIs all da v Saturday, and b reakf a s _ on Sunday.
■ off Campus: $50 - $100 (Anything above $100 would be a much appreciated
deductible donation to DGH)
Includes ax_ conference tees and meais all day Saturday and sunciay
breakfast.
HOW TO REGISTER.: Please go to our website at www.dghonline.org.
can complete print cut the registration form and mail it in.
There you
To obtain more information or to register, please contact Mollie Williams,
Development Coordinator, at 979-774-4079 or developmenttedghonline.org
DOCTORS FOR GLOBAL HEALTH
Promoting Health and Human Rights
"With Those Who Have No Voice"
PC> Box 17 61, Decatur, GA 30031 USA
Tel. & Fax: 1-404-377-3566
dghinfo@dghonline.org
http://www■dqhonline.org
4 d noshed nr Kab-’ ssa
Xc I-i
spsc» for change in .Africa
6/10/02 11:25 AM
4HA-EXchange> International Women anil H.-ims (Au§ 12-16 2002) - Toronto, Canada
Subject: PBA-Exchange> Internationa! Women and Health Meeting (Aug 12-16 2002) - Toronto
Canada
Date: Mon, 10 Jun 2002 17:47141 -0500
From: "George(s) Lessard" <media@web.net>
Organization: http://mediamentor.ca
To: mediamenior@yahoogroups.com
CC: creative-radio@yahoogroups.com. pha-exchange@kabissa.org
International Women and Health Meeting
(Aug 12-16 2002) - Toronto, Canada
The 9th IWHM will focus on ths followino three themes: sexual and
reproductive righto, Violence against WOIuSIi (State Slid family) Slid
environmental health.
Focus is on action and on developing strategies and
solutions for a comprehensive approach to health in the context of
globalisation.
http: //www. comminlt. com/'events cal/2002/1057-event. html
Contact: iwhmQlefca,com
R —) Message Ends 7 Georcre(s) Lessard’s Keywords Begin ( —:
Treelance Media Arts, Management, Training, Mentoring & Consulting
On line; internet / workshops / Research / Presence / content /
On location: TV / Radio / Production / ENG / EFP / Editing
Interests: Access / Activism / Communities / Cultures / Arts
Resume and more @ http://members.tripod.com/^media002
Queries / Offers / Patrcnaoe /
commissions should be sent to
--- Hi -a t-i",
--Hictuac iiu/ o^jcuh wcfe.iicb
Rostered Volunteer UNV# 120933 & CESO/SACO VA# 11799
-Caveat Lector- Disclaimers, NOTES TO EDITORS
s
(c) information may be found 8
http://members.tripod.com/-media002/disclaimer.htm
Because of the nature of email & the WWW,
please check ALL sources £ subjects.
- 30 -
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pkl Z?
[-Exchang.
On privatization of social services
the context of an increasin/iv globalized world
improvements in health
for privileged groups should suggest what could, with political will,
possible for all.
Further details:
http : //www.equinetalriea ■ t r.;/news letter/newsletter .pinp'?id=fc63
.-fl
6/10/02 11:32 AM
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To pest, write to: PHA—Exchangeftkabissa.org
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of2
6/10/02 11:33 .AM
rHA-Exchange> On privatization of social services
Subject; PILVExchangO On privatization cl' social services
Date; Mon, 10 Jun 2002 02:27:19 ->-0700
From: "aviva" <aviva@netnara.vn>
To: pha-exchange@kabissa.org
From: "Equinet Newsletter" <EQUINET-Newsletter@equinetafrica.org>
NEWSLETTER Jt June 2002
1.„ EDITORIAL
P.ene Loewenson^Thumida Maistrv Ecpiinet
(excerpts)
A recent conference hosted by the Municipal Services Project in
Johannesburg highlighted a growing tide of defiance from people around
South Africa over privatisation and its impact on access to basic
services. People travelled from all parts of South Africa to testify in
the workshop on their experiences of hardship as a result of
privatisation and unaffordable service costs, noting stories of
evictions and watar and slecccicicv cut offs. Most of thasa
testimonies articulated the view that basic needs, such
as water and electricity, are basic ricjhts. Many highlighted the
negative impact of reduced access to basic services such as water
supplies on health and quality or lire.
Participants consistently raised the constraints to service delivery
unaer glooalisation, privatisation ana cost recovery measures, and their
negative health impacts. Dunno the workshops, delegates discussed
Would a rights based arproacn or one centred on claiming legal redress
for deprivation of baszc rights be successful? The meeting identified
the need, tor a new wave or social mobilisation as being more important
than Legal battles in achieving constitutional rights around basic
services.
The impact of foreign intervention in basic services was also explored.
It was noted that the worldi#9217;s water management continues to be taken up
by foreign companies.
Globalisation, privatisation, and centralised management of
the world’s natural resources makes humanity itself one or the greatest
threats to itself.
Parker and others noted that the response to such challenges called for
a social movement, able to strateaise, resisting co-option by
international agencies and able to r sist neoliberal policies.
^Brie conference explored now such soc'Lal farces for health are organised
and growing. Community struggles aroi ;nd access to basic services were
seen to be snowballing, particularly when they have support from social
movements around the wor^u. More wej... established movements, j.ike the
youth activists and organised labour ail noted their roles
internationally in targeting access < o serves and in building alliances
with other community based oraanisat* ons.
A growing social movement to pressure for basic services was thus seen
as th© greatest predictor of service cover. This was particularly the
case as neo 1 me ra j. *. orcGs
; v g r own.
Market policies and meouitabj-e development were viewed as primary
threats to increasing cover of basic services.
ALSO IN EQUINET:
Ecruity in health and its determinants need to be placed higher on the
oolicy and research agendas •_< bolh international and national
organizations in low-, niddle-, and high-income countries.
International agencies can strengthen or undermine national efforts to
achieve greater equity. The Friniary Health Care strategy is at least as
relevant today as it was two decades ago; but equity needs to
move from being largely implicit to becoming an explicit component of
the strategy, and progress toward greater equity must be carefully
Shonitored in countries of all per capita income levels. Particularly in
of 2
P
/-)
rzZ x < to
6X10/02 11.30 AM
HA-Exchan.se> Some breastfeeding news
Subject: PHA-ExchangO Some breastfeeding news
Date: Mon, 10 Jun 2002 03:15'15 +0700
From: "aviva" <aviva@netnam.vn>
To: pha-exchange@kabissa.org
From: ted.greiner3chello.se
Breastfeeding: Healthy Mothers and Healthy Babies is the topic of this
year’s World Breastfeedinc Week. You can road about it on WABA’s
website http://r.-:. woba.org.br/wbw2002. htm and contact WABA for the
action folder, exhibit kit, etc.
Recent studies have further retined our knowledge on the association
between breastfeeding in intelligence. Rao et al (Acta Paediatr. 2002;91
(3):267-74.) conclude: ’’Duration of exclusive breastfeeding rias a
significant impact on cognitive development without compromising
growth amona children born SGA Ismail for oestational age] . ” Similarly,
Mortensen ot al. (JAMA 2002;287:2365-71) found slightly higher
intel1icsncs scores m adults who had bean breast-fed longer, with many
confounders controlled for.
Space for change in Africa
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HA exchange— Israeli army is rampagina...man cities breaking all laves and rules
Subject: PUA-Exchangc> Israeli army is rampaging Palestinian cities breaking all laws and rules
Date: Tue, 11 Jun 2002 17:54:42 +0700
From: "Aviva" <aviva@nexnam.vn>
To: ’’pha-exch” <ph3“€xchsnQ€'&k3bissH.or£p>.
P* T'r'IY’ •
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—
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> PdJestine Monitor
>10 June 2002
> The situation in Ramallah is currently one of brutal occupation and
> widespread destruction.
> In the afternoon Apache helicopters shot indiscriminately in wide-range
> areas without any apparent reason and several buildings have been
bombarded
> and joadly damaged.
> The Israeli army has surrounded two hospitals preventing ambulances and
> medical workers to reach the hospitals in order to aive life-savina
kiedical
treatment.. Troops
also obstructing delaying zhe movement or amoulances
> within the city with severe consequences for the sick and injured.
> There is also an increasing shortage of medicine, milk, food and other
supplies as tlis whole ccmmuritv was ur~,prefia^ed for this invasion. The
strict
> curfew makes it impossible for people to obtain the necessary supplies.
> Eyewitnesses in Ramallah repor~ that the Tsraeli army has conducted
> collective arrests of large numbers of young men, handcuffing and taking
> them into buildings foe interrogation.
> For further information olease contact the Palestine Monitor
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Request to mailing list PHA-Exchange rejected
Subject: Request to mailing list PHA-Exchange rejected
Date: Thu. 13 Jun 2002 21:25:40 +0530 (1ST)
From: pha-exchange-admin@kabissa.org
To: sochara@vsnl.com
Your request to the PHA-Exchange mailing list
Posting of your message titled "Gujarat Assessment Report-Oxfam"
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1 of 1
6/14/02 5:13 PlV
( iVii SIH !!' i i'f> FOR IJEMOGR.U’.Y, NEPAL’ APPEALS \j,j SOC (Ai. ANh HI MAN
'
RIGHTS .'.DYOCATES TO PARTICIPATE IN THE PROTEST RALLIES OFAUGUST 25 2002.
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have become every fm\ phenomenon, joecause of emergency the economy of Aepai is coiiapsed. aii social
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I AO ! Dt I AjLS +++ ++++ + + + +++++ + ++4-±-t-++++4' + + 4- + 'f' + + 4-4- + + -i-+ +
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■ -i.- ■ n »r» r-iirrar disagreements 7?S nOVirrniPPlh P’lH b'JS'nRS^ ppni^rpci the
lac: -i:r<Xr
largest meeting ever convened a resounding success, while charities lined up to declare it the “worst political sellout
it toi i; «e WOI iu iiaS Scci i »»”} «Jovc>Gc6 .
Environment secretary Alarcaret Beckett. Britain's lead negotiator at ths 10-day meeting, which was attended by more
ihan i 00 'vo''c seders. said tnat tne resui’ was a victory for everyone .
rhe overall result of the summit is truly remarkable. We had to give it our best shot to get the best deal we cot
I© Uid. t ati'i :O i'iO mvUOI u’iqi vuti ucS^eriUoi’no v/iii lUOK baCix Oil u HS SUiin'iiii. al iU oay vvc Sei Out Oil a ilcW pSti i.
But Oxfam said ths o .'corns fe'! £ar short of what wss needed to address global problems of poverty and
envvonmenta' deorsc's* on After nine dsvs of bluster the world sets some Gains on s few issues and on sanitation
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Charles Secreit director of rrienas of rne earth saia the summit was a damning indictment of world leaders
they
^ubliclv oresched the messaoe of sustainable development but instructed their negotiators to do trade deals above
all else This ;s the w-r-f co!Tsal sellout in decades "
ano maiana
Orner aonievements a”e 'scoo^sad to be targets ror reversing the extinction or species and restoring fish stocks.
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Andy Aikiris for fearfui-td. a ci'iurci'i-uosed choi'ity. summed up ihe disappointment of many British groups. In the race
j rackie worsening giobai poverty and environrrieniei desir action, trie summit merely inched forward when a giant
?20 was needed, Borne coi’ticians nave piaved poker with the planet and the poor, trading progress in areas such as
However, there was goes news last nigh: from China and Russia, which both answered *ony Blairs challenge of the
previous day to ratify trie Kyoto agreement on climate change, i his means the treaty is on course to become lav* by
the end of the year and funner isolates the US now with Australia the only rich country to refuse io sign up.
’ he BU wn ch rouch” haroest ior a bmoing aoreement on renewable energy, but 'was finessed by a coalition of Opec
US
■-??' ■: V''' i* wu-jfd r^lly I;•<€:-(winded countries to increase the use o,erenewable anorny
and se: strict deadlines.
Eariy analysis suggests that no new money has been pledged for aid or debt relief, two of me issues that have most
exercised leaders or deveioomo countries.
"Thl<. <1 ir>
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Hope tf.) the half of thp planet ihftt liv£>s
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However easiness, wriicii rias been promoted to a cential position in world development by trie UN. was cheeu'ui
about its new role. Business and industry is determined to piav its part in making tne priorities tor action and targets
on sustainable devdooment work, saio a sookesman for Business /Action for Sustainable Develooment, a grouoinc
,O thief announces surprise move to stand down (The Lancet: 31 August 20021
Above all. Brundtland looks set to be remembered for her crusade against smoking. The Framework Convention on
Tobacco Control —scheduled for completion next August just after she leaves office—will likely be weaker than she
wanted, but will be the first international treaty' against a product which currently kills 4 million people a year.
"She has done a tremendous job on tobacco. She single-handedly put tobacco control back on the agenda", said
Amanda Sandford, research manager at ASH. "That will be a lasting legacy to Brundtland."
RehinrI-fhe-scenes jockeying to take up the reins has already begun Governments have until November to submit
nominees. The 32-member Executive Board decides next January and this is, in theory, endorsed by the full World
> lealth Assembly in May.
With the exception of Nakajima's 1u-year tenure, turopeans have traditionally held the post. Brundtland's closest
challenoer in 1098 was Sir George Alleyne of Barbados. Next year, developing countries may feel that it is their turn.
C.'sre Kspp
++++++++++++++++j-orwaroea by:
Dr. Unnikrishnan PV
Co-ordinator: Emergencies 8 Humanitarian Action, OXFAM INDIA
E-maii. unnikru@yairoo.cotn
Mobile: 91 (0) 98450 91319
.++++++++++++++++++++++++++++++ CONTACT DETAILS ++++++++++++++++++++++++++++++++++++++++
IbXFAM INDIA
Vijaya Shree, 4th A Main, Near Baptist Hospital, (off) Bellary Rd, Hebbal, Bangalore-560 024 - INDIA
Ph. 91 (80) 363 2964, 363 3274 , Fax . 91 (60) 391 4508 (attn: Oxfam India)
E-mail: oxfammdia@vsni.com Web-site: www.oxfamindia.org
?«r?
9/7/02 10:26 AM
chicf'aiinoinces suronsemoveXiwnVfc’llniPM^Aiimst 2002Y stand down (The Lancet: 31 August 2002)
Subject: WHO chief announces surprise move to stand down (The Lancet: 31 August 2002)
Date: Ihu. 5 Seo 2002 20:41:07 +0530
From: "LJNMKPJSHNAN P V (Dr)" <unnikru@yahoo.com>
To: <unnikru@yahoo.com>
Date: Thu. 5 Sep 2002 20:41:07 +0530
"TTKTMTVT3TQ14XTAXTP V iTX-V Ommh-W.-.
WHO chief announces surprise move to stand down
The Lancet: 31 August 2002
WHO Director-General Gro Harlem Brundiiand dropped a bombshell on Aug 23 by announcing that she will not stand
for re-election when her 5-year term expires next July. Ihe former Norwegian prime minister said she had informed
the chairman of the Executive Board- Burma's deputy health minister Kyaw Myint-that she would "not be a
candidate for nomination" when the board makes its choice in January
"My decision to complete my work as Director-General at the end of my current term reflects the fact that I have had
leading positions in political and public office for neariy 30 years, and would be 69 at ihe end of a second term", she
stated.
j^The news shook the UN community in Geneva out of its summer slumber and set WHO corridors abuzz The US
diplomatic mission to the UN lauded Brundtland for bringing "new strategic direction". The British Medical Association
(DMA) lamented her departure as premature. "Identifying the problems was the first achievement, implementing them
is the second thing, and you need more than 4 or 5 years to achieve that", said BrviA spokesman Nigei Duncan.
Brundtland associates said she wanted to spend more time with her three children and nine grandchildren in Norway,
and has become weary with the travel She is currently in southern Africa to discuss the humanitarian crisis and for
the World Summit on Sustainable Development. She then attends meetings in Jakarta, Copenhagen, Washington,
Cairo, and Brazzaville.
Some WHO officials speculated that their boss was tired of being criticised and was bogged down by reforms. These
were intended to make WHO more efficient and open but have led to low morale and constant changes in senior
management, disparagingly called the "Harlem Shuffle" by insiders
Brundtland took office in July, 1993, when the agency was at an all-time low. She replaced Japan's Hiroshi Nakajima,
who was wideiy criticised for poor management and lack of direction. She vowed to place health on the international
development agenda, to find new partners to reduce the reliance on governments, and to make WHO more
responsive.
"WHO is solidly on track to fulfil the many demands being placed on it", said Brundtland in her resignation notice.
"The critical role of health in development has gained wide acceptance. The world has turned its attention to our
priorities”, shedeciaied.
There is widespread agreement that Brundtland successfully combined her political savvy from her 10 years as prime
minister with her zeal as a clinician to catapult health up the international agenda. This was not least through her
Commission on Macroeconomics and Health, which reinforced the view that health is a prerequisite for, rather than
the result of, development.
But away from the declarations at summits and in policy documents, WHO struggled to Improve its Infamously
ineffective country representation and aid national health systems.
Brundtland ushered in new initiatives such as Roll Back Malaria and pioneered partnerships, such the Global Alliance
for Vaccines and Immunization, with private organisations such as the Gates Foundation.
This opened up new sources of funding, but weakened WHO's grip. "There are other powerful partners in health
these davs. from the Gates Foundation which has injected welcome resources into the health sector, to the
pharmaceutical companies who are making donations of drugs-all of whom are influencing international policy",
commented Gill Walt, professor of international health policy at the London School of Hygiene and Tropical Medicine.
Brundtiand's embrace of tire drug indusby has proved most controversial. Health activists charge that WHO has sold
its soul to Pig business and nas nidden in tne shadow of non-governmental organisations (NGOs) such as Medecins
Sans Frontieres on access to essential medicines. Brundtland allies counter that WHO's quiet negotiations with
pharmaceutical companies have done as much to slash the price of antiretrovirals as the more confrontational tactics
of NGOs.
LJi+o-uJH/t •y’cle
97/02 10:26 AM
^A-Kxchanee> WSSD: Meetins was a sellont. charities sav
FDLA-It<xcii«n^c-'''
Alcctiug was *» sellout. charities say
Date: Thu. 5 Seo 2002 15:29:27 +0530
From: "UNNIKRISHNAN P V (Dr)" <unnikru@jrihoo.com>
To: <unnikrutayanoo.com>
mSCtiFiS **«S S SSiiOUt, OhSFataSS SSy
John Vida! and Pau! Brown in Johannesburg
'neuileSuay September 4, 2002
Tne Guaraian
The earth summit was last night breaking up in hitter disagreements as governments and business declared the
largest meeting ever convened a resounding success, while charities lined up to declare it the "worst political sellout
that the world has seen in decades".
Environment secretary Margaret Beckett, Britain's lead negotiator at the 10-day meeting, which was attended by more
than 100 world leaders, said that the result was a "victory for everyone"
"The overall result of the summit is truly remarkable. We had to give it our best shot to get the best deal we could and
we did. I am in no doubt that our descendants will look back on this summit and say we set out on a new path."
But Oxtam said the outcome tell tar short of what was needed to address global problems of poverty and
environmental degradation. "After nine days of bluster the world gets some gains on a few issues and on sanitation
for the nonr Ri if overall rhp. rlppl ie fpphle It is a friumnh for creed and self interest a traoedv for none neoole and the
” coirl Ar*r<rox«» UouiCit*
Charies Secreri, director of Friends of rhe Earth, said the summit was a damning indictment of world leaders. "They
publicly preached the message of sustainable development but instructed their negotiators to do trade deals above
all else. This is the worst political sellout in decades."
The most significant achievement is recognised as the target of halving the number of people -1.2 billion - who lack
access to safe water and sanitation. This is expected to save millions of children who die each year from diarrhoea
and maiaria.
Other achievements are recognised to be targets for reversing the extinction of species and restoring fish stocks.
Roth have been hailed by governments, but criticised by environment groups for being weak and unenforceable
Andy Atkins for Tearfund, a church-based charity, summed up the disappointment of many British groups: "In the race
io iackie worsening global poverty and environmental destruction, the summit merely inched forward when a giant
leap was needed. Some politicians nave played poKer with tne planet and the poor, trading progress in areas such as
sanitation against other areas like energy".
However, there was good news fast night from China and Russia, which both answered Tony Blair’s challenge of the
previous day to ratify the Kyoto agreement on climate change. This means the treaty is on course to become law by
tire end of tire year and for trier isolates the US, now with Australia foe only rich country to refuse to sign up.
The EU. which fought hardest for a binding agreement on renewable energy, but was finessed bv a coalition of Opec
and US industry interests, said last night it would rally like-minded countries to increase the use of renewable energy
2nd set strict deadlines.
Early analysis suggests trial no new money rias been pledged for aid or debt relief, two of foe issues that have most
exercised leaders or developing countries.
"This summit has delivered absolutely nothing of any substance that will offer hope to the half of the planet that lives
on loss then $2 2 d2y,” S2id B2rry Cootos of ths World Dsvolopmont Movement.
However business, which rias been promoted io a central position in world development by tile UN, was cheerful
about its new role, "business ano industry is determined to play its part in making the priorities tor action and targets
on sustainable development work.” said a spokesman for Business Action for Sustainable Development, a grouping
of the world’s largest companies
+•1 +++++++++forwarc!ed by:
1 <>T2
9/9/02 9:51 AM
^-Exchanges- Israeli
army prevents medical services in Nablus
subject; PUA-ExchangO Israeli army prevents medical services in Nablus
Date: Sat 7 Sep 2002 23:08:44 +0700
-*■ * Vi** a X x v * » V. ~v* » x »
IW.I I a. r aaio: "pna-exch" <pna-exchan.2e(a!kabissa.org^
From:
"Palestine Monitor" <nalmon@hdip.org>
ruvGC'
j. ul uj. uta ulOii
Cicai j.nQiiOuSe
> Information Brief
> FcraaH
r-mtz r'+arranre metd i rtt< 1 S&rvt C&S .TH Nablus
> The humanitarian situation in Nablus is growing increasingly critical as
all
moz-^ir’^7 cartn'rot; ,=» r-o fijrronr 7ir y>x» rg 7 xrresri fay the Tsrael 7 rlFTTH/. Si 7>CP this
> morning, tanks arc surrounding and blacking all access to the Rafidia
> hospital (the regional hospital), the Palestinian Red Crescent and che
A Palestinian Medical Relief. One of the Palestinian Medical Relief
cttnbulances
> is stue.t inside the premises of the P.afidia hospital unable to move.
> nablus has Deen under curfew for 77 continuous days; the population has
only
> been allowed to leave their houses for few hours during this period. Five
y- — ntemat — onals who were in Nablus yesterday were arrested by the Israeli
y army ano ta^en to the Ariel settlement. The army announced that the five
> wiii be deporr.ed and so will all or.ner i nr.ernar.i ona i s r.hey find in the
city.
s
or. Mustafa Darghouthlf President of the Palestinian Medical Relief said
> today: "The situation is very critical in Nablus; people have been living
> under constant curfew for almost three months and are now being denied
> arr-ocm v-r»
rranrmoni-
Th& ^rr^S^ of fl.V^ 1 ntemat.T Onals In NablUS
> ysstsrday shows that ths Israeli army wants to hide its actions. We demand
> Ij/uHtsu-ta Gt? iHicj. nauluiidi liit^j. vention to stop these dangerous and Inhuman
> actions or tne Israeli army”.
>
JT’or-
r.r.r.:.
rnryr-c^ information contact rr'h& Palestine Monitor
wincxom wor. erg
> Palestinians killed this week:
17
> Total number of Palestinians killed since September 2000: 1872
PHA-Exchange is hosted on Kabissa - Space tor change in Africa
To post, write to: PHA-Exchange@kabissa.ora
t<i
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pl-ffl Z? yr f,
9W02 10:13 AM
Exchanges- Africa GM Food Controversy Heats Up
^txbjcct: l^xiA-lLxclisngct' Afncs t.'.! 1 ggc! Uontroycrsy llcots Up
Bate: Sat. 7 Sep 2002 23:23:16 +0700
From; "Aviva" <aviva@nttnam.vn>
To: "pha-exch" <pha-exchange(ajkabissa.org>
—From:
"Mark Covey" <MarkC@oanoslondon.org.uk>
or: GM Food aid and GM policy in southern
> h’c:: Panes
> On Auaust 16th 2002 the Zambian Government announced that it would not
> A^rrant ?7.nnn
nF
aid from the* (TA to feed about two million of
> its people threatened by famine, because the feed contained genetically
> modified (Siij grain.
> Zambia's rejection of the food aid resulted in a stormy international
S
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r\ -ma r> i eta r i mn c
■» <><-' 7 ijrJ 7 n<y
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thO »7GZ‘j.Q ACuj. th G-u"yct-TI-l 3u t J.O27 vtjlxx tluC ViGo^-L-C FQG<a Pol Oy27CiluIuC
> urged Zambia lcj accept, uhc aid, while che EU, uK officials and many NGOs
including a grouping of African civil society organisations criticised the
US for outtina such oressure on Zambia.
Gj.“y lxai J-Oix uJLCai r
t
> The rssue throws a s^otlrght on the crucial guesto.cn of whether countries
can mare cneir own Decisions about introducing GM crops - and make their
> decisions freely after a process of discussion, weighing benefits and
risks
>
•’»->
ooio + jovb
z'«»-ie’i7f-t'r><T
o
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> Denar.e is proving as neared and difficult in Zambia as in many other
> countries: feelings arc very intense, and appear to be predominantly
auainsL
> GlfOs, sc that vcicss arguing in their favour sometimes have difficulty
> getting a hearing.
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Pl-1
tm<r (b
9W02 10:15 AM
1 1 shedding light on stress: Sci...il1ions in U.S. suffer lingering trauma
Subject: Sept. 11 shedding light on stress : Scientists find millions in U.S. suffer lingering trauma
Bate: Mon. 9 Sep 2002 12:39:57 +0530
From: "UNNIKRISHNAN P V (Dr)" <urmikru@yahoo.com>
To: <unnikni@yalioo.com>
Sept. 11 shedding light on stress :
Scientists find millions in U.S. suffer lingering trauma
William Booth The Washington Post (From International Herald Tribune : Monday, September 9, 2002)
WASHINGTON If the goal of terrorism is to sow terror and its offspring of fear, numbing, anxiety and depression, then
the question is: How successful were the Sept. 11 attacks?
Within days, scientists began to probe the mental health consequences of the worst mass trauma the United States
experienced since the Kennedy assassination, seeking to learn what happened not only to survivors and rescue
workers in New York and Washington, but also to those millions whose exposure came solely through watching
television.
Jheir studies illuminate the impacts of trauma on a culture saturated with disturbing news footage. Their data, still
emerging, point to both the resiliency of the human brain and its vulnerabilities: Huge numbers of Americans - as
many as nine in 10 - felt symptoms of stress after the attacks, but most of them were feeling normal within a few
months. Still, a significant minority remain deeply distressed, and through them scientists are further tracing the arc of
shared disaster.
•
"What we are learning is that the ordinary person is not so ordinary - that people can survive things they didn't think
they could," said Dennis Charney, chief of the mood and anxiety disorders research program at the National Institute
of Mental Health in Bethesda. "But people also need to understand what trauma can do. Stress changes the brain.
Stress changes the body. It is real."
Fran Norris, a psychologist at Georgia State University, reviewed the scientific literature of "disaster studies"
published over the last two decades - surveys that included 50,000 victims, of hurricanes and floods, of Three Mile
Island and the Exxon Valdez, of school and office shootings, of the Oklahoma City bombing and other calamities.
What Norris found is that the trauma created by intentional violence was much more pronounced.
"Mass violence was, by far, the most disturbing type of disaster," she said. Of the population samples that directly
experienced mass violence, 67 percent were severely impaired, meaning apparently suffering from clinical anxiety or
depression or other mental illnesses, compared with 42 percent from natural disasters. The trauma from the Sept. 11
attacks was penetrating: In the days and weeks afterward, about 90 percent of Americans reported symptoms of
stress, and about 40 percent of the population gave answers that suggested "severe" distress, according to work by
^^Mark Schuster, a psychologist with the Rand Corp. And surveys by the National Opinion Research Center at the
University of Chicago found a similar post-attack spike in distress symptoms, such as loss of sleep and appetite,
crying, inability to concentrate, increased alcohol and tobacco consumption, and feelings of heightened anxiety and
emotional numbness.
What is becoming clear is that for those whose trauma of Sept. 11 was direct - who knew someone killed or injured in
the attacks - there may be lingering and profound psychological implications, especially among those who were
already suffering from anxiety or depression.
Researchers now estimate that these Americans number in the millions.
Last month, a psychologist, William Schlenger, and his colleagues at the Research Triangle Institute in North
Carolina published the first post-Sept. 11 study of clinically significant psychological distress and post-traumatic
stress disorder in Nev/ York, Washington and the nation as a whole.
"We estimate, based on our survey, that more than 10 million Americans knew a friend, a family member or a
co-worker who died or was injured in the attacks," said Schlenger, whose study was published in the Journal of the
American Medical Association.
■'You've got about 2 million of those people in New York, another 500,000 in the Washington area and the other 7
million-plus around the country," he said. "You have an elderly woman in Des Moines. She is watching TV. She’s
proud of her granddaughter who works in the World Trade Center and sees an airplane crash into the building am
sees the tower fall, live, as it is happening.
1 of?
u
9/11/02 11:39 AM
«6^^ding light on stress : Sci...illions in U.S. suffer lingering trauma
It is an experience we've never had before, and millions of Americans had it." Based on their surveys, Schlenger and
his co-authors estimate that more than 500,000 people in the New York metropolitan area may have developed
post-traumatic stress disorder as a direct result of the September attacks. About 11 percent of the respondents from
the New York area reported symptoms consistent with the disorder, which is about three times the national average.
If the researchers' estimates are borne out over the coming months, as measured by visits to doctors and clinics, this
incidence will extract a steep price.
Post-traumatic stress disorder is a debilitating and lingering syndrome common among the survivors of rape or sexual
abuse, violent attack and combat. Its symptoms include living in dual states of emotional numbing and hyper-arousal.
Sufferers may experience intrusive memories and feel the sense of "dissociation." or being outside their bodies. They
may be panicky, sweaty, quick to anger. They may be less than fully functional for years, and are more likely to
succumb to a host of ailments, such as heart disease and diabetes.
"The numbers of presumed cases in New York of PTSD are significant and disturbing,” Schlenger said.
For Washingtonians, however, the aftermath has been surprisingly dampened. By the Research Triangle Institute
team's estimates, only 2.7 percent of the Washington-area population reported the same levels of presumed
post-traumatic stress disorder. That figure is not statistically different from before the attacks.
Schlenger is not sure why. The Pentagon, he surmised, is more geographically isolated from the city than the World
Trade Center towers were from New York; it is a military, rather than civilian, target, and the attack on the Pentagon
did not produce the same devastation or the spectacular images of death, injury and destruction.
Dr. Unnikrishnan PV
Co-ordinator: Emergencies & Humanitarian Action, OXFAM INDIA
E-mail: unnikru@yahoo.com
Mobile: 91 (0) 98450 91319
++++++++++++++++++++++++++++++ CONTACT DETAILS ++++++++++++++++++++++++++++++++++++++++
OXFAM INDIA
Viiaya Shree, 4th A Main, Near Baptist Hospital, (off) Bellary Rd. Hebbal, Banaalore-560 024 - INDIA
Ph: 91 (80) 363 2964, 363 3274 ; Fax : 91 (80) 391 4508 (attn: Oxfam India)
E-mail: oxfamindia@vsnl.com Web-site: www.oxfamindia.org
2 of 2
9/11/02 11:39 AM
Jiange> Halving hunger: the numbers
Subject: PHA-Excbangc> Halving hunger: the numbers
Date: Tue. 10 Sep 2002 03:07:44 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch" <pha-exchange@kabissa.org>
Today, a total of 792 mill people in dvping countries remain chronically
hungry.
Around 3/4 live in rural areas, and more than 60S are women.
The cost of halving the No. of the hungry was estimated at U$60 bill over
the 18 yrs from 1997 to 2015: just over $3 bill a yr in increased speding.
There are more chronically hungry people in Asia, but 18 out of 23 countries
facing the most severe problems are African.
70% of Africans work in agric in some capacity. Aid to African agric has
fallen by 40% since 1980.
A 1% increase in crop yields reduces the number of people living on less
than $1 a day by between 0.6 and 1.2%.
Armed conflict and civil strife caused agric output losses in devping
countries estimated at an average of $4.3 bill a yr between 1970 and 1997.
Between 1968 and 1998, inti trade in major foodstuffs inceased twice as fast
as food production.
Agric trade is less than 10% of total world merchandise trade. Most —70% of
both exports and imports— is between developed cuntries (70% by
transnationals; a small No. of these dominate major traded agric
commodities ).
Source: Sood for All,
Banos Inst., 2001
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j^BKha$gp. PANOS - IS THE WB'S STRATEGY TO REDUCE POVERTY WORKING?
Subject: PHA-Exchange> PANOS - IS THE WB'S STRATEGY TO REDUCE POVERTY
WORKING?
Date: Fri, 13 Sep 2002 08:33:16 I 0700
brom: "Aviva" <aviva(^netnam.vn>
To: "pha-exch" <pha-exchange@kabissa.org>
From: "Mark Covey" <MarkC@oanoslonclon.org.uk>
'9/0.
> Newspeg: September 25-29 - world sank / IMF annual meetings, Washington
> REDUCING POVERTY: IS THE WORLD BANK'S STRATEGY WORKING?
mree years alter the World Bank and International Monetary Fund (IMF)
> intioduoed theix Poverty Reduction Strategy (PRS) approach as the latest
> template for the world’s poorest countries to get out of poverty, a new
> Panos report examines the progress so far and the arguments about whether
PRS can succeed.
> For over 70 countries producing a Poverty Reduction Strategy Paper (PRSP),
> 0,0roved by the World Bank and IMF, is either a condition for getting debt
> relief, or a condition for receiving concessional loans and some aid.
Since
> their introduction, PRSPs have been widely welcomed as the first serious
> attempt by the international community to put poverty reduction at the
> centre of development planning and finance and for embedding principles of
> countries "owning" their own development strategies. They have also been
> criticised by some non-governmental organisations (NGOs) as being merely a
> new name for Structural Adjustment Policies (SAPs) - the prescriptions of
> zne 30s and 90s for opening economies anct reducing government, expenditure
> which failed to xeduce poverty and allowed the gap between rich and poor
to
> widen.
> Governments are required to develop their PRSPs with the participation of
> civil society. This has led to dialogue between government and civil
society
> organisations on priorities for government spending
dialogue which in
many
> countries has been a new and valuable experience for both sides, even
though
> it may be hesitant and imperfect at first. Governments are encouraged by
the
> PRSP to commit themselves to poverty reduction and to focus on widely
> basic factors for helping people out of poverty
generally education,
> health and rural infrastructure. PRSPs are also starting to establish a
new
> transparency, in which government budgeting and expenditure can be
> scrutinised by parliaments and public. The World Bank and IMF believe that
> this is a crucial factor in accountable and democratic governance, in
i tself
> a necessity for a government committed to reducing poverty.
> But some PRSP critics charge that the whole approach is fundamentally
> flawed. It is based on the premises that economic growth is the first step
> towards reducing poverty, and that this is achieved by opening economies
> world markets and reducing government expenditure. These premises are also
> f-hose nf SAPs, which failed in the past. The critics hold that
> liberalisation in fact often increases poverty, and that the evidence that
> itleads to economic growth is unconvincing. Many countries' PRSPs are
......
. •
•
. -
> on predictions for growth which are unlikely to be realised - even tne
,.r.
9/16/02 10.31 AM
“•Exdiango PANOS - is THE "’B'S STRATEGY TO REDUCE POVERTY WORKING?
World
> Sank and ihi, in their own review of PRSPs earlier this year, admitted
c.ta u
> many countries 'nave given little detail about how they expect to achieve
the
> high growth rates needed.
> Yet the World Sank and IMF, and governments funder the influence of the
IMF,
> according to critics) arc not allowing debate and alternative views on
> fundamental questions of economic policy. The participation in economic
> policy-making to which civil society is being invited in the PRSP process
> strictly limited.
> For PRSPs to succQod, there will need to be 3. strong sense of commitment
and
> "ownership" by governments and people. This report, which draws on
specially
> commissioned reports from Lesotho, Ethiopia and Uganda, points out that so
> far this sense of ownership is not very strong - partly because countries
> have not paid enough attention to the potential role of the media in
> informing people and stimulating engagement.
> —
—
> ihe ±epori. j.s aja^j.able in pdj. or tex<~ format on the Panos London
website > <nttp: //www. panes. org. uk/brieting/reducing poverty front.htm>
> http://www.panos.org.uk/briefing/reducing poverty front.htm.
PEL.—Exchange is hosted on Kabissa — Space for change in Africa
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;i)f2
9/16/02 10.31 AM
' 'han^c-' i
Upcoming PAHO WHO Election
Subject: PHA-Exchange> the Upcoming PAHO/WHO Election
Date: Fri, 13 Sep 2002 08:58:14 +0700
From: "Aviva" <aviva@.netaani.vii>
To: "pha-exch" <pha-exchange@kabissa.org>
> The Role and Future of Public Health in the Americas: Ethics versus
Economics
r«to5O*"'11^mboJ.2 2002__
*ic mcmcnt of t t2i for '“'Ub 1 7*o
s’ health -I.” tJlG AZTiSTa.CaS has arrived. DO iv'G remain Under the hGSl Ci
economic
> determinism or do we value health as the means to enrich, empower and
> enhance our human and social capital?"
>
That is the issue today, says Dr. Mirta Roses, current Assistant
> Director of the Pan American Health Organization, and one of two
ocs
iri the closelv' contested election ±or Director o± PAHO tnat will tajte
place
> on Wednesday, September 2b.
a
> PAHO is the oldest international health institution in the world
> and the World Health Organization's regional office for the Americas.
>
Dr. Roses, a liberal Argentinian medical doctor, and the first
b j.emaj.e candidate for a major post m any Interamerican Organization m 100
> years, has spent 30 years in the field of public health, the last 18 of
> them at PAHO. Her conservative opponent is Dr. Jaime Sepulveda, a Mexican
> who works in the Institute of Public Health, and has less experience in
the
> delivery of technical cooperation and in United Nations activities.
>
"For some people, health is an expenditure that has to bo
b justified with economic arguments," asserts Dr. Roses. "This is a mistake
> that is too often made by opinion leaders and policy-makers. Economic
> calculations and financial considerations, altnougn they must be
evaluated,
> should not be the driving force and over-riding criteria for the most
> important decisions about health.
>
"Health programs are the reflection of the ethical decisions of a
> country. Tney mirror t,.e value scale that is assigned to life ano human
> development in geneial, and more specifically, the value of every person's
> life, particularly women and children, the elderly and the disabled.
>
"For most people public health consists of giving more years to
p life and more life to the years. This holistic approach is about promoting
> good health and wellness, preventing and controlling risks, and having
,■> vaccinss and drugs available to prevent or cure diseases when they appear.
> Improving the quality of life is the realm. of ths State. This was ths
DaSiv
> philosophy underlying the "Health for All" movement in the late 70s. Hut
> starting in the 8Gs it became increasingly necessary to demonstrate the
> economic value of health in order to receive or be allocated the level of
> resources either needed or deserved. I am against this approach."
>
Dr. Roses went on to say that "almost every country's Constitution
> in ths Americas snshrmss the view that access to health is a right of the
> people. And yet although evezyone knows that watez is a basic element zoz
> the support of life, health and human dignity, it became essential to
p l-f
,,
> the cost-benefit relationship for communities to qet water. But what is
not
> questioned (so long as someone pays for It) Is the fact that as much water
w
> necked tv^maihc.a^.n u^c- grass Ci a golf course in one day as to sustain the
9/16/02 10:29 AM
> Director of PAHC or. September 25 will determine whether acces to health is
> considered a fundamental rigtit to be guaranteed tor all or is only
> justifiable with the arguments of economic returns. My choice is clear."
>
>
Pre-election predictions suggest that Mexico, the United States
-* of America, FranceCanada,- and Colombia will vote for Dr. Sepulveda,
Argentina, Brazil, Uruguay, Paraguay, Bolivia, Dominican Republic, El
> Salvador, Barbados, Jamaica and Cuba are in favor of Dr. Roses.
> Altogether, 38 Ministers of Health will be casting ballots, but many
> countries in Central and South America and the Caribbean have not yet
> indicated their position.
PHA-Exchange is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-Excnange@kabissa.org
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*•ACh&Ilfic■«
.......
_T
Subject: l’tiA-Exchange> A report from Ani Whibey in Brazil
Date: Sat. 14 Sep 2002 11:11:29 ~0200
r »‘OtH ■ Mana tiaiTiiiii Zuillgci” <ipiiC@Cablcilct.COiil.ili>
To: <PHA-Exchange<gkabissa.org>, "Qasem Chowdhury" <gksavar@citechco.net>,
"Qoniniunirv health cell 5 <sochArA/ffivs;nl
"irHCWORLD WIDE" <IPHC WORLD WTDE@y alioogroups. com>
CC: "Aviva" <aviva@netnain.vn>, "UNNIKRISFII^AN P V (Dr)" <iinnikni@yahoo.com>,
L1JUJUXJ C*
1 JLk'llJ 1CUI. < Wil 1
'■GUI llrvj U\Ul 1 IVIIIKIil.VVll I-''
11 PH UPDATE FROM BRASIL
September 1G,
For rhe past four weeks, PHM has doubled its.efforts and participation in
the National Cameaion against ALCA and the use of the Space Base in
■l_ oi Latin America is into the Campaign with each country responsible tor
its own methods. Here in Brasil, PHM is part of the State coordination for
MaranhMo. Since Arril, we have worked to prepare the entire population for a
PLEBLISCITO scheduled for the "Semana da Patria" (National Week) , September
1 to 7; the "th being Independence Day and the 'Grito dos Excluidos"* (Cry of
Gathering signatures for voting had us working day and night.
The 3
questions on tne state
we re:
Should the Brasilian Government sign the Free Trade Agreement for the
territory -the Space Base in Alcantara- co USA military control?
All 3 questions naa a "yes" and "no" square co be checked. All returns in
rhe country were due in Monday, September 9 th M
Durinc this reried, PHM delivered 100 coties of the Charter at various
gatherings with explanation of it? origin and our movement. Some of these
Rights Association, Church groups, Women groups and High School students.
/.e circulated a new flyer informing of our Global Campaign for 2003.
.A new PHM committee is being born for Solidarity with Palestine. Study of
the charter is stimulating enthusiasm for .ACTION. We are in contact with
the Palestine "• '
>sa ’or and other Palestinian organizations here in Brasil,
The Nd u. xunal Cvtnu-idiJi o_ x'ARHAN, r^ctur Custodro M de Sousa, has sent tor
copies of the Charter, he received my address from Deolinda of Abio who was
with us at the WHA in Geneva. Artur is also on the Brasilian National
Council for Health and a member of the Global Alliance for Eliminating
Hansen Disease.
<pvjAC.p nnniar<= being ent, both by electronic mail and hard copies that
j" Lhe Chartei aLz
me ncizds
severax Natronai Organrzd^roxis who
cicipacing in the preparation for the /<orld Social borum in Porto
lanist movement!
Subject: humanist movement]
bate: Tue, 27 Aug 2002 06:14:53 +0700
From: "Aviva" <aviva@netnam.vn>
To: "Communin' health cel!" <sochara@vsnl.com>
Dear Ravi,
Warm greetings.
Zn what content did ”cj send me the attachements about the humanist
iiioveiiien t?
if 1 recognize the signer
S1LO, we should have little to do
organized his first aroues in Chile in the 70s (if it is the with it. silo
same
more mystic than political outlook o^ things.
and had a
* j, O -I. aAll WV_Z A A g f A^/ 1— te* <A
Huy
Claudio
8/29/02 1:59 PM
Subject: 1 vV: PHA-Exchange> Lancet: Violence against women - global scope
Date: Sun 1 s Sep 2002 14:36:58 -0600
s.’ FOtui ivlcuiicu3.i<il8uiii?7. bu.biiuSiiCC’UilCii.uig
To: PHA-Exchange4z)kabissa.org
u tu
To
pha-exch
I would like to be a member of PHA-Exchange distribution list .1 Dr. Momena
Khatun , v?rkir.a as National Adviser. Nicare/ The British Council Dhaka
-A *- i-A ~~ — ~
z. icr.er.a rxi.atun
Original Message-------From: Peters, Gordon ;Bangladesh)
Sent: 15 April 2002 13:02
To: Khatun. Momena .'Bangladesh'
Subject:
---------- - - -
T2"ra"'
-----------
VT^’ianr'a
------ - -----
-5 r> <sr f.rrvnior)
— 3-------- -------
—
fflnh
a" ---s/vjpo
---------- £---
J
Momena,
orioution,out in case you are nor thought this mighr oe
Gordon
_o: pha-exch
Subject.: PHA-Exchange> Lancet: Violence againsc women - global scope
> Health Po
ny zinunermsn
Department or Public Health and Policy
Trooical Mediciner UK
Number 9313 - Aoril 2002
com/pdrdownload?uid=llan.359.9313.editorial
review
9/18.02 10:07
Subject: Social butterflies : .McDonald's. Nestle ei al are rushing to get the latest business fashion
accessory; n conscience
brom: "UNN1KKISHNAN P V (Dr)" <uroukru'<r vahoo.com>
To: <i>nniknv'? '.■"hO'.'>.i.‘,?ni>
McDonald's, Nestle et a! are rushing to get the latest business fashion accessory: a conscience
Felicity Lawrence
•vionriay August t-\ 2002
”*”hC £•**? FC?ieiv
Recent wet weather end the heat genereted by preparations for the Johannesburg summit on sustainability have proved
the perfect breecmg conditions ter a new species ct corporate creature. Suddenly hatching out like fashionable butterflies
at every seminar on development are electors of corporate social responsibility - or CSR. as they might write it on the
T-shirt.
p 02 ch :s 2 newly published company report on their employers' social performance
oy ocOi cn.i jren in (he GGVGlopmg countries whore they go business, one any
ciose-ups of Wild fowers
•i<r, ‘ney
, most definitely not be endangering by their activities.
I he vogue tor social responsiomty :n business has been around ror some time - wearing, in the main, environmental
clothes But just going green was so-o-o early 80s. The anti-capitalist protests in Seattle made companies realise that they
would have to do more to preserve their reputations.
in the past year McDonald's Rio 'to. Nike. Nestle and British American Tobacco have al! produced "sustainabi!itv
roj.v.ws c< Os—. >eports covering seen issues as human rights, labour conditions anc environmental impact.
McDonalds chief executive, Jacs Greenberg, in his company's first social report in April, shared his vision of "how
McDonald's will make the world a better place" Not much mention of nutrition, but lots of litter initiatives.
Nestle CEO Peter Brabeck-Lemathe says his initial "sustainability review” is an effort to 'describe our impact on the
wenpeinc of nennie ang the :"angr
Susio.li ..ng tvi< ns ou; to cc «
oar. o> ■. te Ncs.lc business. More than one million jobs were sustained by the Nestle
Group, employment .~ats may not cfjife match your definition of sustainability, bur how about this for a commitment to
development A large p<-op<r ■■on o' Nestle factories are in developing countries even ihougii iess than a third of iis
business is. me report boasts.'Doos me pnrase "cneap labour" spring to mind?) Nestle's statement on baby miiK,
jjpanwhiic reads like a list of promises not to do all the things campaigners have previously accused them of.
Rio Tinto controversialiy included in the British delegation to Johannesburg - not least according to international
development secretary Clare snort. because of its "ven/ bad history” - deciares.’ "VVe recoonise that our business can
The tre”:iserters are bob enoug > io ov.o up io iheir sins BP, which has been ahead of trie pack on CSR. warns you io
Know mat it nas k.uso five people in Papua New Guinea by mistake but that it deeply regrets the suffering or an me people
involved" and will not rest until it stops lulling people by mistake.
A key part of CSR is to subject yourself willingly to the tirades of NGOs and campaigners This is called dialogue with
stakeholders. ’t may be pa-mu’ but vou can aiwavs sav you don't agree with them at the end. The most uncool thing is to
have to admit that "UK stakeholder inputs cannot be described as fully representative", as BAT's first ever social report did
last mor."'. ■ i'e report decares .here is no such I'mg as a sare cigarette' and accepts "the popular understanding thar
smoking is addictive" bu; .h's fine display of seT-fiageiiaiion came even though hardly anyone had spoken io iis authors.
: nere was significant non-paixapaiior. cy government, pressure groups, neaitn organisations and family ano youth
groups." it notes somewhat ruefully n a section on reporting limitations. Those nonparticipants were, it seems, uncertain
about BAT's motives.
it is impossible not to be cynical sbout this latest fashion, it is no coincidence that the list of companies leading ths* way with
urvu.r.r^K.^rrvfS
reads Tz.e g rc.. z u-..
qqd
But while some of it is
notion ct CbK reports
- sophisticated PR aimed at anticipating and then deflecting broader criticism - the
: u.ne error: to consider me wiaer role of easiness in civil society
,
I
f
I
Ky0l|,p^tg;y7
p — o: tne problems is mat USP. reporting is so random. dome of it is independently audited, some of it not. Some of it
covers a whole gamut or issues, some of it highlights only the areas with which the companies doing the reporting can feel
comfortable.
j ne Doo~rtmsrt
Tm-de is the middle of 3 ms'or overhaul of company law. Directors currently have s legal dutv to put S
busi'ness's o'"1 ~rc- '
■ n.r<-.“>-07
of the social impset of its activities looks like!’-' to remain voluntary
■' 00 c c7.~p'6;~.'. coo-0 "8rx6 rhe oppcnun:ry .o make CSR reporting mandatory. If it were universal and inaependently
veMfieo ihe-e slight not be so much temptation io puli the wings on the butterflies.
-i-+++-t-+++-i-+4-+++Forwarded By:
Dr Unnikrishnan PV
Co-orciinator: Emergencies & Humsriitsrisn Action. OXFAM INDIA
CONTAC! DETAILS •*•++++++++++++++•*■•*•+++++++++++++++++++++++
O / \ FA LI i N DIA
Vijaya Shree. 4th A Main. Near Baptist Hospital, (off) Bellary Rd. Hebbal. Bangalore-560 024 - INDIA
Pn' y i iv80; 363 2964 363 3274 : rax ' y i (au) 39'1 4oOS parin' Oxfam India)
oxtam:nd;3’'’c?vs^! cc.m
Wee-site: WA^ACOxfsminchs.orG
’HA'ExdMnge> "The lives of
a generatin...ddes.
warns an inicmational expert.
Subject: PHA-Exchange> "The lives of a generatineed to control the indiscriminate use of killer
pesticides, " warns an international expert.
Date: Thu, 25 Jul 2002 21:23:56 +0700
From: "aviva" <aviva@netnam.vn>
To: pha-exchange@kabissa.org
From: "UNNIKRISHNAN P V (Dr)" <unnikru@yahoo.com>
urgent : PRESS RELEASE
Bangalore, India: 25th July 2002
Greenpeace ,
Toxics Link,
Community Health Cell
CorpWatch
India,
Thanal,
Paryavaran Suraksha Samiti
"The lives of a generation are at stake.
Efforts needed to control the
indiscriminate use of killer pesticides," warns an international
expert.
Tossing a ball is fun. But if a large number of children fail to catch
it, it is not a child's play, especially if the poor coordination is a
^iesult or exposure to pesticides. Recent studies amongst the Mayo tribe
in the Yaqui valley of Mexico have made startling revelations.
"Children are the worst affected. Pesticides, used indiscriminately as
a catalyst for the Green revolution have put. the lives of a whole
generation at risk. Ke have lessons to learn and it is a costly warning
signal," said Dr. Elizabeth A Guillette, a renowned anthropologist and
visiting professor at the University of Florida.
Dr, Guillette, perhaps one of the first scientists who studied the
fallout of the pesticides poisoning found "mental and physical
deficits” amongst children exposed to pesticides and chemicals.
"Pesticide-exposed children were not able to play and lead a normal
life. The exposed children also had poor co-ordination and balance,
memory problems and hiah infections rates," said Dr, Guillette. She is
in town to address a group of health, environmental and labour
activists, medical experts and mental health professionals who are
coming together for a three day event - CHESS-2 (Community Health
Environmental Survey Skillshare) at Bangalore from 26th-28th July,
2002. The skillshare aims to equip people from or working with
pollution impacted communities to assess community health, and use tne
Aata for planning immediate and long-term health care interventions,
stopping pollution, and making the polluter pay.
Her observations and warnings will be the central theme for this
national event that will be attended by over 75 people from across the
country. A key highlight of this event will be the personal testimonies
of common people (pollution-impacted people) from some of the toxic
hotsoots in India. Studies show that children are among the most
vulnerable to chemical poisoning. However, health and environmental
policy in India continue to be dictated by commercial interests rather
than scientific evidence. According to Dr. Kabra of the Indian
Institute of Health Management,
Jaipur, an estimated 8,000 babies are
born with neural defects each year in Rajasthan just, because of the
pesticide residues in food.
Concern among environmental activists and public health professionals
over the increasing health impacts due to pesticide pollution and its
Irreversible damage on children's health has been unprecedented.
"Today, the medical establishment is incompetent and ill equipped to
deal with Bhopal-like scenarios. There is an urgent need to involve
'seal communities in educating and preventing such fallouts, and
preparing for disasters in the unfortunate event that they happen,"
«ai'd Ur Thelma Narayan, a public health expert associated with the
i o£2
9/24/02 11:44 AM
[A'Exchange> "The lives of a
.
.1
generatin. ..tides," warns an intsmativnal expert
Subject: PHA-Exchange> "The lives of a generatineed to control the indiscriminate use of killer
pesticides,*1 warns an international expert.
Date: Thu, 25 Jul 2002 21:23:56 -0700
From: "aviva" <aviva@netnam.vn>
To: pha-exchange@iabissa.org
From: "UNNIKRISHNAN P V (Dr)'1 <unnikru@yahoo.com>
urgent : PRESS RELEASE
Bangalore, India: 25th July 2002
Greenpeace ,
Toxics Link,
Community Health Cell
CorpWatch
India,
Thanal,
Paryavaran Suraksha Samiti
"The lives of a generation are at stake.
Efforts needed to control the
warns an international
ind isc rimine tc use or killer r/So
expert.
M-4
•H
r -l
O
(1)
r-1
a)
•r-|
(])
Tossing a ball is 1fun.. But if a large number of children fail to catch
si;
^t, it is not a ch:Lid'1 d
poor coordination is a
Result of exposure uO pesticicies. Recent studies> amongst the Mayo tribe
in the raqui valley of Mexico have made startling revelations.
"Children are the worst affected. Pesticides, used indiscriminately as
a catalyst for the Green revolution have put the lives of a whole
generation at risk. We have lessons to learn and it is a costly warning
signal," said Dr. Elizabeth.A Guilletle, a renowned anthropologist and
visiting processor at the University of Florida.
Dr. Guillette, perhaps one of the first scientists who studied the
fallout of the pesticides poisoning found "mental and physical
deficits” amongst children exposed to pesticides and chemicals.
"Pesticide-exposed children were not able to play and lead a normal
life. The exposed children also had poor co-ordination and balance,
memory problems and hioh infections rates," said Dr. Guillette. She is
m town to address a group or health, environmental and labour
activists, medical experts and mental health professionals who are
coming together for a three day event - CHESS-2 (Community Health
Environmental Survey Skillshare) at Bangalore from 26th-28th July,
2002. The skillshare aims to equip people from or working with
nollurion impacted communities to assess community health, and use the
Bata for planning immediate and long-term health care interventions,
stopping pollution, and making the polluter pay.
par observations and warnings will be the central theme for this
national event that will be attended by over 75 people from across the
country. A key highlight of this event will be the personal testimonies
of common people (pollution-impacted people) from some of the toxic
hotspots in India. Studies show that children are among the most
vulnerable to chemical poisoning. However, health and environmental
policy in India continue to be dictated by commercial interests rather
than scientific evidence. According to Dr. Kabra of the Indian
Institute of Health Management, Jaipur, an estimated 8,000 babies are
born with neural defects each year in Rajasthan just because of the
pesticide residues in food.
Concern among environmental activists and public health professionals
over the increasing health impacts due to pesticide pollution and its
irreversible damage on children's health has been unprecedented.
"Today, the medical establishment is incompetent and ill equipped to
d°al with Bhopal-like scenarios. There is an urgent need to involve
local communities in educating and preventing such fallouts, and
preparind for disasters in the unfortunate event that they happen,"
said Dr. Thelma Narayan, a public health expert associated with the
1 of2
9/24/02 11:44 AM
.Clue:
' Warns aii intciuativtiai expert
a alobal coalition.
tor the multibillion-dollar pesticide industry, though, public health
a^-d health of future generations has been only secondary to the health
r)T its balance sheets. "The ongoing efforts by the industry to cover up
tho endosulfan poisoning cases in Kasaragod, Kerala and Kokkada,
Karnataka exposes the extent to which pesticide manufacturers are
prepared to go to put profits ahead ot people," said Dr. Narayan.
The studies and advice of Dr. Elizabeth comes at a most appropriate
time when reports from places around the country suggest that we may
have many Yaqui valleys in our own backyards.
Three weeks prior to the Earth Summit in Johannesburg, this national
event once again highlights the lack of progress made since P.io in
preventing pollution, safeguarding public health and holding polluters
liable.
Dr. Thelma Narayan
Gopa1an
Community Health Cell
Greenpeace
Manu
PHA-Exchange is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-Exchangeykabissa.org
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oil
9/24/02 11.44 AM
■ humanist movement]
Subject: Ke: humanist movement]
Date: Fri. 30 Aug 2002 17:59:13 4-0530
From: Community Health Cell <sochara@vsnl.com>
To: Aviva <aviva@jietnam.vn>
I passed on the note from Humnist Movement becuse they wrote to me out
of the
blue and my reply is enclosed. Since you know of them and as I have
mentioned in
my letter their understanding of health is too simplistic, we should
ignore it
for now.
I see no reason why the ie Monde piece shoulld not go into PIIA
-Exchange? If you
have any doubts write to David Sanders or other reference point as well.
^Jest Wishes,
Ravi Narayan.
CMC / PHM
Aviva wrote:
> bear Ravi,
> Jfarm greetings.
> Tn what context did yon send me the attachements about the humanist
> movement?
> If I recognize the signer
SILO, we should have liLLle to do with IL. Silo
> organized his first groups in Chile in the /Us (if it is the same) and had a
> more mystic than political outlook on things.
> Maybe I am wrong, but is a coincidence..
>
V”.-*
> Claudio
> PS: I need your advice:
> pha-exch?
Should I post the Le Monde Diplmatique piece in
Subject:
Kind Attn: Dr Ravi Narayan
Date:
18 Sep 2002 05:07:27 -0000
From:
"vasudevan vishnu nair" <nvnair5@rediffinail.com>
To:
sochara@vsnl. com
Dear Dr Ravi
Greetings from Health Action!
May this find you in the best of health and cheer!
Received your email. We have published reflections by Caludio Schuftan under the title
“Key Statements” in the December 2000, Vol 13. No. 12 issue of Health Action.
Regards
N Vasudevan Nair
Editor-in-charge
il-afe: Sao 5 (•£•
kTOKui .' wive.
1 oz *
• 1 •: 17:02
lC
0700
ncuiam.vn>
ji-
CC: ':Ra\ i” <sochara ci vsni.com>
jf HJ3
re
i
reg
?
'6\i°
C I C^_-_aC<LzG3^
1U-5.'02 0.59 PM
pi lin’
Subject: Schuftan Hanoi
Date: Sat 5 Oct'’OOZ 1' 21 '1
0700
from: : Aviva <aviva << netnam.vn>
’
"M
I’era’.?: 'IQ)" <h.2'?.r;iin'i'??csiar.oi'2':>
('<': '4<avi" <socharavi vsni.com>
'changes- Palestine: Two years of Intifada
Subject: PHA-Exchange> Palestine: Two years of Intifada
Bate: Sat, 5 Oct 2002 12:25:21 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exclT <pha-exchange@kabissa.org>
> Today marks the second year of the current Palestinian uprising against
the
> Israeli occupation of the Palestinian territories and the repression of
the
> Palestinian people. During the last two years, the Israeli response to the
> Palestinian people's struggle for internationally recognized right to
> self-determination and towards an end to the Israeli colonization of their
> land has grown increasingly violent and aggressive. In September 2000,
> Palestinians were met by Israeli soldiers firing rubber-coated-metal
bullets
> and live ammunition, today nearly all the Nest Dank towns have been fully
> 're-occupied' by the Israeli army and have been placed under strict
> military-enforced curfew. In Gaza, the population is bracing itself for an
> Imminent reoccupation.
More than 1,914 Palestinians have been killed by Israeli soldiers,
settlers
> or police since September 2000. Also counted among these are those who
died
> as a direct result of the Israeli occupation, i.e. those denied access to
> life saving medical treatment when ambulances were stopped and turned away
> at checkpoints, and the unborn babies who died when their mothers could
not
> reach hospital because of closure or curfew:
> • 71 Palestinians have died after being prevented access to medial
> treatment,
21 of those were children, 13 were newborn babies.
> ■ 169 have died in extra judicial assassination attacks, of these 31 were
> bystanders at the time and 44 were "unintended" victims killed as they
were
> with the victim. 22 were children.
> ■ 22.5% were aged 18 or younger, i.e one out of every five killed
> ■ 60% were shot with live ammunition
> • 85% were civilians or not involved in any violent action or attack at
> time they were killed
>■ 17 medical personnel were killed while on duty
> An estimated 41,000 Palestinians have been injured in the same period:
2,500
> of those are permanently disabled, 500 of whom are children
/'’if p) E vtc In
> The prolonged Israeli closure of the Occupied Territories has destreoyed
the
> Palestinain economy and lead to serious damage to infrastructure and civil
> society:
>
> • 75 % of the Palestinian population live in poverty (less than US$ 2 per
> day) and unemployment has reached 65%.
> • 30% of children under 5 years of age suffer from chronic malnutrition,
1^1'°
21
> % from acute malnutrition
> ■ 45% of children under 5 and 48% of women of childbearing age suffer from
> moderate to mild anemia
> • During the first 15 months of the Intifada the occupation caused
physical
> damage amounting to US$ 305 million. During the month long invasion in
10/10/02 10:47 AM
'change> Palestine: Two years of Intifada
v
March .
> and April 2002, the Israeli army destroyed and looted USS 361 million
worth
> of property
> This violent and dangerous occupation regime is now being met by a popular
> non-violent resistance. Including peaceful inarches in the streets with
> people protesting the three-month long curfew regime, the siege and the
> continued killing of innocent people.
> For more information contact
www.palestinemonitor.org
Palestine Monitor,
see
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of2
10/10/02 10:47 AM
jXdiange> UN reform right from the top
Subject: PHA-Exchange> UN reform right from the top .
Bate: Sat, 5 Oct 2002 13:44:55 +0700
From: "Aviva" <ativa@netnamvn>
To: "pha-exch" <pha-exchange@kabissa.org>
> Kofi Annan calls for reform at the United Na Lions, asks officials to
> simplify their labyrinthine procedures
> By RANJAN ROY, Associated Press Hrit er
> UNITED NATIONS - Countless committee meetings, fat reports written in
> dense language, reams of paperwork that tie up a complex web of officials.
> That's not a critic's cynical view of the United Nations. It's what the
> U.N. Secretary-General Kofi Annan himself says about the world body in a
> report released Monday on the need for reform. "He must be prepared to
> change with the times - constantly adjusting to new conditions and new
> needs," Annan told a news conference at U.N. headquarters.
> Calling on his officials and the 190 member nations to help redraw
> priorities, Annan's report to the General Assembly prescribes
> streamlining various departments, simplifying labyrinthine procedures,
> firing or retraining staff and recruiting more skilled people.
> "Activities which are no longer relevant must be dropped, while on new
> issues ... the U.N. must deepen its knowledge, sharpen its focus and act
> more effectively," the 55-page report said.
> According to the report 15,18'1 meetings were held by various U.N. bodies
> and 5,879 reports were issued in 2000 and 2001. Most U.N. reports appear
> in the six official languages of the United Nations.
> "But it must now be clear to everyone that the international agenda has
> become overloaded with such meetings," the report says, warning that
> "summit fatigue" had set in both among the general public and governments.
> "We are not saying conferences are obsolete or should be abandoned. But
> there could be other ways of organizing these conferences," Annan told
A reporters.
> He advocated more planning ahead of conferences so that all the
> documents are ready before delegates meet. Otherwise, he warned "you
> come up with a document with is an agreement on the lowest common
> denominator."
> The report added that even larger countries find it difficult to
> participate in and keep track of all such meetings.
> Annan said U.N. reports, which often run into hundreds of pages of
> dense, technical prose, should now have size limits and be written in
> "simple, crisp language."
> Annan began a major effort to overhaul U.N. operations when he took
> office five years ago, a key demand of the United States and other
> members. He has continued his effort during his second five-year term
> that began in January.
> Annan also said the fight against international terrorism will remain at
> the top of the U.N. agenda, along with the priorities spelled out in the
> Millennium Declaration adopted by more than 150 world leaders in
> September 2000.
<A-Exchange> UN reform right from the top
> The Millennium Summit targets include cutting in half the proportion of
> people living on less than one dollar a day, ensuring that every child
> goes to primary school, and reversing the AIDS epidemic by the year 2015.
> To c.rear.et a leaner organization, the United Nations may for the first
> time start offering golden handshakes for staffers whose jobs arc
redundant, the report said.
> It said its Department of Public information will be trimmed and many of
> the 71 U.N. Information Offices worldwide will be closed and subsumed
> into regional hubs.
> As a first step, 13 such offices in Western Europe will be consolidated
> into one regional information center.
> More than 5,000 people are employed in the 35-story U.N. headquarters in
> New York. Hundreds of thousands of others work full-time, part-time or
> as consultants worldwide.
> However, Annan's plan does not envisage a lower budget, a U.N. official
> said. Money saved in the restructuring would be used to retrain staff
> and improving the organization's information systems, the official said.
For 2002-2003, the regular budget is $2,625 billion, up $90 million from
> the $2,535 billion in 2001-2002.
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of2
10/10/02 10:51 AM
HA Exchanges- Conference on poverty, food and health
Subject: PHA-Exchange> Conference on poverty, food and health
Bate: Sat, 5 Oct 2002 14:59:11 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch" <pha-exchange@kabissa.org>
From: "PFH2003 - International Conference" <pfh2003@tvtcl.pt>
http: //www.pfh2003.org
Conference Announcement and Call for Papers
Dear Colleague:
Thank you very much for your interest in the International Conference
Poverty, Food and Health in Welfare: current issues, future perspectives,
which will be held in Lisbon, July 1-4, 2003.
The PFH2003 Conference will be the forum to emphasise the role of poverty on
food security and health in welfare. The Scientific Programme has to face
the challenge of dramatic socio-economic transformations while leading
Experts will analyse the burden of poverty, hunger and disease and the
challenges to social policy in welfare. This Conference offers an
outstanding opportunity for the discussion and dissemination of research
findings, reviews and theory in all areas of common interest to researchers,
health professionals, social scientist, policymakers, educators and students
through plenary sessions, workshops, poster sessions and social gatherings.
We welcome your abstract submissions on a variety of topics related to the
Conference themes and related issues. Electronic abstract submission, along
with guidelines and instructions is available at. the Conference web page:
liLip: //www.ofh2003 . org
In addition, feel free to share this email with colleagues who you think may
be interested in this Conference.
We are looking forward to meet you in Lisbon.
On behalf of the FFH2003 Conference Organising Committee,
h
Sofia Guiomar
PLEASE DO NOT REPLY DIRECTLY TO THIS MESSAGE***
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/Va <,
Purl
p<^p^
PI-IP
lofl
10/8/02 11:13 AM
Claudio
Subject: Re: Claudio
Date: Tue, 08 Oct 2002 15:53:33 +0530
From: Community Health Cell <sochara@vsnl.com>
To: Aviva <aviva@netnam.vn>
Dear Claudio,
Greetings from Community Health Cell!
My trip to Hanoi is uncertain since Thelma is still recovering from a
nasty
attack of vestibular neuritis. If I do attend than it will be from
14th-16th arriving on 14th late morning and departing on 16th afternoon because of
the
available flight connections from Chennai. So I shall miss meeting you
both even
if I do make it. A pity but in the circumstances extending or preponing
the
states are just not feasible. CEHAT has also invited us for the Human
Rights
workshop since CHC and CEHAT have been collaborating on a host of issues
in
recent years. Thelma is on their Research Advisory Committee and I am
the
Convener of their Social Accountability group. The dates still not
definitive,
is unfortunately a month away from the Asia Social Forum 3-6th January,
2003,
where we arc still hoping some of you may be able to join in. See
separate
letter. It will be a repeat - but a larger gathering of the PHA-Calcutta
type.
Any way whether you can make it or not, please keep Bangalore on your
itinerary
for the December visit and we can organize some PHM activity locally
(also as
the new secretariat perhaps by then!}.
^est wishes,
Ravi Narayan
CHC / PHM
P.S: Regarding Mocumbi candidacy separate letter to Qasem,
and you
follows.
Pam, Ilalfdan
Ce
Aviva wrote:
/‘Z'j
> Ravi, my firend,
> \Are you coming to Hanoi?
When?
-'T'”'
H/10
> 1 have to leave Sun 13 AM and will be back Sun 20 RM.
> Can you come a day before my leaving...or stay beyond the 20th? You are
> welcome to stay with us...or in our house while we are gone.
> My mtg with OXFAM/CEHAT in Mumbai was postponed to Dec 9-12. I still plan to
> come to Bangalore before or after that. Will you two be there?
> Clau
10/8/02 6:44 PM
Exchanges- New e
• , - , ■
,
,
■-■uKiicuunsL legislation and iiuHlcul 1 ightS
Subject; PHA-Exchange> New antiterrorist legislation and human rights
Date: Sat, 14 Sep 2002 00:40:05 *0700
From: "Aviva" <aviva@netnam.vn>
lo: "pha-exch" <pha-exchange(iz)kabissa.org>
From: <pambazuka-news-admin@pambazuka.org>
> SEPTEMBER 11 - AND ITS IMPLICATIONS FOR AFRICA
> ROTIMI SANKORE
> (excerpts,'
> No one in his or her right mind will deny that the key problems facing
Africa today are those of economic underdevelopment, poverty, lack of
democracy and
> human rights. The proportions are different in all countries but the
problems are the same. Without democracy and human rights, the problems of
economic underdevelopment and poverty in Africa will never be fully
sddrGSSGCi.
> Prior to September 11, the rhetoric from a significant number of African
governments suggested that even it not fully committed to good governance,
^uman rights and democracy, many of them at least recognised the need to be
Jeen to walking in that direction. .Arter September 11, such rhetoric did not
necessarily diminish but became qualified with "recognising the need to
fight terrorism". Many governments which for years have resisted the
pressure from civil society to enact legislation, or adopt good practice
upholding fnoodoin of
DSyalx
xUSulng unrOUgn ’’SHZi-uG iTiSO ISiSITi 1Gyl31st1OH” CUL"tci Id-llig tuOSG 331116
rights. In many of cases, the provisions of the laws are so broad that even
peaceful and legitimate democratic opposition can be targeted as
"terrorists".
Some countries have adopted or are at advanced stages of adopting
’’antiterror!st” legislation that restricts freedom of expression,
association and assembly,
could define certain peaceful activity as
abetting terrorism, erodes the right
> to a fair and open trial, legitimises arbitrary and prolonged detention,
and increases powers or surveillance. Many more Atrican countries are
openly considering similar legislation.
Several Amnesty International
reports document such an international cover for less democratic
countries. In many cases, some of these laws adopted in Africa could have
been
^borrowed almost directly from US or UK laws.
> The direct implication of this is an "unholy and unlikely" alliance of a
variety of governments against civil liberties in the name of fighting
terrorism.
> Add to this the contradiction of key EU governments and the US
administration
turning a blind eye to "allied" undemocratic governments
while condemning others.
> The war on terrorism should not and cannot be fought outside an ethical
framew.—.rk. Any policies that sacrifice human rights tor this war will only*
succeed in fuelling the conditions in which terrorists thrive.
> African civil society needs to make it clear in policy and advocacy that
they are one hundred percent opposed to terrorism, but also one hundred
percent committed to democracy. There is no contradiction in this. There is
nothing
> anti-American about upholding democratic rights. There should be
absolutely no doubt that any laws that curtail freedom of expression,
association, assembly,
and so forth in Africa will be used against
democratic opposition and human
> rights activists.
It is therefore important to begin now to call for the immediate repeal of
all provisions of anti-terrorism legislation that promotes the suppression
of human rights and for a halt to such legislation in Africa. Not to do so
may pinnae Africa into strife and conflict from which it may never emerge.
■Xc]ian&^> v
6
anUien»nst Ic^iSiutiC’i cJ'.u uUiikui nSjiis
PHA-Exchange is hosted on Kabissa -Space for change in Africa
To yjO'^4' «?ri r«3 ro* PHA.—ExciianQ@0k?aDissa. org
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9/16/02 10:34 AM
Subject: PHA-Exchange> i'oor Human right situation - our observation
Date: S-;n
Sen
J. ?00?
— 07-5- -V44
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The People’s Health Assembly process set out to achieve a number of
objectives. The first few questions on this form are designed to get feedback
from you about how much you think has been achieved so far. They should
take only a few moments to complete.
The second section asks you to think about and reflect on your experience of
the PHA process - before the Assembly in Savar, the Assembly itself, and
anything that has happened afterwards. This also includes an opportunity to
express ideas about what could have been done differently or better. This
may take a little longer - five to ten minutes.
The final section asks for your suggestions about what should happen next,
what the growing PHA Movement could be doing, what you think would be
helpful to enable you to take the process further. Again, this might take five
minutes or so. There are also a few optional questions at the end that could
help us to better analyse the information.
Please take the time to complete this form and send it back. The feedback we
receive will help the PHA Secretariat to plan for any future activities more
effectively and will help to identify lessons that can be of use to others.
Part one:
(please mark an x in the box next to the answer that you think most
answers the question)
To what extent do you think that the PHA process to date has:
1. helped to hear the voices of the unheard?
.□Very much ^jzSome [] Don't know
Not really
Q Not at ail
2. communicated the idea of health as a broad cross-cutting issue?
Very much ^jfSome Q Don’t know
Not really
Not at all
3. shared and improved knowledge, skills, motivation and advocacy for
change?
Very much
Q Some
Don’t know ..flzNot really
Not at all
4. improved communication among concerned groups and institutions?
Very much -^Some Q Don’t know
Not really
Q Not at all
5. improved cooperation between concerned actors in the field?
Very' much ^Some 0 Don’t know 0 Not really
0 Not at all
6. increased media interest in health/equity issues?
Very much ^Some
Don't know
Not really
Q Not at all
7. increased the involvement of poor people in taking decisions that affect
their health and well being?
Very much j/Some Q Don’t know
Not really
Q Not at all
**Please fax or post by 1st August 2002**
Part two:
z
//see
8. How did you first hear about the PHA process? F>,!. A-» '‘'c ■ ■
[] mailing
Q e-mail
website
[] article in a newsletter
word of mouth
^"brochure— • P&->■>-> A c >-■ . Jsh ''G't
o other (please specify): P-e>m rv
‘! L
9. Why did you get involved in the process or attend the Assembly? (If you
give more than one reason, please give what you think is the most important
*reason
ujo
o-*'
• ■
U 'v ; . ■ ■
1 10. What do you think is the biggest achievement of the PHA process?
'_f-11. What for you is the most memorable or significant moment of the
Assembly itself? - ■
12. Was there anything else that you particularly liked about the Assembly?
[Wr
'
s(
z/icowmI I:
13. What do you think was the least successful part of the Assembly?
14. Were there any other aspects of the Assembly itself that you think cp.uld ' '
have been improved or done differently?
'
, 'yy)
15. As part of the process, have you met with and been able to link with- .
people or organisations doing similar work that was not possible previously?
(If yes, please give an example.)'' y Cvp 'p\
c
.
■.
j ® .' d se
16. After the Assembly, did you do any of the following?: (please put an X in
as many boxes as are relevant)
[J/uiscussed the Assembly with colleagues
□/field a meeting/workshop to share the outcomes
[Wanslated the Charter (please send a copy)
distributed the Charter to others
- I
[[/wrote a report about your experience (please send a copy)
QXvrote an article for a newsletter or journal (please send a copy)
drav'ded information to the media about the PHA/Charter
e.f .?,> ee
dot involved in an ongoing campaign
[/contributed to an e-mail discussion
gkput information about the PHA or the Charter on your website (please
provide your website address):
Started a new campaign
drote/e-mailed or phoned someone you met at the Assembly
o other (please specify):
**Please fax or post by 1st August 2;002
: <>e.
(.
2-P i^C- t"»C
i.->
17. Are you aware'of any activities being carried out by others after the
Assembly?
■
Part three: - ,
j - pun. echoes •
18. What do you think is the most important thing for the PHA Movement to do
now?M
> tW '
‘
19. What could the PHA Movement do that would most help you in your work? ’
20. Is there anything that you are doing (or could do) that you think could
contribute to strengthening the PHA Movement?
..
. .
. -
Please add any additional comments:
Optional questions:
01. Is the organisation you work in/with a: (please mark an X in as many
categories as are relevant)
□ government ministry/department
{pnon-governmental organisation
0 donor agency/foundation
U academic institution
[[.network
[] health care facility
[] community based organisation
[] consumer organisation
[pmedia/communications organisation Q consultancy/self-employed
{pother (please specify): P^l,^
H
-
E
i
i
.a fv'
02. What country are you based in?
03. Are you?: Q>rnale 0 female (please mark an X in one box)
Q4. Would you like further information about?: (please mark an X in as many
categories as are relevant)
[presuits of this feedback study pother PHA activities
jyhe work of Exchange
Please provide your e-mail address, fax number or current postal address if
you have selected any of the above choices.
E-mail:
Fax:
t
P o Address:
Please fax or post this form by 1st August 2002 to:
Andrew Chetley, Exchange: chetley.a(a)healthlink.orq.uk
Or by post or fax to:
Andrew Chetley, Exchange, c/o Healthlink Worldwide, 40 Adler Street,
London E1 1 EE, UK.
Fax:+44 20 7539 1580
=>
elf
FEEDBACK ON THE PEOPLE’S HEALTH ASSEMBLY
PROCESS
Part one :
(Please mark an x in the box next to the answer that you think most answers the
question)
To what extent do you think that the PHA process to date has:
1.
Helped to hear the voices of the u nheard?
Some
2.
Communicated the idea of health as a broad cross-cutting issue?
Some
3.
Shared and improved knowledge, skills, motivation and advocacy for change?
Not really
4.
Improved communication among concerned groups and institutions?
Some
5. Improved cooperation between concerned actors in the field?
Some
6.
Increased media interest in health / equity issues?
Some
7. Increased the involvement ofpoor people in taking decisions that affect their
health and well being?
Some
Part Two
8.
How did you first hear about the PHA process? (All three sources in the same
month)
>/ Word of mouth
Q,
f/ Brochure (from Prem John (ACHAN).^From Dr. Zafarullah Chowdhury at the
South Asian Dialogue on Poverty and Health organized by CHC with WHOy HSD in November l999.-o~y
9.
Why (lidyou get involved in the process or attend the Assembly? (Ifyou give
more than one reason, please give what you think is the most important reason
.first)
For the CHC team, it was the culmination of one of the long standing objectives of
the Society - which was to support a people’s health movement and a coalition for
health (one of the dreams of the co-initiators of CHC in 1984 (RN & TN) when
they moved out of their faculty positions in a medical college in Bangalore to
support grass roots community health action.)
CHC was therefore actively involved in
State level
Karritaka / Tamil Nadu 7 urban community health groups
National level
National Coordinating Committee and National Working Group
+ booklet editor;resource persons
International level
Invitee to core organizational group
Resource persons for workshops at PHA.
10.
What do you think is the biggest achievement of the PHA process?
The Charter that symbolizes a consensus document evolving out of an interactive
gathering of health professionals and health and development activists and
members of civil society from 92 countries - the largest consensus document in
Health since Alma Ata declaration.
11.
What for you is the most memorable or significant moment of the Assembly
itself?
Three significant ones:
i.
ii.
iii.
12.
The March to the National Memorial symbolizing the collective public commitment
'The World Bank meets the people?as an expression of both democratic
dissent and democratic dialogue symbolizing the ability of the
movement to^taire on the globalising force.
The actual ethos of international interaction and collectivity undeterred
by the differences of language, culture and perception.
Was there anything else that you particularly liked about the Assembly?
Gonoshasthya Kendra (GK) did a fantastic job of hosting the Assembly - the rural
ambience, the involvement of women’s groups in the bamboo and ca/e cafeterias
- the enthusiasm of local volunteers - the simplicity of arrangements and
facilities.
What do you think was the least successful part of the Assembly?
13.
Planning for documentation, communication and organization for after the event b) pre-assembly mobilization in many countries was limited to a few NGOs and
individuals.
Some proactive efforts by core organizing group and networks
should have been thought off.
14.
Were there anything else that you
differently?
i.
ii.
15.
think could have been improved or done
More space for people’s voices even in workshops
More space for ‘action in health’ initiatives.
/is part of the process, have you met with and been able to link with people or
organizations doing similar work that was not possible previously?
i.
ii.
CHC works with 23 networks and several NGO partners in PHM
Karnataka.
CHC works with 18 National Networks in PHM India (NCC)
In both these situations, we had good working relation with 5-6 health
networks/but now we work with a large number of non-health networks
including science movement, environment movement, women’s movement
and people’s movement.
After the Assembly, did you do any of the following? :
>'<
-■/Discussed the Assembly with colleagues o.Z-,''-■/'.c'
LsPfect
16.
-Z Held a meeting / workshop to share the outcomes f Translated the Charter info ;
■ ■ : • ' 1-■ -: "
/ Distributed the Charter to others — S’tz.r & -■<
7/ Wrote a report about your experience
''’
7- Wrote a report about your experience
■X Wrote an article for a newsletter or journal — c
..,
y Provided information to the medical about the PHA / Charter
Got involved in an ongoing campaign-f
7/ Contributed to an e-mail discussion
'
P/>
Put information about the PHA or the Charter on ybur website
3/Started a new campaign
7/ Wrote / e-mailed or phoned someone you met at the Assembly
./Lobbied with WHO to take PHM' seriously—
'*
^/Presented PHM I charter at Public Health Training Centres in Chennai,
Bangalore, London, Bergen, Stockholm, Copenhagen.
17.
Are you aware of any activities being carried out by others after the Assembly?
a.
CHC has presently a file on many states in India (Karnataka, Tamil Nadu,
Maharashtra, Kerala, Andhra Pradesh, Madhya Pradesh, Haryana, West
Bengal, North East on PHM activities.
6
_ t-snTt-t
Through the WHO-WHA Circle of which I am Convenor and as a potential
future PHM Secretariat (beyond November 2002), we are now in touch with
PHM activities in the following countries : Bangladesh, Sri Lanka, Nepal,
Iran. UK, USA, Latin America, Norway, Sweden, Denmark.
b
In the following countries - Bangladesh, Sri Lank, Nepal, Iran, UK, USA, Latin
America. Norway, Sweden, Denmark.
In April 2002 - we did a six country - PHM - advocacy and lecture tour through
Bergen. Norway, Stockholm, Sweden, Copenhagen, Denmark, The Hague,
Netherland, Aachen and Frankfurt (Germany)
and finally PHM Geneva,
Switzerland.
18.
What do you think is the most important thing for the PIIA Movement to do
now?
Build active network of networks (not just NGOs and individuals) in as
many countries as possible
Lobby with WHO / UNICEF / GFHR / GF ATM / World Bank I Donor
governments on People’s Health Charter formulations
i.
ii
19.
What could the PHA movement do that would most help you in your work?
Support a good communication network
proactive, action oriented, interactive website and e-group
20.
Is there anything that you are doing (or could do) that you think could
contribute to strengthening the PHA Movement?
i.
Have offered to him the PHM secretariat from October-November,
2002.
Would actively promote work of WHO-WHA lobby circle including
Alma Ata anniversary meeting
Support communication efforts at different levels - publications,
website, e-groups, video/films etc., with a strong focus on campaigns
and people’s health action.
ii.
iii.
Optional Questions
1.
Is the organization you work in/with a :
□
□
□
Non-governmental organization
Network
Media I communications organization
□
Ot6her - Policy research and training support group to community
health action initiators among NGOs, networks, governments and civil
society (CHC is reaching 20lh milestone next year)
4
2. What country are you based in?
India
3. Are you Male or female
Male
4. Would you like further information about?
Results of this feedback study
Other PHA activities
The work of Exchange
Please provide your e-mail address, fax number or current postal address if you have
selected any of the above choices:
Email
: sochara@vsnl.com
Fax
: 0091-80-552 53 72
Address
:
Community Health Cell,
# 367, Srinivasa Nilaya, Jakkasandra I Main, I Block, Koramangala, Bangalore - 560
034, India.
[NOTE : This has been filled both as Ravi Narayan (personal) and as CHC
because all our team are involved at various levels of PHM support]
5
Feedback—
Subject: PHA Feedback
Date: Mon, 23 Sep 2002 16:00:51 +0530
From: Community Health Cell <sochara@vsnl.com>
To: chetley.a@healthlink. org. uk
Greetings from Community Health Center!
We received your PHA feedback form in the mail on 27th August. CHC has
been so involved in PHA at so many different levels (see our website
www.sochara.com) that it was difficult to keep your 31st August
deadline. We are sending the reply by email and posting the original
with a bundle of books and papers as well. Sorry about the delay.
Perhaps you already have our newsletter and booklets but don't leave us
Best Wishes,
.
UYr
A'
pIj-rl
^3 I
uri
9/23/02 -1:01 PM
C/o Healthlink Worldwide
40 Adler Street
London E1 1 EE
United Kingdom
Tel: +44 (0)20 7539 1591 Fax: +44 (0)20 7539 1580
e-mail: healthcomms@healthlink.org.uk
http://www.healthcomms.org
Hello,
The organisations that were involved in organising the People's Health Assembly
have asked the Exchange programme to facilitate an evaluation of the process
leading up to it, the Assembly itself, and the activities and events that have been
happening since. As part of the evaluation, we are attempting to contact everyone
who attended the PHA, and hope that you will be able to give us some feedback on
how you viewed the experience.
To help with that, we have enclosed a short feedback form. Please take a few
minutes to complete the feedback form and send it back to me by 31st August 2002.
You can fax or post it back to me.
Also, if you have written anything about the PHA could you please send it along
(even if it is in your own language). Pan of the work of the evaluation is to help
collect together the various materials that have been produced by different groups all
over the world. These will ultimately be housed with the People's Health Movement
secretariat as a record of the diversity and creativity that is at the heart of the
movement.
Thank you.
Best wishes,
Andrew Chetley
Programme Director, Exchange
A networking and learning programme on health communication for development
c/o Healthlink Worldwide , 40 Adler Street, London El 1EE, UK
Tel: +44 (0)20 7539 1591 (direct)
Fax: +44 (0)20 7539 1580
E-mail: healthcomms@healthlink.org.uk
http://www.healthcomms.org
o/fjo 2.
'CEr and McDonald's
Subject: UNICEF and McDonald's
Date: Sat. 19 Oct 2002 17:45:35 +0530
From: Communin' Health Cell <sochara@vsnl.com>
To: Claudio Schufiun <aviva@netnam.vn->, pha~exch3nge@kubissa.org, wabaforum@pd.jaring.my
Greetings zrez Community Health Cell!
I fully aoree with Zafarullah's suggestions. There is enough in the PANA.
news item to evolve a short, strongly worded letter to Ms.Carol Bellamy
and send it out on PHM Secretariat letterhead after circulating a draft
and getting WABA, HAI, CI, IPHC, WGNRR, ACHAN, DHF, GK okay - The G8
and PHM must respond immediately.
We have been m touch with JT/ICEz representatives and staff here over
the last few months getting them to understand the UNICEF-anti A.lma Ata
perspective. We need a UNICEF lobby circle but-lets begin with this
fetter. Who will take the initiative?
Best wishes,
Ravi Narayan
CHC / PHM
Ppfi
7'V
r;
IC
—5>
T) wdJ
O<a|— 2
s
10/21/02 11;
! Xc<!,-H . .
r«?e> Report from V SSI). Johannesburg, Correction
Subject:
Bate: Thu. 3 Oct ? ; P
>6 CTOO
'Tom: ’Aviva" <a\iva <inemam.vn>
-c
jxch'*
if ki'bisSii.orG^
iv-7 02 1
4A tL>«-X
-Xvuai'«c--Report from
V. SSID, Johannesburg, South Africa
Subject: PHA-Exchange> Report from WSSD, Johannesburg, South Africa
Date: Tue, 10 Sep 2002 12:10:56 -0200
From: "Lynene Martin" <Imartin@uwc.ac.za>
To: <iphci’3’cab!enel.com.ni>. <PHA-Exchanse@kabissa.org' >
Dear Colleagues,
Below follows a report on the Jonannesburg World Summit for Sustainable Development (WS:
I'm happy to answer any questions although I cannot provide much more detail.
In solidarity,
David Sanders
Southern Africa Coordinator, International Peoples Health Council
Southern Africa focal ooint Peoples Health Movement
REPORT FROM WSSD, JOHANNESBURG.,
SOUTH AFRICA
Early this year an unfortunate split occurred within the South African Civil Society/NG<
This split undoubtedly contributed to the very last-minute, poor organization of the G1
The breakaway group formed the Social Movement Indaba which held its own event
2)
(see lat<
Very late in the process - in early July - some Civil Society health activists <
The South African civil society grouping Look responsibility for organizing the Health <
3)
Social Movement Indaba
This group,
(S.M.I.)
initially a breakaway from the Global Peoples Forum, organized a teach in o>
The teach-in,
a two day artair, was herd at the University or Witwatersrand and attract<
Mira Shiva spoke on the second day. Although her focus was not primarily on the PHM,
4)
sh>
The Global Peoples Forum was held in distant, not very comfortable surroundings
On 30th August the health sector met in two commissions, one of which I chaired togethe'
We developed a consensus statement
5)
(Appendix 2) which went to the G.P.F. leadership for
On 31 August there were 2 marches from Alexandra
(a poor black township)
to San<
The S.M.I. had had a smaller march on Saturday 24 .August during the teach-in. This was 1
6)
Stakeholder Forum
On the weekend of 24/25 A.ugust, at the same time as the G.M.I.
I was invited to a very
5 ro
On 31 August WHO and the S. African Ministry of Heath held a one-day symposium on "Healall in plenary - c<
After too many lengthy and boring official statements, the meeting
Investing in health: the evidence, the action
Children's health and the environment
Research, human health and sustainable development
innovative partnerships for action
I of 5
C’cJrS
fce He*
Report from W SSD. Johanacsbiirg, South Africa
action in practice: programmatic examples of health and sustainable devel<
Tn summary then, the WSSD was mostly a failure. The final declaration by Governments wa.I hope that this summary is useful for those who are interested. Others - such as Mira,
APPENDIX 1
WSSD Global Forum: Health Commissions
30th Aug 2002
Feedback to the Drafting Committee on. the discussions on:
a)
b)
The Role of the State
Water, Sanitation and Primary Health Care in the context of Globalisation
Situational analysis
Debt and globalisation are impacting negatively on the distribution of all reso>
Environmental degradation is increasing the burden of ill health
Lack of knowledge about environment and health and hygiene are sorely lacking ai
Environmental services are a basic right which every citizen should enjoy
Privatisation of services, including through public private partnerships, has b<
War and military occupation both severely restrict access to health and basic s<
y issues
Globalisation is driving inequity through privatisation of all public services
Public Private Partnerships may reduce government defi
but are impacting n<
Local involvement and public public partne :hips for provision and governance o:
Specific recommendations
•
Scrapping of debt is a prerequisite for health improvement in poor countries
■
The negative effects of privatisation of public services must be exposed to bot)
•
Governments must be rendered accountable through evidence based advocacy and coi
Communities need to have control over the provision of health and other social :
The importance of the relationship between environment and health and hygiene n<
•
Learning and advocacy should be promoted at global level through interchange be'
•
Powerful governments must be called to account for continuing military occupati>
Conclusion
■
Unfettered globalisation threatens the planets environment and population healtl
APPENDIX 7
NASREC HEALTH DECLARATION
C. HEALTH
1.
Globalisation has fuelled impoverishment,
ill health and marginalisation of the
Poverty, unemployment, hunger and ill health constitute a vicious cycle. The gr<
Real poverty alleviation requires cancellation or this debt by all institutions, such a:
3,
The Primary Health Care
(PHC) Approach as encapsulated by the Alma Ata declarat
of 5
9/13/02 12:29 PM
'SSD. Johannesburg. South Africa
Health services must be strengthened through new investments in infrastructure,
“'•
A focus on equity is required in the development of all health programmes and ii
Women and girls bear a disproportionate burden of poverty and ill health as a r<
International efforts to support greater funding for and implementation of HIV/,
8.
Children's health and particularly the welfare of orphans needs urgent attentioi
2-
Adoption of adequately resourced and comprehensive programmes must be fast trac.
10.
Health,
11.
The Governments of the world must take cognisance of the incidence and impact o
12.
The effective role of civil society in health and development must be enhanced thro:
reproductive and human rights should be provided for people with disabi
The Indaba Declaration
on Food, Nutrition, Health and Sustainable Development
"e from Africa, A.sia,
the Middle East, Latin America, Europe and North America,
In the Zulu language 'Indaba' means 'meeting together for a common purpose,
from go-
to agree on
THE BASICS
Good health is a vital input to, and outcome of, sustainable development.
•
Good health can be achieved only by addressing the underlying and basic causes <
•
The modifiable causes of health and disease are environmental.
The nature and quality of food systems, and therefore of diet and nutrition, an
THE ISSUES
^Levels of environmentally determined diseases now amount to a global emergency, project.
The triDie burden now borne by almost all middle- and low-income countries of: nutritio)
•
Nutritional deficiencies and infectious diseases persist throughout the world.
•
The effect of HIV-AIDS most of all in sub-Saharan Africa is catastrophic.
•
Rates of many chronic diseases in middle- and low-income countries arc soaring.
•
Cancer, heart disease and stroke are now the Leading causes of premature death .
■
Projections show a vast increase of chronic diseases,
including obesity and dial
On a population basis, no country has the resources to treat chronic diseases.
In general, current political and economic policies are increasing the global bi
> of 5
^HA-F.xrhar.ops- Report from V/SSD, Johannesburg, South Africa
9/13/02 12:29 PM
sey immediate cause of all types of disease is grossly inadequate or inappropriate fo-
f imriflrlvirc and basic causes of disease are social, economic and political. These in<
On a population ’oasis,
the only rational approach to all types of disease is prevention
this approach must include the protection, development and creation of food systems tha
Information and education,
including product labelling, are necessary but insufficient
Successful and accepted public policies for example concerning transport, energy, firea:
The protection and creation of healthy food systems, integral to healthy environments ai
THE ACHIEVEMENTS
he acknowledge Principle One of the Rio Declaration on Environment and Development, whi<
We note that the agenda of the World Summit on Sustainable Development rightly indicate:
We accept existing frameworks of understanding of causation of health and disease,
such
We endorse the policy on infant and young child nutrition now adopted by WHO and all re
"e support the WHO Global Strategy on Diet, Physical Activity and Health, and the draft
Ke applaud the decision of the International Union of Nutritional Sciences to set up a .
THE ACTIONS
Many actions can now be taken that will have the effect of controlling and preventing a
We, the signatories to this document, have the capacity to act as follows.
Inspired bv '
•
To support the basic philosophy of the WHO global strategy and the joint FAO/WII<
•
To disseminate this Declaration on relevant websites and journals,
•
To use our professional and national networks,
•
To advocate chat the strategy be amplified, become holistic, and so include all
in meetings i
and the Stakeholder Forum networ
^ksigned
Benjamin Alli
Gordon Baker
Dolline Susalo
International Labour Office
Stakeholders Forum
Helpaqe
Geoffrey Cannon World Health Policy Forum
T o v* y ' ’ C 2 S 2 Z Z 2
World Vision
MK Cham
Yvonne Clemen
UK
Kenya
Rrazi1
USA
World Health Organization
Wellness IntoNet
Elizabeth Danie lyan
Switzerland
South Africa
Armenia.
Women for Health
Human Riohts
Farida Dollie
Rockefeller Foundation
Timothy Evans
Stakeholders Forum
Lars Friberg
Christiaan Geld1enhuys Sweetspot
Cinnabar Global Circle
John Goss
Stakeholders Forum
Minu Hemmati
Johann Jerling Nutrition Society
of 5
Switzerland
South Africa
USA
Sweden
South Africa
South Africa
London
South Africa
9/13/02 12:29 PM
PKA-E’'vc-
-^pbri frciu \\ SSD, Johannesburg, South Africa
O 2? CI S
Kav'=,y'°^'h
T Cu* 17
’asorge de Klerk Department of Health
Estelle de Klerk
Department of Health
Salome Kruger
Potchefstroom University
T.am Kok T.iang
Consul rant.
Zimbabwe
South Africa
South Africa
South Africa
Ma 1 ays 1 a
Philip Makhumul a~ Nkhcma University of Malawi
Ma1awi
Paul Rheeder
University of Pretoria
South Africa
David Sanders
University or the Western Cape South A.frica
Louise Sarch
National Heart Forum
UK
Andrew Seiter
Novarti s
Swit zerland
1 Ux Js.c_y
Kudos
Marthinette Slabber
University of the Free State
South Africa
Louise Smith
Country Women of the World
South Africa
Peter Smith
Slow Food Movement
South A.frica
Nel la Stev'
Medical Research Council
South .Africa
Liz Thebe’
lassi ve Effort
South Africa
Pamela Thole
Zamseed
Zambia
Anne Till
South Africa
Anne Till Associates
George du Toit Society for Obesity
South Africa
Jantlie Tumi
Uthingo Management
South Africa
Hester H Vorster
Potchefstroom University
South Africa
■eroen Warner
Wageningen University
Netherlands
Sandton. South A.frica
A.uaust 2002
Notes
The stakeholders in this process include civil society,
the health profes;
systems. This concept is holistic. Food systems include the whole process of produi
Chronic diseases. These are non-communicable diseases,
either debilitating, disabling, >
[not to be printed: includes corrections 3.9 John Goss]
Prof David Sanders/Lynette Martin
^School of Public Health
University of the Western Cape
Private Bag XI7
Bellville, 7535
Cape, South Africa
Tel: 27-21-959 2132/2402
-s-,. 27-21-959 2372
Cell: 082 202 3oj.u
PHA-Exchanqe is hosted on Kabissa - Space for change in Africa
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9/13/02 12.35 PM
ddniiniSiraiivri removed scientific info
Subject: Politics over science - Bush administration removed scientific info
Date: Thu, 24 Oct 2002 13:51:05 +0700
rioiii; "Aviva" <aviva@netnam.vn>
To: "Ravi" <sochara@vsnl.com>
WASHINGTON (AP) - Two Democratic congressmen contended Monday that the
Bush administration is putting ideology over science, citing
appointments to advisory committees and the removal of information from
Web sites.
s.eps. Henry haxman of California and Sherrod Brown or Ohio demanded
explanations in a letter to Health and Human Services Secretary Tommy
Thompson.
They complained that information about the effectiveness of condoms had
been removed from a Centers for Disease Control and Prevention Web site;
that experts serving on advisory committees were being replaced because
out .-._Ds groups with probing audits.
it addition, they said, information showing that aoortion does not
Bfcrease the risk of breast cancer was removed from a National
Institutes of Health Web site. ’’Scientific information ... has been
removed, apparently because it does not fit with the administration's
idsolocicsl s.g9nd2, 1 ’ Wsxm.sn snd Brown wroto.
They enseged chsc
ideology he 5 replaced scientific giisxixicaxions
ss
HHS chooses members of advisory committees. Among other examples, they
pointed to a report on a CDC advisory committee on sate lead levels tor
children. The report found that nominations of respected academics had
been withdrawn and replaced with consultants to the industry.
''?'e are deeoly* concerned that stacJcino advisory committees with
individuals whose qualifications arc ideological rather than scientific
will fundamentally undermine the integrity or scientific decision-making
at our leading public health agencies,'' the Democrats wrote.
HHS spokesman Bill Pierce said it is Thompson's prerogative to appoint
whomever he chooses for advisory committees. By contrast, he said.
Waxman and Brown ’’would like all of us to follow their agenda, their
liberal agenda, on these issues.''
10/21/02 18:44 EDT
,-a.r onno two Associated Press. The information contained in the AP
—=ws report mav not be published, broadcast, rewritten or otherwise
distributed without the prior written authority o£ The Associated Press.
All active hyperlinks have been inserted by AOu.
vn
10/24/02 10:09 AM
http:/ hst.org.za
Subject:
Date:
From:
To:
PHA-Exchange> Situation in Southern Africa
Wed, 23 Oct 2002 13:30:02 +0700
"Aviva" <aviva@netnain.vn>
"pha-exch" <pha-exchange@kabissa.org>
Second Regular Session of UNICEF’s Executive Board
16-20 September 2002
ESARO Regional Director's Presentation
Mr. Urban Jonsson
Mr. President
1. Eastern and Southern Africa continues to be plagued by deepening poverty, continued
armed conflicts and an increasingly devastating HTV7AIDS catastrophe. Given current
trends the Millennium Development Goals will not be achieved in the region, or in subSaharan Africa as a whole. And that means that these goals. endorsed by so many
conferences, will not be achieved globally. In addition to all this. Southern Africa is
experiencing a terrible crisis, manifested bv extreme food shortages. It is important to
understand that these different crises are interconnected and constantly reinforcing each
other. I will come back to that later.
2. This year only two of the smaller countries in the region have submitted new Country'
Programmes of Cooperation - Botswana and Comoros. Apart from both having a
relatively small population they are very different. Botswana is one of the least poor
countries in the region with a GNP of US$3,300 per capita, very high primary school
enrolment rates and almost universal access to basic health services. It has also had
remarkable political stability since independence, Comoros, on the other hand is one of
the poorest countries in the region with a GNP per capita of only US$380, very low
primary school enrollment rates and low access to basic health services. The country' has
faced chronic political instability with, more than twenty coups or attempted coups during
the last 25 years. There is, however another significant and rather surprising difference.
Botswana has the highest rate of HIV infections in the world - 38.8% of the adult
population is infected, while Comoros has one of the lowest rate of HFV infections in the
region - about 0.1%. The- fact that the highest HIV prevalence occurs in one of Africa's
wealthiest countries, rather than among the poorest raises questions, suggesting causes of
HIV infections other than just poor access to services.
3. The new five-year UNICEF Country Programme of Cooperation in Botswana is the
first Programme which is almost totally focused on HIV/Al DS. It is the first Country in
Africa where a PMTCT Programme is being implemented on a national scale. The
orphan care and support project aims directly at improving the lives of orphans and other
vulnerable children, while the integrated ECD project and the girls' education project
indirectly aim at preventing the spread of HTV The Programme contributes directly to
the UNDAF priorities on HTV/AIDS and poverty reduction and is ’well integrated
with the National HIV/AIDS programme.
4. The new five-year UNICEF Country Programme of Cooperation in the Union of
Comoros addresses aii five UNICEF MTSP priorities. The education programme will
focus on early childhood development and primary education, particularly for girls. The
health and nutrition programmes will address child and maternal mortality, nutrition and
the control of STD''AIDS. The child protection programme aims at harmonizing national
laws with the CRC for ensuring better protection of children. In both Botswana and
Comoros the overarching strategy is community capacity development in a human rights
framework.
5.
Mr. President,
Already in April this year the signs of an impending food crisis were obvious in several
countries in Soulhem Africa - Lesotho. Malawi, Mozambique. Swaziland. Zambia and
Zimbabwe were at particular high risks. A joint UN Consolidated Appeal (CAP) for the
six countries was launched in July. At present only USS38 million have been committed
by donors of a total request of USS611 million.
6. The Southern Africa Crisis has been described as primarily a food crisis. It is,
however, very important to recognize that the critical shortage of food is only the most
visible manifestation of a much larger and deeper crisis. In reality, it is the first
significant manifestation of increased vulnerabilities created by the IHV/AIDS
catastrophe in Southern Africa. The required response must therefore combine short
term measures of food distribution with health, nutrition, education. WES and protection
interventions to mitigate the impact of HIV; AIDS. These are not just ‘non-food items';
thev are crucial and necessary for reducing the vulnerability to shocks like drought and
flooding. Or in other words, these interventions if implemented rapidly and effectively
will ensure the survival of millions of children.
7. UNICEF response was rapid and well coordinated with the WFP and government
actions. This was possible for two reasons. First. UNICEF was already on the ground
before the crisis came, with support to programmes in health, nutrition, education, water
and sanitation and protection. Second, as a result of the last two years support form
DFID, the region has significantly strengthened its emergency preparedness and response
capacity, hi five of the six countries contingency plans had been prepared during the last
12 months.
8. In keeping with UNICEF's core commitments during emergencies, all six country
offices have conducted rapid assessments of the situation of children and women.
UNICEF is supporting therapeutic and supplementary' feeding, training of health workers,
immunization campaigns, in particular against measles, vitamin A supplementation,
leaching materials, sanitation and hygiene. All planning and implementation is done in
cooperation with the WFP and other partners.
9. In line with the Policy Statement of the IASC Task Force on the Prevention of Sexual
Abuse and Exploitation in Humanitarian Crisis. UNICEF has organized training of
trainers in all six countries to support efforts to prevent sexual exploitation and abuse of
children and women. UNICEF promotes strongly a zero tolerance policy.
Mr. President.
10. In the GA debate yesterday all seem to agree that the New Partnership for Africa's
Development (NEPAD) provides new hope for Africa.
After its endorsement by the
OAU Summit in Durban in July 2002 it has become the overarching framework for
Africa's future development. But. as we heard, the challenges are formidable. SubSaharan Africa with 12 per cent of the world population and only 1 per cent of the
world's economw accounts for 43 per cent of the world's child deaths, 50 per cent of
maternal deaths, 70 per cent of people with HIV/AIDS and 90 per cent of all children
orphaned by AIDS. I did not hear this reality in yesterday's debate. As a matter of fact.
leaders from some of the most affected African countries did not even mention
HIV AIDS m their brief presentations.
11. At the OAU summit in July 2001 in Lusaka an Africa Common Position (ACP) was
adopted. The ACP includes specific goals, targets and strategies aimed at creating an
'Africa Fit for Children'. NEPAD is mainly concerned with long-term development.
UNICEF believes that NEP AD should include some actions to improve the situation for
children and women in the short-term. As the Secretary General stated yesterday, the
most urgent actions are to ensure girls' education and to intensify and focus the war
against HIV/AIDS. It is very clear that Africa has no future unless this war is won.
12. One of the most serious and tra°ic effects of the HTV/A1T)S pandemic is the lame
number of children orphaned by AIDS - 11 million in Africa; 90% of the world's total.
The African extended family can not extend any more, cannot cope any longer. Masses
of orphans are forced to become street children, beggars and thieves and are often targets
for abuse and exploitation. And even if new HIV infections would slop today, millions
of new orphans would be added over the next ten years. This is a very, very serious
problem that needs to be attacked immediately.
13. Last week I attended a consultation called by Nelson Mandela and Graca Machel to
discuss and agree on necessary actions to deal with the orphan crisis in the next 24
months. One recommendation was to request ail Parliamentarians in Africa io hold
formal debates on the situation of orphans. I hope that these debates will take place and
that they will be guided by Mandela's statement at the meeting. 'Every moment that is
spent on deliberations that does not lead to decisive action is a moment tragically wasted.'
Mr. President
14. The Black Death in 14th century Europe killed about one third of the population and
changed Europe dramatically. In the same way, the FHV/AIDS pandemic will transform
Africa as we know it. We know the expected impact on GNP from the HIV/AIDS
pandemic. For example, by 2010 the South African economy will be 20 per cent smaller
than it would have been without HIV/AIDS i a total loss of about USS 17 billions. We
know that the private sector will be affected, both through reduced production and a
switch in foreign direct investment to less affected countries. We know that the
HIV AIDS pandemic will reduce the number of teachers and health workers, both by
death and by immigration. And we know that the number of orphans will double. What
we don't know is the future impact of lUV/AIDS on governance, peace and security.
Uncontrolled, the HJV/AIDS pandemic may make countries helplessly unprepared to
cope with drought and floods and may ultimately break down societies as we know them
to-day. This is what some observers call 'Aids-related national crises'. What we witness
in Southern Africa to-dav is the result of such Aids-related national crises'. This will
threaten the peace and security in Africa and the whole world.
PHA-Exchange is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-Exchange@kabissa.org
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Subject: PUA-Exchange> I
Says Essential Drugs i\ot Sufficient
Date: Thu. 2 ! Oct 2002 13:58:38 -0700
brom: "Aviva" <aviva:anetnam.vn>
A third or ail people
unaole to obtain lite-saving medicines
XHO declares.
cion despite a rong international campaign ror
■sential drugs, the World Health Organization
der
'onday.
st
or
Lie to ootam tnose
■d, out there remai ■s "a huge unfinished
'.an Quick, the head of the U.N. agency's
2 billion people who can't regularly get medicines
them, at a quality they trust and at a price they
ity can afford," Quick told health experts at a
a.
ealch agency's list includes more chan 300 medicines
o guide mainly Third World governments and health
what, druas should he available, at. what, aualit.v and
■sac
poor c<
a daily income or SI or $2 is the norm,
.ealth care often falls on those who are
'■er.eral Gro Harlem Brundtland said so-called
payments cy patients account ror as muon as 90^ or
■are spending in some poor countries.
•e
of Doctors Without Borders said patents
BIDS treatments, translate into high p.
’t result that C-trOO.!-? 7 o Hz^vz^ 7 nr> i rrr r-nur:
c
■lek logic that says he who cannot pay.
n Kabissa - Space for change in Africa
PEA
;xchange@kabissa. org
s.kahissa.ora/mailman/listinfo/pha-ezc'
&
Subject: Re: Postal Address
Date: Fri, S Nov 2002 09:39:25 +0530 (1ST)
From: muriidharv@vsiil.com
To3 sochnrg^Tyvsn!.corn
Occupational Health and safety centre,
0/
licciKdilU
dppis,
Gokuldas pasua Road,
oadar (E),
Mtipibai 400 014.
HI, 1/2,
Paradise CHS,
sanpada,
navimunmai. 400 705.
□h:761 4098
.fax: 407 6100: attn dept of
secnaracvsnj.. com wroce
Dear Madam/Sir,
Kindly send your postal address with phone no.,
fax no. etc.
Noreen
ofl
11/8/02 9.59 AM
e: Postal Address
Subject: Re: Postal Address
Date: Fri, 8 Nov 2002 09:49:37 +0530 (1ST)
Prom: sujvij@vsnl.com
To: sochara@vsnl.com
dear Norodn my postal ad is vijay kanhcrc
1347,17 B, 1'1 H B Colony,
tata power Road, Borivli (East), Mumbai 400 066.
phone 022-8868329. sincerely,
vijav kanhere.
sochara@vsnl.com wrote
Dear Madam/Sir,
Kindiv send vour postal address with phone no.,
fax no. etc
With regards.
Noreen
of I
11/8/02 9.58 AM
>/T
-•Annual Events. .
\
Subject: IEHA Annual Events.
Dale: Fri. 16 Aug 2002 15:38:53 +0530
From: Community health ceil <sochara@vsni.com>
Toi csr^ndav^niQiiisoiilinc.coni
Greetings from Community Health Ceil!
It was nice meetinc you and your daughter even thoucth a bit rushed as
always. Hope your visit to Bangalore was useful for both of you.
There are a few issues of follow up in the context of a potential visit
to Delhi in September and I need your advice.
-• An International e—:iea_th Association on the suggestion of Ilalfden
Mahler asked me to help organise an International Health Seminar during
their IEHA annual events in London. Now theres a change in plan and I
have been invited to be a speaker at a Tele-conference organized by
IMS and British council on IBth September which will be broadcast to
Che conference.
nave agreed and offered to do a social audit of
Telemedicine as a member of the panel. In this context I need more
background on
a' Who is Prof. Narendra ^ehrs ®**of
^1,~ars^lantatior ar^
Inmiun o g enet i c s ?
b) Do you know about this conference?
c) Is there a policy document or report on 'Telemedicine in India' which
one could use as a framework for the Social Audit?
dDoos AT
a vo 3 ~ o' om^'d' c ~ no
n t a t i vo
~ v s-o wha t
2. If I am in Delhi on 19th I could be willing to stay an additional day
on 20 th and spend a day at Al IMS to do some 'Reaching the Unreached'
activities including
a) Presenting the Peoples health Charter to staff and students (I shall
ts at CMC-Vellore end or the month on the same mission).
b) Discussing with INCLEN Researchers-socio-epidemiology (if there are a
small grout of INCLEN researchers or PGs etc on the campus who are
terestedj .
c; Discussing Ethics curriculum or other Medical Education initiatives
with your Adjunct Faculty of the ME cell. As an AIMSONIAN its a long
time since I gave even a full day to AIIMS. This is just a possibility.
Perhaos you and Srinath and Adkol may have ideas.
3. The India Peeples Tribunal are planning to have a Jana Sunvayi on the
Mercury problem in Kodaikanal on 25 August. Did you manage to get a copy
of the report that Dr.Rajgopal presented to you? He has been using your
endorsement for a very ’opportunistic sample* they took and so basing
decision for follow up on averages from such a sample is highly suspect.
Try and get a copy as soon as possible or if he left notes or OHPs with
you send copies by courier immediately. Dr.Francis, Dr.Venkatesh,
Dr.RajMohan, Dr.Mohan Issac and I made a short professional critique of
followed it up with a paper.
what
1 think its important that they do not use your credibility in an
irresponsible way. If you actually saw the report, you and other
researchers may have different comments as well since we are all
trained
C H’ c J>de.—s> Ll io
4. I nave stiii co have the final confirmation from IEHA including where
they will be putting me up. But if you have a hotline to Prof. Narendra
8/16/02 3.39 PM
Annual Events.
-'-~hra then
o 11 ■"'■•■ ■’■p th®t •Sx' ’■•ell ~ for advance information.
booking forward to the possible Ai_?’S interactions.
^2st wishes,
■rtdvi Kdididn,
Community Health Advisor,
CHC.
e- V isit to bangalore
Subject;, Re: Visit to bangalore
Date: Sat. 6 Jul 2002 13:54:02 +0530
From: "Mantra" <cspandav@mantraonline.com>
To: "Community health cell" <sochara@vsnl.com>
Dear Ravi
Thank you. I reach Bangalore on the 7th july evening (Sahara Airlines S2 123
reaching Bangalore at 20.15 Hrs). I will be staying at the NIMHANS Guest
House. 10th seems fine. Would you mind calling me on my cell phone (Cell No.
9810038423) and we could fix up a mutually convenient time.
Thanks
With warm regards
Chandrakant Pandav
-------- Original Message -------From: "Community health cell" <sochara@vsnl.com>
To: "Dr. C.S Pandav" <cspandav@mantraonline.com>
Sent: Friday, July 05, 2002 3:26 PM
Subject: Re: Visit to bangalore
> Dear Pandav,
>
>
>
>
>
>
>
>
>
Greetings from Community Health Cell!
It would be great to meet during your visit.
Thelma is leaving for
Orissa on 7th and will return on 13th since CHC is presently consultants
on a Orissa Health Sector Strategy Initiative.
Call as soon as you
arrive so that we can meet perhaps for a meal and discussion.
8th and
9th seem rather full but 10th or 11th seem okay.
What are you coming
for and where will you be staying? My work with Peoples Health Movement
> has been increasing.
I shall be in Geneva the week from 16th.
More
> about all this when we meet.
> With best wishes,
>
> Ravi Narayan,
> CHC / PHM.
> "Dr.
>
C.S Pandav" wrote:
> >
Part 1.1
> >
1 ofl
Type: Plain Text (text/plain)
Encoding: quoted-printable
7 6/02 3:53 P\
r>>stal Addresses
Subject: Re: Postal Addresses
Date: Thu, 7 Nov 2002 15:56:42 +0530
Prom: "Centre of Indian Trade Unions (Central Office)" <citu@vsnl.com>
To: "Community Health Cell" <sochara@vsnl.com>
B T Ranadive Bahawan
13—A, Rouse Avenue
New Delhi - 110002
Indis
T q 1 . QQ_O1_1T_3O? n 9 Q C
Fax: 00-51-11-322 1284
322 1306
--------- Original Message --------From: "Community Health Cell” <sochara@vsnl.com>
To: <Idpd2001@yahoo.com>; <Deogharbiddu@hotmail.com>; <citu0vsni.com>;
<tkjoshi@vsnl.com>; <mmpnorth@vsnl.net>
Sent: Thursday November 07, .2002 2:32 PM
S ub o c t * Postal — dd **0 s s c s
Dear Madam/Sir,
> Kindly send us your costal address with phone no., fax no. etc.
> With regards,
i ui 1
11/8.-02 11:26 AM
"^Addresses
Subject: Re: Postal Addresses
Date: Thu, 7 Nov 2002 01:47-54 -0800 (PST)
From: ARUN MITRA <idpd2001@yaltoo.comi5To: Communin' Health Cell <sochara@vsnl.com>
Dear Noreen,
My Postal Address etc. are as under :
D; .Arum Mitra
Gencrs1 Secrct*arv
Indian Doctors for Peace and Development.
E-139, Kitchlu Nagar,
S.udhiana - 141001
Piinioh
/TNI IT AxyA
-*• vujuu
Phone: 0161 - 470252, 477360, 446906
Fax : 0161 - 470252
Thanking you.
Dr Arun Mitra
Community Health Cell <sochara@vsnLcom> wrote:
Dear Madam- Sir,
Kindly send us your postal address with phone no., fax no. etc.
With r^.op.rfl.s
Noreen
Do you Yahoo'?
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11/8/02 11:28 AM
Subject: Re: Postal Addresses
Date: Fri. OS No\ 2002 20:45:41 +0530
From: "bidhan singh" --deogliarbiddu@hotmail.com>
To: sochara@vsnl.com. Idpd2001@yahoo.com, citu@vsnl.com. tkjoshi@vsnl.com,
mmpnorth@vsnl.net
dear Noreen.
i work w ith greenpeace india. The postal address of GP will do.
take care
bidhan
•From: Community Health Cell
I o: klpd2001@yahoo.com, Deogharbiddu@hotmail.com, citu@vsnl.com.lkjoshi@vsnl.com.
mmpnorth@vsnl.net
Subject: Postal Addresses
■Date: Thu. 07 Nov 2002 14:32:57 +0530
Dear MadamSir.
Kindly send us your postal address with phone no., fax no. etc.
With regards.
■Noreen
Add photos to your messages with MSN 8. Get 2 months FREE*.
■■I I
Illi 02 I
Subject : Re: Postal Address
Date: Fri, 08 Nov 2002 11:27:03 +0000
From: "shivalp pavvar" <shivalp@hotmail.com>
To: sochara@vsnl.com
Dear Noreen
I had already sent my petal address toyou about a couple of days back I
don't kmow whether you have received it or not. I am sendig it again
ie
st:
>From; Community Health Cell <socharaisvsnl.com>
k>Tc: caitoisyahoo.com, shivalp@hotmail.com,
^■kumbhamsngrediffmail. com, upendra hosbet@hotmail. com, tidegvsnl. com,
>murlidharv@vsnl. com, sujvij @vsnl. com, srisrikargrediffmail. com
>Subject: Postal Address
>Date: Thu, 07 Nov 2002 14:33:19 +0530
>Kinaly send your postal address with pnone no., tax no. etc.
Ada photos to your e-mail with MSN 8. Get 2 months FREE’.
http://join.msn.com/?page=features/featuredemail
11/11-02 1:33 PM
VBxchangei Conference
on "Poverty, Inequality & Malnutrition in Nigeria
Subject: PHA-ExchangO Conference on "Poverty, Inequality & Malnutrition in Nigeria
Date: Sun, 27 Oct 2002 17:34:57 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch" <pha-exchange@kabissa.org>
From:
"Prcmananda Bharati" <bharati@isical.ac.in>
> Africa Statistical Institute
(AFRISINT), Nigeria, is a non-profit
> organization of Africa Exchange Programme. We need help from Economists,
> Statisticians and other scientists all over the world to achieve its goal.
> It is our task to organize a Conference and Seminar on "Poverty,
> Inequality and Malnutrition: Experiences From the Developing Countries"
> during 25-30 April 2003. The programme will be sent out later. The aim of
the conference is to
> introduce Nigeria to the outside world and to show that Nigeria is far
more peaceful and safe than it is thought of.
We invite abstracts The details of ’the conference will be sent
course.
in due
> Please give it a wide circulation.
*^^With best regards,
> Members
> Board of Directors
> Africa Statistical Institute
> Nigeria
> Dr. Premananda Bharati
> Associate Professor
> Anthropo!ogy and Human Genetics iJnit
> Indian Statistical Institute
> 203 Barrackpur Trunk Road
> Calcutta 700 108
> India Tel: (R) 091 (033) 578 0117
>
(o) 091 (033) 577-8087 Extn. 3210, 578 1834
> e mail: bharati@isical.ac.in, bharati35@hotmail.com
-Exchange is hosted on Kabissa - Space for change in Africa
post, write to: PHA Exchange@kabissa.org
Website: http:Z/www.lists.kabissa■orq/maiIman/listinfo/pha-exchange
<
10/29/02 3:42 PM
lufl
iA-Exchangei Global Fund Could Dry Up By the Middle of Next Year (2)
Subject: PHA-Exchange> Global Fund Could Dry Up By the Middle of Next Year (2)
Date: Fri, 25 Oct 2002 14:24:13 +0700
From: "Aviva" <aviva@netnam.vn>
To: "afro-nets" <afro-nets@usa.healthnet.org >
From: <Profitinafrica@aol.com>
Re this article you posted::
> The performance of the GFATM was entirely predictable. The fund is a great
> idea, but it has been hijacked by the UN and ODA establishment so that it
> now perceived as just another boondoggle of the international community.
Who
> needs another black hole to absorb good money?
>
> Richard Feacham has responded to the criticism of accounting and
> accountability by retaining KPMG, Crown Agents and PricewaterhouseCoopers
to
dh > "monitor the fund's spending for programs in some developing countries". I
do
> not have details of the engagement contract for these three NORTH
> organizations, but I am sure that the hourly rates to be paid to the staff
of
> these organizations will be substantial. I am also sure that the
methodology
> that these organizations will use will be far from the optimum from the
point
> of view of maximising Information for true accounting and accountability.
The
> typical "audit" approach Lakes an enozmous amount of useful information
and
> then summarises it into something that has has rather limited incremental
> value to the public
it legitimizes an organization's accounting
without
> providing any incremental transparency.
> A organization like the GFATM that requires public trust should not need
KPMG
(ft > and the Crown Agents and PricewaterhouseCoopers to legitimize its
accounting
> and its processes and the use of its resources
it should exude
> transparency and be in a position to celebrate its successes objectively
> and be able to have its celebration independently validated.
> What the GFATM really needs is a way for the success of its funding of
> programs and valuable initiatives to be put into public display by an
> INDEPENDENT group that is merely interested in publicizing the performance
>
good and bad
associated with the use of development and
> humanitarian assistance resources in general .... and the GFATM funds in
> particular.
> Under the present paradigm for oversight and management and monitoring and
> evaluation .... the PUBLIC is never going to get to know how much good is
> done by the GFATM
and unless the PUBLIC gets to know about the value
> that is derived from the use of GFATM resources
then the GFATM fund
is
> doomed.
> It is not too late
of2
but valuable time has been lost
10X30/02 12:21 PM
-txctiange> Global Fund Could Dry Up By the Middle of Next Year (2)
> Sincerely
-> Petbr Burgess
> ATCnet
PHA-Exchange is hosted on Kabissa - Space tor change in Africa
To post, write to: PHA-Exchange@kabissa.org
Website: http://www.lists■kabissa.org/mailman/listinfo/pha-exchange
10/30/02 12:21 PM
uf2
alth for all
Subject: Health for all
Date; Mon, 28 Oct 2002 00:10:05 +0000
From: pamzinkin <pamzirikin@gn.apc.org>
To: pha-exchange@kabissa.org
CC: sochara@vsnl.com, uque@bluemail.ch
BMJ 1996;313:316 (10 August)
Editorials
Health for all by the year 2000?
No, and not for many generations without concrete and credible actions to alleviate poverty
"No child in the world will go to bed hungry by the year 2000." This was one of the final statements at the
closing of the Food Security Conference in Rome in 1974. According to the UnitcdNations Development
Programme, hunger now prevails among at least a quarter of the world's inhabitants.1 Every day there are 30
000-40 000 child deaths in die world, most of these from diseases related to malnutrition1 This means that there
are 12 to 14 million child deaths associated with hunger each year. Can we expect this figure to have improved by
Aic year 2000?
the well known phrase "Health for all by the year 2000" was coined at the United Nations Alma Ata conference
in 1978. Only four years are left for hunger and disease to be defeated. Objectives are natural when setting targets
and are often linked to a change of century or to a historically important date. But what is the use of wishful
thinking far away from the bitter reality of widespread poverty? And what arc the risks of indulging in lip
sendee—some would call it claptrap—reflected in statements of the kind above, which serve only to undermine
people's confidence?
"Health for all by tire year 2000" seems less probable today than it did in 1978. The vulnerability of the poorest
has increased, as has their number. According to the World Bank, almost 65% of the inhabitants of Africa live in
"absolute poverty,"3 a term used by former World Bank president Robert McNamara to describe a condition of
total deprivation of the minimum living conditions essential for human dignity1
One of the foremost mechanisms in this impoverishment is servicing and paying interest on national debt. The
"debt trap" is arguably the single most important causative factor in the prevailing morbidity and mortality among
women and children, the most vulnerable groups. This "pathology of poverty" in the Third World is associated
with increasing scarcity of resources, more hunger, and increasing death rates.1 The poverty gap has increased by
30% during the past decade.5 Every year there is a net drain from the Third World to rich countries amounting to
$150bn, most of it as debt servicing.5 From sub-Saharan Africa alone, more wealth is extracted each year than is
vested by governments in health and education for Africans.6
ris is happening in an era in which HIV infections and AIDS related deaths are dramatically increasing, a trend
which is only beginning. In parts of central, eastern, and southern Africa today, 30-40% of pregnant women
attending antenatal care arc seropositive for HIV.5 Most of them will have died within the next 10 years, as will
most of their husbands, leaving behind grandparents without support and orphans without care. We know that the
only defences against this disaster are literacy, knowledge, and understanding of measures to decrease
transmission among the population at risk. But schools and education cost money, and meanwhile the poverty gap
widens and disempowerment increases.
Two mechanisms seem to be prominent as threats to the objective of "health for all," particularly for the two
thirds of the African population that live in absolute poverty. The first is the debt trap, reinforced by the so called
structural adjustment programmes that the World Bank and International Monetary Fund have devised. The
second is the increasing privatisation ofhealth care that has resulted from shrinking public service budgets. If a
country is to be "free" to determine its own health policy, it has to accept the shackles of harsh loan stipulations
and budgetary constraints, making it impossible to allocate resources for health services to those most in need
and most at risk. During 1978-88 Ghana was forced to reduce its health budget by 47%, with corresponding
reductions of 43% in the Ivory Coast and 50% in Mozambique.2 In nearly all the African countries health budgets
do not allow for more than symbolic wages to most professional workers. To avoid massive brain drain, these
countries must permit doctors to supplement their incomes by private practice. It has been calculated that more
than 30 000 university trained staff have left Africa during the 1980s as a direct consequence of vanishing
government support for education and research.2
It can be argued that it is sound policy that all citizens understand that health care costs money. But the effect can
«
*f3
10/29/02 1:59 PM
•altli for all
be devastating. In some countries a pregnant woman urgently in need of a lifesaving caesarean section has to buy
surgical gloves, suture material, and drugs before a doctor will consider operating. In Zimbabwe the number of
hospital visits declined drastically after the introduction of fees for patientsA There was no evidence that
morbidity had decreased or that there was unnecessary consumption of care that could have been avoided. In
fact, an increase in maternal mortality parallelled the introduction of fees. The same sequence of events, with
rising numbers of maternal deaths accompanying the implementation of structural readjustment programmes, has
been reported in Nigeria.^
As medical doctors, we have a responsibility to describe, in medical terms, what happens when impoverishment
takes its toll among the most vulnerable groups in society. We must make the "pathology of poverty"
understandable and show that the widening poverty gap is directly associated with disease and death. This
responsibility is a question of medical ethics, unrelated to political beliefs or creed.
Development programmes should focus more on the quality of human resources, on human wellbeing, and on
productivity. Access to health services, education, food, security, and safe drinking water are basic prerequisites
in this regard. But health for all is a distant dream, and, without concrete and credible actions to alleviate the
pathology of poverty, we must expect it to remain a dream for many generations to come.
Professor Division of International Health Care Research, Karolinska Institute, S-17177 Stockholm, Sweden
Prime minister, Mozambique
Staffan Bergstrom, Pascoal Mocumbi
United Nations Development Programme. Human development report, 1991. Oxford: Oxford University
Press, 1991.
Grant JP. The state of the world's children. Oxford: Oxford University Press, 1992.
Duming AB. Poverty and the environment: reversing the downward spiral. New York: Worldwatch
Institute, 1989.
McNamara RS. The McNamara years at the World Bank: major policy addresses of Robert McNamara
1968-1981. Baltimore: Johns Hopkins University Press, 1981.
Bergstrom S. The pathology of poverty. In: Lankinen KS, Bergstrom S, Makela PH, Peltomaa M, eds.
Health and disease in developing countries. London: Macmillan Press, 1994:3-12.
Bergstrom S, Syed SS. Population control: controlling the poor or the poverty? In: T .ankinen KS,
Bergstrom S, Makela PH, Peltomaa M, eds. Health and disease in developing countries. London:
Macmillan, 1994:25-36.
Werner D. The life and death of primary health care. Third World Resurgence 1992;42:10-4.
Logie D, Woodroffe J. Structural adjustment: the -wrong prescription for Africa? BMJ 1993;307:41-4.
Ekwempu CC, Maine D, Olorukoba MB, Essien ES, Kisseka MN. Structural adjustment and health in
Africa. Lancet 1990;336:56-7.
This article has been cited by other articles:
K. Abbasi
the slaves
BMJ, June 12, 1999; 318(7198): 1568 - 1569.
[Full Text]
D. E Logie and S. R Benatar
Personal paper Africa in the 21st century: can despair be turned to hope?
BMJ, November 29, 1997; 315(7120): 1444 - 1446.
[Full Text]
of3
10/29/02 1:59 PM
Related letters in BMJ:
Health for all by the year 2000
F S Antezana
BMJ 1996 313: 1331. (Letter]
Much can still be done
Alexander R P Walker, Lesley T Bourne, and Barbara J Klugman
BMJ 1996 313: 1331. [Letter]
Pam Zinkin
pamzinkin@gn.apc.org
45 Anson Road
London N7 OAR
UK
C3
tel:44 (0)20 7609 1005
fax:44 (0)20 7700 2699
10/29/02 1:59 PM
^'''-Exchanges Attention Dorothy!
Subject: PHA-Exchange> Attention Dorothy!
Date: Tue, 29 Oct 2002 09:50:06 +0600
From: CAAP <caap@citechco.net>
To: <PHA-Exchange@kabissa.org>
Dear Dorothy,
I sent you a mail expressing my interest to join Lhe PHM poverty and AIDS
circle but the mail tailed to reach you.
Regards,
Dr. Mohammad Hossain
Medical Consultant
Confidential Approach to AIDS Prevention (CAAP)
House # 63/D (1st floor), Road # 15, Banani, Dhaka - 1213.Bangladesh.
Phone/Fax: 9884266,
Email: caap@citechco.net
PHA-Exchange is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-Exchange@kabissa.org
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10/30/02 2:45 PM
lA-Exchango World Health Report YEAR...E CAN BE INCREASED 5-10 YEARS, WHO SAYS
Subject: PHA-ExcfanngO World Health Report: YEARS OF HEALTHY ELFE CAN BE
INCREASED5-10 YEARS, WHO SAYS
Date: Wed, 30 Oct 2002 10:10:58 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch" <pha-exchange@kabissa.org >
YEARS OF HEALTHY LIFE CAN BE INCREASED 5-10 YEARS, WHO SAYS
Worldwide, healthy life expectancy can be increased by 5-10 years if
governments and individuals make combined efforts against the major health
risks in each region, the World Health Organization (WHO) says in its new
yearly report.
The World Health Report 2002 — Preventing Risks, Promoting Healthy
Life -breaks new ground by identifying some major principal global risks to
disease, disability and death in the world today, quantifying their actual
impact from region to region, and then providing examples of
cost-effective ways to reduce those risks, applicable even in poor
^^sountr ies.
> » "This report provides a road map for how societies can tackle a wide
range
of preventable conditions that arc killing millions of people prematurely
and robbing Lens of millions of healthy life," says WHO Director-General
Gro Harlem Brundtland, MD. "WHO will take this report and focus on the
interventions that would work best in each region and on getting the
information out to Member States."
From more than 25 major preventable risks selected for in-depth study, the
report finds that the top 10 globally are: childhood and maternal
underweight; unsafe sex; high blood pressure; tobacco; alcohol; unsafe
water, sanitation and hygiene; high cholesterol; indoor smoke from solid
fuels; iron deficiency and overweight/obesity. Together, they account for
about 40 per cent of the 56 million deaths that occur worldwide annually
and one-third of global loss of healthy life years.
»
> These leading risks are comparatively much more important than widely
believed.
» WHO calls the contrast between rich and poor people "hocking." The burden
from many of the risks is borne almost exclusively by the developing
world, while other risks have already become global. Some 170 million
children in poor countries are underweight, mainly from lack of food,
while more than one billion adults worldwide - in middle income and high
income countries alike are overweight or obese. About half a million
people in North America and Western Europe die from
overweight/obesity-related diseases every year.
> » WHO warns that the "cost of inaction is serious." The report predicts
that
unless action is taken, by the year 2020 there will be nine million deaths
caused by tobacco, compared to almost five million a year now; five
million deaths attributable to overweight and obesity, compared to three
million now; that the number of healthy lite years lost by underweight
children will be 110 million, which, although lower than 130 million now,
is still unacceptably high.
> »
> If all of these preventable risks could be addressed as WHO recommends
(which WHO acknowledges is a highly ambitious goal), healthy life spans
could increase as much as 16 plus years in parts of Africa, where healthy
life expectancy now falls as low as just 37 years (in Malawi). Even in the
10/30/02 12:24 PM
HA-Exchange> World Health Report YEAR...E CAN BE INCREASED 5-10 YEARS, WHO SAYS
richer developing countries, such as Europe, the United States, Australia,
New Zealand and Japan, healthy life spans would increase by about five
years :
> "Globally, we need to achieve a much better balance between preventing
disease and merely treating its consequences," says Christopher Murray,
M.D., Ph.D., Executive Director of WHO's Global Programme on Evidence for
Health Policy and overall director of World Health Report 2002. "This can
only come about with concerted action to identify and reduce major risks
to health."
> WHO has developed a unique framework for using a wide body of scientific
evidence to comparably assess the impact of different risks in a 'common
currency' of lost healthy life years, called the DALY (disability-adjusted
life year). This takes into account the impact of the different risks on
mortality and on morbidity. A DALY is equal to the loss of one healthy
year of life.
> Risks that result in death reduce life expectancy. Risks that result in
short or long term morbidity mean that people stay alive, but not in full
health. Healthy life expectancy (HALE) is, therefore, lower than life
expectancy.
For example, overall life expectancy in Japan is 84.7 years
for women and 77.5 for men, versus a healthy life expectancy of 73.6 years
for men and women.
» The report divides the world into 14 different regions on the basis of
geography and health development [see Annex (WHRrelease Oct 24 annex.doc)
attached], then analyzes the risks most important in each area and the
gains in healthy life span that can be achieved. The top risks vary
widely, from being underweight and unsafe sox in most of Africa to tobacco
use and high blood pressure in North America, Western Europe and developed
countries in the Western Pacific such as Japan.
> The major risks reviewed in the report are responsible for a substantial
loss in healthy life expectancy
on average about five years in
developed countries and 10 years in developing countries.
> The amount of lost healthy life years due to these leading risks varies by
region In Canada, the United States and Cuba (highest ranked group in the
Western Hemisphere), healthy life expectancy can increase by 6.5 years,
from their current healthy life expectancy of Canada, 69.9 years; Cuba,
66.6 years, U.S., 67.6 years. In the wealthiest countries of Europe,
including Germany, France, Italy, Spain and the United Kingdom, healthy
I lite expectancy can grow by 5.4 years; in most of Latin America, including
Argentina, Brazil and Mexico, 6.9 years; in an Asian group including
China, 6 years; in another Asian group including India, 8.9 years. (WHO
estimates apply to each region as a whole and may not apply to any given
country.)
> A considerable part of this burden could be reduced by that of
cost-effective interventions identified in the report.
WHO has developed
a first-ever system of identifying and reporting cost-effective health
interventions consistently across different regions that it. calls CHOICE
(CHOosing Interventions that arc Cost-Effective). Various CHOICE options
are contained in a new statistical database Dial is also a pari of the
World Health Report 2002, one of the largest research projects ever
undertaken by the World Health Organization.
These interventions can be
implemented on an a la carte basis, depending on each country's individual
circumstances.
» "Although the report carries some ominous warnings, it also opens the
door
to a healthier future for all countries - if they're prepared to act
boldly now," says Dr. Murray. "In order to know which, interventions and
of6
‘^A-Exdmge> World Health Report YEAR...E CAN BE INCREASED 5-10 YEARS, WHO SAYS
10/30/02 12:24 PM
strategies tc use, governments must first be able to assess and compare
the magnitude of risks accurately. Our report gives assessments for each
of -the major risks."
■Selected Major Risk Factors and What to Do About Them
The report shows that a relatively small number of risks cause a huge
number or premature deaths and account tor a very large share of the
global burden of disease. For example, at least 30 per cent of all disease
burden occurring in the highest mortality developing countries, such as
those in sub Saharan Africa and south east Asia, results from underweight
and deficiencies in micronutrients like iron and zinc, unsafe sex, unsafe
water, sanitation, and hygiene and indoor smoke from solid fuels, the
leading risks examined in those countries.
» "Every country has major risks to health that are known, definite and
increasing, sometimes unchecked," says Anthony Rodgers, M.D., Ph.D., of
the University of Auckland, New Zealand, and a WHO consultant who is one
of the report's main writers. "For each of these risks, we have
established effective, but often underused, interventions."
» The report also breaks new ground by assessing avoidable death and
disability at a global scale. By incorporating current knowledge in risk
factor, demographic and mortality trends, an intriguing picture emerges an increasingly ageing world facing some major risks globally (such as
tobacco), as well as remaining very high mortality regions, particularly
sub-Saharan Africa.
» "This report brings out for the first time that 40 per cent of global
deaths arc due to just thclO biggest risk factors, while the next 10 risk
factors add less than 10 per cent,” says Alan Lopez, Ph.D., WHO SeniorScience Advisor and co-director of the Report. "This means we need to
concentrate on the major risks if we are to improve healthy life
expectancy by about 10 years, and life expectancy by even more."
» Given the risks measured in this Report and other known major risks,
current scientific knowledge has clearly identified causes for most death
and disability globally. For example, more than three-quarters of major
diseases such as ischaemic heart disease, stroke, HIV/A.IDS and diarrhoea
were due to the combined effects of risks assessed in the Report. WHO
emphasizes that each risk is also a prevention opportunity, and the
potential for prevention from tackling major known risks is clearly
substantial, and much greater than commonly thought.
—> "Since many of these risks are continuous, without a threshold, the most
cost-effective interventions are often those that move the entire
population to a lower risk zone," says Dr. Rodgers. "A good example would
be government- and industry-led reductions of salt in processed foods,
which would have major population-wide benefits."
» Underweight/under-nutrition -- Childhood and maternal underweight was
estimated to cause 3.4 million deaths in 2000, about 1.8 million in
Africa. This accounted for about one in 14 deaths globally..
Undcr-nutrition was a contributing factor in more than half of all child
deaths in developing countries. Since deaths from under-nutrition all
occur among young children, the Loss of healthy life years is even more
substantial: about 138 million DALYs, 9.5 per cent of the global total.
»
» Undcr-nutrition is mainly a consequence of inadequate diet and frequent
infection, leading to deficiencies in calories, proLein, vitamins and
minerals. Underweight remains a pervasive problem in developing countries,
where poverty is a strong underlying cause, contributing to household food
insecurity, poor childcare, maternal under-nutrition, unhealthy
environments, and poor health care.
3uf6
10/30/02 12:24 PM
HA-Exchange> World Health Report YEAR...E CAN BE INCREASED 5-10 YEARS, WHO SAYS
» Interventions — The most cost effective strategy to reduce
under-nutrition and its consequences combines a mix of preventive and
curative interventions. Micronutrient supplementation and fortification -
Vitamin A, zinc and iron - is very cost-effective.
It should be combined
with maternal counselling to continue breast feeding, and targeted
provision of complimentary food as necessary. In addition, routine
treatment of diarrhoea and pneumonia, major consequences of
under-nutrition, should be part of any health improvement strategy for
children.
» unsafe sex — HTV/AIDS caused 2.9 million deaths in 2000, or 5.2 per
cent
of total. It also causes the loss of 92 million DALYs (6.3 per cent of
all) annually. Life expectancy at birth in sub-Saharan Africa is currently
estimated at 47 years; without AIDS it is estimated that it would be
around 62 years. Current estimates suggest that 95 per cent of the HIV
infections prevalent in Africa in 2001 are attributable to unsafe sex.
In
the rest of the world the estimated percentage of HIV infections prevalent
in 2001 that are attributable to unsafe sex ranges from 25 per cent in
Eastern Europe to 90 per cent or more in parts of South America and the
developed countries of Western Pacific.
Interventions -- Most people infected with HIV do not know they are
infected, making prevention and control more difficult. Various sexual
practices contribute to the risk of sexually transmitted infections.
High-risk sex practices include multiple partners, together with lack of
condom use and the type of sex acts involved. Treatments include:
*
Popul ar.ion-wi de mass media health promotion using the combination of
television, radio and printed media.
*
Voluntary counselling and testing.
*
School-based .AIDS education targeted at youths aged 10-18 years.
*
Peer counselling for sex workers.
*
Peer outreach for men who have sex with men.
*
Treatment of sexually transmitted infections as a way of reducing
transmission of HIV infections.
*
Treatment of mothers with HIV infection to prevent maternal to child
transmission.
*
Anti-retroviral therapy has also been evaluated.
*
Intervention combinations: WHO says that the best way to address the
roblem is to apply a combination of the above interventions at a
population-wide level.
r
» High blood pressure and cholesterol — Worldwide, high blood pressure is
estimated to cause 7.1 million deaths, about 13 per cent of the global
fatality total. Across WHO regions, research indicates that about 62 per
cent of strokes and 49 per cent of heart attacks are caused by high blood
pressure.
» High cholesterol is estimated to cause about 4.4 million deaths (7.9 per
cent of total) and a loss of 40.4 million DALYs (2.8 per cent of total),
although its effects often overlap with high blood pressure. This amounts
to 18 per cent, of strokes and 56 per cent of global
ischemic heart
disease.
» Blood pressure is a measure of the force that the circulating blood
exerts
on artery walls. High blood pressure levels damage the arteries that
supplyblood to the brain, heart, kidneys and elsewhere. Cholesterol is a
fat-like substance found in the bloodstream that is a key component in the
development of atherosclerosis, the accumulation of tatty deposits on the
inner lining of arteries of the heart and brain.
»
» Interventions
I of 6
The World Health Report 2002 urges countries to adopt
10/30/02 12:29 PM
HA-Exchange> World Health Report YEAR...E CAN BE INCREASED 5-10 YEARS, WHO SAYS
polities and programs to promote population-wide interventions like
reducing salt in processed foods, cutting dietary fat, encouraging
exercise and higher consumption of fruits and vegetables and lowering
smoking. These are the most cost-effective interventions identified to
reduce cardiovascular disease. This reflects recent evidence that such
therapy benefits all groups at elevated risk, even those with average or
below average blood pressure or cholesterol.
» When added to this base, a combination of drugs -- statins (cholesterol
lowering), low-dose, blood pressure lowering medications and low-dose
aspirin (blood thinning)
given daily to people at elevated risk of
heart attack and stroke, would achieve very substantial additional
benefits. This highly effective drug combination is likely to more than
halve stroke and heart disease incidence and could be widely used in the
developed world, and is increasingly affordable in the developing world.
» "Our new research finds that, many established approaches to cutting CV
disease risk factors are very inexpensive, so that even countries with
limited health budgets can implement them and cut their CV disease rate by
50 per cent," says Derek Yach, M.D., Executive Director of the Cluster on
Non-communicable Diseases and Mental Health. "In addition, drug treatments
are increasingly affordable in middle and low-income countries, as
effective drugs come off patent."
» Tobacco Use — WHO estimates that tobacco caused about 4.9 million
deaths
worldwide in 2000, or 8.8 per cent of the total, and was responsible for
4.1 per cent of lost DALYs (59.1 million). In 1990, it was estimated that
tobacco caused just. 3.9 million deaths, demonstrating the rapid evolution
of the tobacco epidemic and new evidence of the size of its hazard, with
most of the increase in developing countries.
»
» Interventions -- Countries that have adopted comprehensive tobacco
control
programs involving a mix of interventions including a ban on tobacco
advertising, strong warnings on packages, controls on the use of tobacco
in indoor locations, high taxes on tobacco products and health education
and smoking cessation programs have had considerable success. WHO found
that for every 10 per cent real rise in price due to tobacco taxes,
tobacco consumption generally falls by between 2 per cent and 10 per cent.
Tn addition to national programs, an effective Framework Convention on
Tobacco Control will address transnational aspects of the issues.
Nicotine replacement therapy (NRT) targeting at all current smokers was
less cost-effective than the other strategies, but affordable in higher
income countries. NRT includes nicotine patches, nicotine chewing gum,
nicotine nasal sprays, lozenges, aerosol inhalers and some classes of
anti-depressants.
» Unsafe Water and Sanitation — Approximately 3.1 per cent of deaths (1.7
million) and 3.7 per cent of DALYs (54.2 million) worldwide are
attributable to unsafe water, sanitation and hygiene. Of this burden,
about one-third occurred in Africa and one-third in south-east Asia.
Overall, 99.8 per cent of deaths associated with these risk factors arc in
developing countries, and 90 per cent are deaths of children. Various
forms of infectious diarrhoea make up the main burden of disease
associated with unsafe water, sanitation and hygiene.
»
» Interventions — The United Nations has adopted a goal of halving the
number of people with no access Lo safe water and sanitation by 2015.
Improved water supply and basic sanitation, it extended globally, could
prevent 1.8 billion cases of diarrhoea (a 17 per cent reduction of the
current number of cases) annually. If universal piped and regulated water
supply were achieved, 7.6 billion cases of diarrhoea (69.5 per cent
,f6
'-A-Exchanzo World Health Report YEAR...E CAN BE INCREASED 5-10 YEARS, WHO SAYS
10/30/02 12:29 PM
reduction) would be prevented annually. Universal piped water is the
ideal, but is high cost.
In the short term, the most cost-effective
strategy evaluated was disinfection of unsafe water at the point of use.
This is a simple technology, is of very low cost, and would achieve
substantial health benefits.
» Iron deficiency -- Iron deficiency is one of the most revalenL nutrient
deficiencies in the world, affecting an estimated two billion people with
consequences for maternal and perinatal health and child development. In
total, 800,000 (1.5 per cent) of deaths worldwide are attributable to iron
deficiency, 1.3 per cent of all male deaths and 1.8 per cent of all female
deaths. Attributable DALYs are even greater, amounting to the loss of
about 25.9 million healthy life years (2.5 per cent of global DALYs)
because of the non-fatal outcomes like cognitive impairment.
>> Interventions — Iron fortification is very cost-effective in areas of
iron deficiency.
It involves the addition of iron usually combined with
folic acid, to the appropriate food vehicle made available to the
population as a whole. Cereal flours are the most common food vehicle, but
there is also some experience with introducing iron to other vehicles such
as noodles,rice, and various sauces.
»
"?.’e surprised even ourselves in how far-reaching the health benefits can
be if governments and health systems adopt our recommendations," says Dr.
Murray. "WHO believes that the wide distribution of this report should
I become a prime goal of all Member States."
PHA-Exchangc is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-Exchange@kabissa.org
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uf6
10/30/02 12:29 PM
.~v-Exchange> reference materials
Subject: PIT\-Exchauge> reference materials
Date: Mon, 4 Nov 2002 21:10:51 -0700
From: "Aviva" <aviva@netnam.tn>
To: "pha-exch" <pha-exchange@kabissa.org>
■From: "Philippine Health Social Science Association" <phssa@mydestiny.net>
> Health InterNetwork
> Ths HQ21th Internetwork sinis to b-rldoo ths "dioitsl divids" in hs^lth .b'z
> ensuring zhsz
> ZSlSVaFit lF:for~datj.CT: - aF;d thS tOChZOlOgiSS tO dsl1VSZ It ~ aic Widely
> available and effectively used by health personnel, researchers,
> scientists, and policy makers.
> Launched by the Secretary General of the United Nations in September
> 2000 and led by
> the World Health Organization, the Health InterNetwork brings together
> public 2nd
> private partners under the principle of ensuring equitable access to
y' hsa i th
> information.
> As the first phase of making vital health content available, the Health
A InterNetwork has
provided internet access to a vast library of the latest and best
> information on public
> health: nearly lf50G scientific publications.
This collection is
> available through the efforts of WHO together with the 6 biggest
biomedical publishers: Blackwell / Elsevier Science, the Harcourt
> Worldwide &TM uroupf Woluers hi.uwer international Health <* science,
> Springer Verlag and John Wiley.
> Please visit the Health InterNetwork at: http:/
> /www. healthint ern e t work .net
> Communication Programs has developed a new CD-ROM: "Media/Materials for
> Health
> Communication" which is a portable version of the M/MC's website: a
> resource center with
> numerous databases of health communication materials, photographs,
> videos, etc., as well
> t3a eoyo7 m^ewsle11srs. J^lso included is a checklist that walks tho
abuser tnrougi. uns
Wplanning and establishmenl of a multi-media lesource ceiitez.
> ±0 order your free copy, contact:
> Susan Leibtag
> Email: sleibtag@-jhuccp.org
> Please include your:
> Name, Title, Organisation, Address, City/
> State /Postal Code/Country, Phone, Fay. and
> E-mail aodiasa.
—
> —r----oOc----------> The International Foundation for Science (IFS)
Cait for Research Grant Applications from
> Developing Country Scientists
> The InLernatiunal Foundation foi Science (IFS) provides suppoiL Lo young
> scientists of merit
> in developing countries by awarding research grants and additional
> services such as travel
> grants and purchasing assistance.
> IFS supports research related to the renewable utilisation of biological
> resources. I-”
e- ckitzcCc cruf
iA-faxciiange> reference materials
-* health field.- research topics supported include nutrition (relating to
> food ^composition),
' .n-^i^nutrients, weaning foods, food safety, alternatives to use of
> chemicals in food
> production, zoonotic pathogens (epidemiology, control and prevention),
> water
> quality, and medicinal products, including traditional medicines.
> Proposals for projects
> i?iav 2Q'c*r^ss blolocicalchemical, or ohysical orocesses as well as
nxr*-* -^-n
z', —.
r C* z“* *"* -j.~i o 1 □ n s_.'
> relationships important 17: the CO7:SerVat 1071, product 1071, aiid .r<SI2S;vc?jb_Zs
> utilisation of the
> biological resource base.
> Research grants are awarded up to a maximum value of USD 12,000 for a
> period of one to
> three years and may be renewed twice. They are intended for the purchase
> of eon ioment■
> expendable supplies, and literature.
Applicants must be citizens cf,
> and carry out
> the research at, a university or national research institution in a
> developing country
> (see the IPS Website for a list of eligible countries). Candidates must
> be under the age
> of 40 (under 30 for applicants from china), at the start of their
rsssarch carssr, and havs an MSc dsgrss or Qguivalsnt.
A Applications in English or French can be submitted to the Secretariat by
'7~ lufiij. or
Gloccronicany.
> IFS
> Grev Turegatan 19
> S-114 38 Stockholm
> Sweden
> Fsx' ~46 8 f458 18QI
> Website: http://;r,rr. ifs.se
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11/8/02 11:15 AJvI
of Training Prosrsms in H^.uth Scr
Subject: PHA-Exchange> Directory of Training Programs in Health SeiDate: Fri, 8 Nov 2002 09:32:42 +0700
From: "Aviva" <aviva@nemam.vu>
To: "pha-exch" <pha-exchange@kabissa.org>
2002 Directory of Train!.-.•? ?rcar-xts in Health Services and Health Policy
Research
> Websi te ■ h tt o: //acade.’rvhesl th. org/directory/i n de.". h tin
O'
> The 2002 Directory of Training Programs in Health Services and Health
Policy
> Research, is in the process of being updated.
> The Directory of Training Programs in Health Services Research and Health
_> policy provides information about U.S., Canadian, and European
> pest-baccalaureate certificate, master's, doctoral, and postdoctoral
f programs m the fields o, health services research and health policy.
Each, program profile lists: program objectives, program focus, aegree (s)
offered, program director (s), senior faculty and primary research
> interests, tuition, financial aid, average completion time, average
number
> of students, start date, program structure,
language of instruction,
> application requirements, and contact
r m orma ti on.
> Contact information:
> Virginia Van Horne
> AcademyHealth
> 1801 K Street.
Suite 701-L
> -vsshinaton / DC 2000 6
Tr 7 • 2025 2_ c~' g.~
s'f * 202_ 0y__ C0xri
x-r3cic?rnTi
x" <’Zhg 1 i t O 2
2~|S'2 Z £ . ''3.ci C,<u ti GiTiy 'i Sa It T: . Ci Tess'
O7”,<r
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ufl
11/11/02 1.16 PM
A-F.xdiange> U.S. May Abandon Support ofUN Population Accord
Subject: PIIA-Exchange> U.S. May Abandon Support of U.N. Population Accord
Date: Tue, 5 Not’ 2002 16:09:04 —0700
From: "Aviva" <aviva@neinam.tii>
To: "pha-cxch" <pha-exchange@kabissa.org>
US MAY ABONDON SUPPORT OF U.N. POPULATION ACCORD
By JAMES DAO
-ight at tue United Nations, has threatened to withdraw its support for a
landmark family planning agreement that the United States helped write eight
years ago.
The reason tor the threat is contained in two terms that the administration
contends can be construed as promoting abortion. The terms - reproductive
health services and reproductive rights — figure in the final declaration of
uiic Unl tz o d Me.tz2.cns nonn 1 nt2.on con^oxoixco
n 199^ i t? Cq i t’q
w^*1 7 ch cirJ32?ciccc* c
new concept Oj. population policy based on improving the legal rights and
economic status of women. The declaration has since been endorsed by 179
.nations.But during a population and development conference in Bangkok this
'week, the American delegation announced that Washington would non reaffirm
its support for the Cairo "program of action" unless the disputed words were
changed or removed, United States and United Nations officials said.
attending the Asian and
Racine ?opuj.ation Conference and drew immediate CxluiciSRi LrOiTl ChlRSSS,
Indian and Indonesian officials, who argued that the American position would
undermine a global consensus on population policy, according to United
Nations officials. The threat has also elicited a sharp response from some
Europeans. "I think it is disappointing and incredible," said Agnes van
Ardenne, the Dutch minister for development cooperation. "Poverty reduction
will nor ha successful without reproductive heeltii and without women being
able to make their own choices."
Congressional Democrats and United Nations officials underscored these
concerns'today, saying that a decision by the administration to withdraw
support for the Cairo program 'would undermine the efforts of family planning
officials in countries that have looked to the United States to take the
lead in checking population growth.
"The impact of these public statements is devastating and could undermine 10
^JBvears or work, " Representative Carolyn Maloney, Democrat of New York, said
in a draft letter to Secretary of State Colin L. Powell that she began
circulating on Capitol Hill today. "It is likely chat repressive countries
will follow the U.S. in its decision and the progress that has been made
will cease."
The State Department declined to comment on the dispute today. But
administration officials acknowledged that the United States might not
reaffirm its support tor the Cairo program unless the disputed phrases were
withdrawn or modified.
The 1994 conference was widely considered a watershed event because it moved
away from traditional ideas or family planning and embraced the idea that
givina women more control over their lives would provide a check against
explosive population growth.
P 11/4'
The program of action called fcr stabilizing the world's population at no
more than 9.8 billion by 2050 and iL urged countries to make health care
widely accessible, reduce maternal mortality, provide universal access to
primary education and stem the spread of H.I.V. and AIDS. The program also
suggested that where abortion is legal, it should be made sate.
The program's acknowledgment that legal abortion could be part of health
care ha'drawn objections from the Vatican and several Muslim and Latin
Ameri "a’~ countries. But over the years, the United States has consistently
11/8/02 11:19 AM
•cxcliango u
May Abandoa Support of U.N. Population Accord
raaffj.rm.ad tha Cairo orinciolas.
Ono of H-.os Vatican's chist nagotianors m Cairo, John Klink, was an advisar
to the United States delegation in Bangkok, United Nations officials said.
£1 O
Douglas Johnson, legislative director of the National Right to Life
Committee, praised the Bush administration’s stand. "We certainly approve of
any effort by the administration to make it clear that abortion is not an
acceptable method of family olannino," Mr.Johnson said. "There is a sort
code used in some of these U.N. documents, and groups that advocate oxpan
access to abortion do construe these phrases co include abortion."
The dispute over the Cairo program is only the most recent example of
administration efforts to withdraw American support from United Nations
programs that it contends promote abortion.
In July, the administration decided to withhold $34 million in nreviouslv
approved aid to the United Nations Population Fund, contending that the
agency helps Chinese government agencies that force women to have abortions.
m May, curing the united Nations General Assembly’s special session on
children, the Bush administration, the Vatican and some Muslim countries
unsuccessfully pushed for a policy to prevent teenagers from getting
anorcions. The group also sought to make abstinence the centerpiece of sex
education for unmarried teenagers.
Timothy Zj. oirLh, the under secretary of
said he expected the Bush administration
eventually. It it does not, he said, the
important allies just as io is trying to
Iraq policies.
state for global affairs in 1994,
to reaffirm the Cairo program
United States -might alienate
build international support for its
"The reaction would be verv negative " Mr. Wirth added "at a time when the
administration is trying to put together international coalitions on various
~ -c. 4= „ .-i. _ „
SOURCE:
http://www.ny times.com/2002/11/02/international/asia/02ABOR.html?pagewan
November 2, 2002
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of2
11/8/02 11:19 AM
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t o; pha-cxch <pha-exchan.sc(d kabissa.org>
> "iQuCd - io;, ai;i<.<pendl ure and Pov^r'cy Reduction in East Africa:
I.?.55c=:r ?.ca raczncia-'
cb.anae
K.» <U IK. ». *. i * M
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From: 'Aviv?/' <avJv.' A;neivn>
it %»« Oiid-< AVii •^<''n?i-CXCii<3ijiiC u XaOiSScl.Ofg>
"iie -?5:
Global. Leu.caci ai?_i :be recent announcement of a partnershio between
PHA-Excnange is nosteo on Kanissa - Space tor cnange in Arrica
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PUfichange> PLACE PEOPLE BEFORE PROFITS AND POWER
Subject: PHA-Exchangc> PLACE PEOPLE BEFORE PROFITS AMD POWER
Date: Sat, 23 Nov 2002 14:16:32 +0700
From: "Aviva" <aviva@netnam.vn>
To: "afro-nets" <afro-nets(ajusa.healthnet.org>
From: <pambazuka-ncws-admin@pambazuka.org>
1.EDITORIAL
(excerpts)
> PLACE PEOPLE BEFORE PROFITS AND POWER, CIVIL SOCIETY TELLS MINISTERS
> Statement to the SADC EU Ministerial Meeting, from the SADC EU Civil
Society
Society
Conference, 3-5 November 2002, Copenhagen, Denmark and the Civil
meeting in Maputo 5-S November:
> We share a common vision of an equitable society that cares for all its
members, that strives continuously to enhance their socio-economic rights
and political freedoms, and that places people not profit or power first.
We also share a common vision of meeting in a partnership of equals, not
shackled
By exploitative relations.
> We see development as a people-driven and a people-centered process. We
struggle for this development in
> the context of severe inequalities of economic and political power
inherited from previous colonial relationships and the damage done to
regional development and integration by apartheid. This adverse context
also includes non—democratic governance, lack of media independence and
1iiriitoLions m the freedom of rhe caval society an some countries.
> We believe that those unequal relations have been perpetuated by
international institutions such as Lhe IMF, WoxTd Bank and WTO and economic
structures of dependency, including the debt trap and unfair trade
relations. We believe that they are being abused to secure the
> unilateral imposition of trade liberalisation, privatisation and maximum
repayment of debts. These processes undermine regional efforts to define
alternative development frameworks, to pursue regional integration and to
address structural problems of production and sustained resource management.
The current famine in Southern Africa demands an urgent response. Assistance
^nust be provided with due sensitivity to the danger of reinforcing
dependence. In the longer term, lessons must be learned about the local and
international policy failures, which have contributed to famine. The
> right of developing countries to pursue policies aimed at securing food
security must be defended against inappropriate international policy advice.
>
Internationally supervised structural adjustment has failed to promote
African development. This has been exacerbated by mismanagement of official
development assistance, poor domestic governance of assets and the corrupt
practices of
> public and private officials associated with development projects.
>
> Any recovery plan must clearly identify the failures of past
> conditions attached to aid, loans and investment and adopt African
proposals for people-centered development. Adjustment policies are mainly
concerned with raising external resources, appealing to and relying on
external governments and institutions. In addition, they are driven by
African elites and drawn up by the corporate forces and institutional
instruments of
globalisation, rather than being based on peoples
experiences, knowledge and demands. A legitimate African programme has to
start from Lhe people and be owned by Lhe people.
The HIV-AIDS pandemic
11/25/02 10:59 AM
HA-Exchange> PLACE PEOPLE BEFORE PROFITS AND POWER
Because HIV/AIDS affects women with household
> responsibilities and the young and economically active sections of the
population, the epidemic has devastating implications on production and
economic growth. It is already putting an unbearable burden on social
servi ces
> and reversing hard-won development gains.
The HIV/AIDS pandemic represents
immense obstacle to reaching the national poverty reduction targets and
an
development goals agreed upon at the United Nations Millenium Summit.
> We call on EU Governments to: (omitted for brevity; see orignal)
> We call on the SADC Governments to: (omitted)
> Debt and reparations
> Debt repayments are having a crippling effect on the ability
of
Governments of the region to implement development programmes, invest in
health and education and cope with the devastating impact of the HIV/AIDS
crisis. The failed policies of the structural adjustment do not provide a
framework to tackle the special nature
of Southern Africa's debt.
> Apartheid-caused debt: (omitted)
> Given that these apartheid caused debts served a criminal system we call
the EU Governments to:
on
- Accept that all apartheid caused debt is illegitimate and illegal;
™ - Recognise that their corporations and banks aided and abetted apartheid
reaped profits from it;
and
> - Recognise that the peoples of Southern Africa therefore are entitled to
full
cancellation and reparation for apartheid-caused debt.
> Structural adjustment caused debt
> He call upon the EU to recognize that dependency by SADC countries on
international financial institutions is caused by falling commodity prices
of African exports, lack of access to markets in the EU and the USA. because
of protectionism and agricultural subsidies, and reductions in official
development aid.
> Privatisation
> IVc believe that access to essential services, such as health, energy and
water, are basic human rights and should not be subject to privatisation and
profit, thus falling outside public control. The privatisation of such
services and needs only serves to widen the gap between the rich and the
poor,
> to increase the gender gap and to impact unfairly on women and girls who
mre
the first to lose education and health services when user fees are
'introduced.
> Privatisation ignores the question of people's ownership and control of
resources, while benefiting big capital.
>
> We call on the EU and SADC Governments to:
> - stop using privatisation as a pre-requisite for granting development
assistance and access to trade, especially as applied to the
conditionalities
imposed through the activities of the IFl's and the WTO.
> - ensure that any implementation of Public-Private Partnerships (PPPs)
remains under public conr.roi and ownership, and ensures access to affordable
services
> by the people;
> - stop using development funds to promote private sector delivery of
services;
> - commit to pursuing, with the full involvement of civil society, >
comprehensive economic and social impact assessments prior to the
implementation of any privatisation initiative;
> - explore alternative strategies to upgrade public services, including
gender
budgeting, while keeping them under public control that is
accountable and
>
transparent.
scrap failed cost recovery policies on basic services and implement
of3
■iA-Exchange> PLACE PEOPLE BEFORE PROFITS AND POWER
11/25/02 10:59 AM
cross-subsidisation and budget subsidies;
> - recognise that privileged elites, conpanies and countries are driving
and
tenofiting from privatisation.
> Further details: nr.tp://www.pambar.uka. org/newslet.t.er.php. id 7 75A5
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11/25/02 10:59 AM
13 of 3
Subject:
Date:
From:
To:
PHA-Exchange> News posted by DailyTimes.com
Sun, 24 Nov 2002 10:16:00 "GMT"
Naeem <anaeemkhan@hotmaiLcom>
friends <pha-exchange@kabissa.org>
‘New laws to gag Pakistani Press’
By Ahmad Naeem
LAHORE: Three ordinances recently promulgated by the president of Pakistan would
exert a chilling effect on the freedom of expression in Pakistan, said ARTICLE 19, a
London-based organisation, on Saturday,
The Press Council Ordinance, Registration Ordinance and Defamation Ordinance not
only restrict the freedom of expression but also undermine the process of democratic
transition. Nothing about them justifies the urgent procedure invoked by the president,
and if necessary, that should have been left to the new parliament, the organisation said.
The Press Council Ordinance establishes a press council, largely controlled by
government appointees - the chair, for example, is appointed by the president - with
responsibility for enforcing an Ethical Code of Practice, binding on all journalists, it said.
The Code contains a number of extremely vague obligations such as to “strive to uphold
standards of morality” as well as illegitimate obligations such as to avoid printing
material which may bring the country or its people into contempt, it added.
The Registration Ordinance requires all publishers, printers and owners of newspapers
and news agencies to be centrally registered, no matter how small their circulation.
Registration may be refused if the applicant has been convicted of a criminal offence or,
in the case of printers, of a crime involving ‘moral turpitude’.
The Defamation Ordinance provides for criminal sanctions for defamation, including a
minimum level of compensatory damages of Rs 50,000 - one third of the annual per
capita GDP - and up to three months imprisonment.
The ordinance fails to address serious problems with existing defamation laws,
preserving existing criminal defamation provisions and the power of public bodies to sue
in defamation, ARTICLE 19 said. Toby Mendel, head of ARTICLE 19’s Asia
Programme, said: “These ordinances are aimed al controlling the media.
The enforcement mechanisms in the Press Council Ordinance and the Registration
Ordinance are wide open to political abuse and imprisonment for defamation is clearly
contrary to the international law. Together, they are likely to result in significant self
censorship by Pakistani journalists.”
Home | National
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A-Exchange> The State of the World's Vaccines
Subject: PHA-Exchange> The State of the World's Vaccines
Date: Tue, 26 Nov 2002 15:54:03 +0700
From: "Aviva" <aviva@netnam.vn>
> The State of the World's Vaccines and Immunization
.> Jointly produced by the World Health Organization
> World Bank
f October
(WHO) , UNICEF and the
> Available as PDF file [ 116p.] at WHO website:
> www.who.int/vaccines-documents/
> or UNICEF website at:
http://www.unicef.orq/notew0rthy/sowvi/sow en 2002 rev.pdf
> Related press release: Low Investment in Immunization and Vaccines
Threatens Global Health
> <http: //www. unicef.org/newsline/02pr61sowv.htm>
. One in four of the world's children are not inoculated against
> common, vaccine-preventable diseases such as tuberculosis, measles,
tetanus,
> and whooping cough.
.The report points out that while vaccines have saved billions of lives
> in the past century and are still the least expensive way of controlling
the
> spread of infectious diseases, they are not reaching the populations that
> need them most
"
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c.
■Exchange* How many lives is Equity worth?
Subject: PHA.-Exchange> How many lives is Equity worth?
Date: Sat, 30 Nov 2002 14:40:29 -r0700
Prom: "Aviva" <aviva@netnam.vn>
To: "Barbara Starfield" <bstartic@jhspli.cdu>
Excerpted and paraphrased from:
Inti. J. for Equity in Health 2002, 1:1, 22 April 2002.
(www.equityhealthj.com/content/lz1/1 )
Macinko J.A. and Starfield B., 'Annotated bibliography on Equity in Health'
HOW MANY LIVES IS EQUITY WORTH?.(borrowed from Lindholm et al, 1998)
1.Inequality is reflected in differences in health between population groups
in any given society.
2.Equity is defined as the absence of potentially remediable, systematic,
differences in one or more aspects of health across socially, economically,
demographicallv or geographically defined population groups or sub-arouos.
(IJEH)
defines inequity as differences in health status which are not only
unnecessary and avoidable but, in addition, are considered unfair and
unjust.
(This because not all health differences (inequalities) are considered
unfair or unjust... But beware: Despite the fact that members of society
have legitimate claims to fairness in health, there is no way to assess
fairness without imposing some value judgement].
4.Two types of equity have to be considered:
-Vertical equity, i.e., preferential treatment for those with greater health
neeas —or ‘the unequal, bur fair treatment of unequals', and
-Horizontal equity, i.e., equal treatment tor equivalent needs —or 'the
caual
treatment of equals'.
o
5.Tn other words, equity implies no differences in health services where
health needs are equal (horizontal equity) or enhanced health services being
provided where greater health needs are present (vertical equity).
Therefore, from a vertical equity perspective, groups in society that have
the lowest starting points require preferential treatment and investments.
^.6.Overall, the dilemma we are often faced with is whether to provide the
^jreatest good for the greatest number of beneficiaries or rather to improve
the health of lhe most disadvantaged in society.
7.There are three types of responses to health inequities:
a) Increasing or improving the provision of health services to those in
greatest need;
b) Restructuring health care financing mechanisms to aid the disadvantaged;
and
c) Altering broader social, economic and political structures intended to
influence more distal determinants of health inequities. [Note that this
influence (the one of politics on inequities in health) has been grossly
under—researched.-•.certainly not a coincidence...].
8.Success of these responses is to be measured by the size of the reduction
in the gap between the better off and worse off group —or by the
improvements attained by the worst off group relative to where it started
from before the intervention.
9.Note that 'individual-based measures of (and responses to) health
inequalit”' do not address differences across population sub-groups and are
thus oFlimited use in policy making since they do not inform us about
comparisons between the more and the less disadvantaged groups in society.
Individual measures: a) ignore tne important social determinants of health
inequalities, b) prevent them from being placed in the policy agenda, and
c) ignore guiding resources to those with both poorer health and lower
12/1/02 11:17 AM
Hn.-Exchange> How many lives is Equity worth"
.socio-economic position. Increased individualization also explains the fact
that only rarely arc structural policy measures being taken to more
frontallv tackle health ineaualities worldwide: the driving force in
individualization is mainly utilitarian.
10. An equitable health care system, therefore, is one that assures
probabilities of access will be equal across population groups for a given
set of health needs and problems.
11.'Distributive justice' focuses on the distribution of health outcomes
across oroues in society. 'Procedural justice' —needed as much-- emphasizes
fairness in the processes followed rather than fairness only in the actual
outcomes.
12.'Benchmarks of fairness' can be set to judge these two types of justice
in hearrn. Examples are: tne existence or financial and non-tinancial
barriers to access, levels of accountability of providers and empowerment of
beneficiaries, comparisons of each income group's share of need for medical
care with the share of medical care they actually obtain (equity of health
benefits).
13.To reiterate, then, equity in health is ultimately concerned with
creating equal opportunities for receiving quality health care, and with
bringing unfair health differentials down to the lowest levels possible.
"4.Six principles of action flow from this, namely: improving people's
living and working conditions, decentralizing decision-making/encouraging
true participation, enabling healthier lifestyles, assessing health impacts
of all major development actions, keeping equity on the agenda, and
providing quality services accessible to all.
15.Inequalities in health status attributable to the distribution of income
are inequitable, basically because they are systematic and remediable;
moreover, income inequality is associated with individual morbidity and
mortality risks.
16. Socioeconomic position is the major contributor to ditterences in death
rates. The mortality burden attributable to socioeconomic inequality is
large and has profound and far-reaching implications. There is thus a
'social patterning in the causes of morbidity and mortality'. This is as
true tor ditterences seen between black and white men in the US as it is for
the fact that death rates arc highest in the most disadvantaged areas; they
also differ by gender, i.e., higher mortality rates are found among lower
educated women.
[Since gender is a significant marker of social and
economic vulnerability (as, tor example, manifested in inequalities of
access tc health care), gender inequality and limited economic opportunities
Lay be two of the pathways through which the unequal distribution of income
adversely affects a population's health].
17.Another typical example of inequality in rich countries is seen in the
fact that lower income groups are more intensive users of general
practitioners and hospitals; the rich have higher rates of use of specialist
services. A. pro-rich inequity also exits tor the total number of physician
contacts.
18 .Additionally, income inequality within a given society has an independent
effect on life expectancy, distinct from the well known association between
absolute per capita income levels and a population's health. The greater the
income inequality, the greater likelihood that poor individuals will report
poorer health.
19 Class at birth and educational attainment seem to be good proxy measures
of social position when studying equity. [Nevertheless, how social class is
specified makes a difference in drawing conclusions about the magnitude of
ineaualities). Occupation, indexes or material living standards, and health
expenditures as a proportion of a household's total budget have also been
used as proxies. But equity is too complex a concept to be reduced to a
single or a couple indicators.
of3
?HA-ExdMnze> How many lives is Equily worth?
12/1/02 11:17 AM
20.The reduction of systematic inequalities in health care is thus seen as
an overall strategy for the improvement of a population's health. But the
use sf generic categories, such as "the poor” or "the very poor" leads to
insufficient disaggregation of the impact of changes in financing mechanisms
sue! ot -Ogiessivo ussr less.
21.Ultimately, what really matters and counts is the equity aspects of the
actual resource-allocation decisions being made. For instance, policy-makers
have done or are doing little to reduce current inequality-perpetuating
government subsidies to the private sector —which serves a minority of the
population. Further, many questions have been raised as to whether
public/private partnerships can be expected to explicitly address the health
needs ot the poor.
22.Despite the above, the most significant reasons for increased
inequalities in health today stems: a) from public policies that benefit
globalization, and b) from technocratic, humanitarian and apolitical
approaches being used by international aid agencies and governments; these
approaches disregard the growing inequalities and unequal power relations
among and within countries. This, despite the well accepted fact that
different power relations in different societies are the most important
force that determines the level of well-being and health of their
populations. In short: the growth of inequalities is rooted in power
relations that are skewed against the poor.
For example, as the world moves towards globalizing free market solutions,
equity in health has (ideologically) come to bo scon as conflicting with the
market system's efficiency goals.
23.Private insurance and out-of-pocket payments have negative redistributive
effects (...and user fees only raise an insignificant fraction of revenue
for the health sector ...and exemption systems for the poor seldom work).
Taxes used to finance health services, on the other hand, are generally
pro-poor in their overall redistributive effects. Moreover, it is proven
that one gets more health per dollar by aiming at the health of the poor.
Tax progressivity (those who earn more paying more) is key though in
determining the redistributive effect of public health care investments.
24.Finally, as part of inequality, we see a widening gap in health status
between urban and rural residents correlated with increasing gaps in income
and health care utilization rates. We also see increased financial barriers
to access in rural areas and, more worrisome yet, diminished rural
publicly-financed public health services and programs.
25.As a way out, we basically need to promote greater direct
community-surveillance of equity issues; the latter can mobilize political
forces and strengthen community empowerment. The focus should be on the
health status of the most vulnerable —with an eye on acting promptly if
eauity targets are not being met. Local authorities are to be held
^responsible/accountable tor meeting equity targets. Furthermore, some have
suggested that international agencies should condition their aid on the
surveillance of equity; therefore, each country should decide on a stepped
approach towards achieving health equity targets.
Claudio Schuftan, Hanoi
avi va8 netnam. vn
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5 of 3
12/1/02 11:17 AM
A-Lxc.ges /
PreX.cSIS rl<!p r<?nukcs
Subject: PHA-Exchange> Do Microllnauce Programs Help Families
Date: Fri 6 Dec 2002 15:12:01 -0700
From: "Aviva" <aviva(3.netnam.vu>
To: "afro-nets" <afro-nets/t?iisa.healthnet.org>
Pzcjyxd/ui' Help Td.'riilles Tnsurts Consumption Against
Gerties, U.C. Berkeley and MBER
Levine,- 'J. C. Berkeley
> Available online as EDI file [25p. 1
3Z ’ n~Zc’ //. .ou. edu/econ/led/ seminars/'odf/levinef~30~02Microiinanee. odf
.•
rc^Hntr.Ms face enormous financial risks
from major illness bath in terms of the cost of medical care and the loss
Pp
associated with reduced labor sucolxr and product, ivitxr. authors
> whether access to microfinancial savings and lending institutions helps
> Indonesian families smooth consumption after declines in adult health. In
> general. results support the importance of these institutions in helping
' i~s to sel^—insure consu™.otion
>
t'he paper concludes that governments should promote microfinance ano
> rriicrosavings proqramrries in addition to
> r.~ad' r - c.r.a' hoods such as .subsidies, mandates, or direct, government
> provision of health insurance and disability
?rt_a_-£v.7h?.nG= is hosted on Kabissa - Space for change in Africa
To post, ’..'rtte to: i*HA ExchangsGlcabissa.org
Kebs 1 r.e : httn: /
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Plrf-fi
5>
iib71
12 10 02 11:03 AM
IA-Exdiange> Various topics
Subject: PHA-Excliange> Various topics
Date: Fri 6 Dec 2002 15:46:30 -0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch" ■^pha-exchantje^kabissa.orn^
> FFFMUZ/i FOF SUCCESS? NEEDS-BASED RESOURCE ALLOCATION IN HEALTHCARE
> A countryrs policy on healthoaze financing can help or hlndez access io
> services by poor people. How can different approaches to resource
allocation
> Gna.ble poor oeoole ~o access essential health services? A. revert from the
UK
> Department for International Development's Health Systems Resource Centre
> presents lessens from Cambodia, South Africa and Uganda. In many
low-income
> countries resources are allocated through a mixture of political
nsgot2.a~2.cn
> and incrementa' nndgering based on established patterns. This can result
S1- resources going disproportionately to more vocal and visible urban
populations, oerpetuatino ore—existing inequity. Allocation based on need
> wotud be a significant breax with tradition. The report concludes that a
> needs-based approach is not necessarily pro-poor. The definition of equity
> must be consistent with any existing pro- poor health policy. Reallocation
> of resources takes time and should be incorporated into medium-term
2* expenditure dans. Using a formula is c'c’sctivs and transparent and
k preferable t.0 liid'er Subjective alternatives.
> US RUT.T.YTNG GN DRUG PATENTS: ONE YEAR AFTER DOHA
http://■,nn-:, ox fa org/eng / pdfs/ppO 21112 bullying patonts.pdf
> This paper presents findings from an Oxfam commissioned review of US
> government bilateral policies on patents and medicines, pre and post Doha,
> to find out how far It has lived up to promises made in that agreement. It
> focused on the annual r Special 301 ' trade revert cf the US Government
’•■<hi cH
> identifies countries it considers have inadequate intellectual property
> rights and which is widely reared by developing countries because of the
> attached threat of sanctions and associated diplomatic and political
pressures. Some of the findings from the Oxfam review show that,- contrary
> the spirit and the 'ether of the Doha agreement: US bilateral policy on
> patents and medicines is still heavily influenced by the narrow commercial
> Inteiests of the giant pharmaceutical companies seeking to stave off
Generic
> competition for lucrative patented drugsThe US government continues to
P Hty jEycafi
> bilateral and regional trade agreements outside the WTO to pressure
> developlnc countries to Implement TRIPS-plus standards. Oxfam argues that
>
cent'nued bilateral pressures against developing countries delay or
~.i- ^-y.~ production of cheaper generic versions of new medicines. This
> no~ only reduces poor people's access to medicines in these countriesr but
> also chokes off the supply of cheap drugs to the vast majority of other
arug
> importing poor coun
patented medicines.
>
NARROW TNG THE 10/90 GAP:
them entirely dependent on expensive
D i REGTTNG FUNDTNG FOR HEALTH RESEARCH TOWARDS
THOS^
WHO NEED IT MOST
> http://www. eldis. org/abtw-wpd/exec/
> dbtwpcgi.exe?
of 2
12/9/02 11:58 AM
naiigo Various topics
' 10% is actually allocated for research into 90% of the world's health
> problems. This is whsr. is known as r.he 10/90 can. This r.hird landmark
> of Lhe Global Foxui:; for Heal Lh Research underlines the crucial role that
> health and health research. funding plays in breaking the cycle o±
> poverty.The report covers progress towards narrowing this gap over the
pa St
> prioritisation of health research spending at the global and national
levels
> is a necessity if research funds are to have the greatest impact possible
> the level of world health. However, it also notes that setting priorities
> terms of individual diseases is not enouoh and that cross-cutti.no
influences
oiiCi; c.S W.? 0030 02
COunt-Ty' to del -1VG2" health SerVJ-CSS , the
nor-ac;
-- ■-----— i -rv
j
tO look <5u uc.lQcr' QiZr erences , behaviour and HfeStyl&S harmful to health,
> and environmental problems like indoor air pollution must also be
> considered.
>
^iAUHOh’CChVC’JdiCS AND HEALTH LAUNCHES ELECTRONIC NEWSLETTER
> The Commission on Maosoeuonomlcs and Health (CbiH) has created an
e i ecr.ron i c.
> newsletter to provide up-to-date information about national efforts to
> Increase li.ves Lment In health and improve Lhe effectiveness of health
> expenditure. The MacroHealth Newsletter will feature Macroeconomics and
> Health Support Secretariat news, new findings on health investment and
> economic growrh, country CMH launches and orocress in implementing
> work in macroeconomics and health.
> Further details:
> http://www.eguinetafrica.org/newsletter/newsletter.php?id=943
F ron: 1 QUINEI-Nswsletter
EQUINET-Newsletterisequinetaf rica. org
Neb site: htto:// www.lists.kabissa.org/mailman/listinfo/eguinet-newsletter
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12/9/02 11:58 AM
■IA-Exchange> SciDev.Net
Subject: PHA-Exchange> SciDev.Net
Date: Thu, 12 Dec 2002 09:07:36 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-cxch" <pha-exchange@kabissa.org>
> SciDev.Net - First Anniversary
> Keep informed on science technology and the developing world
> The Science and Development Network (SciDev.Net) is an organisation
> that promotes the communication of information about science and
> technology relevant to the needs ot developing countries. Our main
> activity is running a website (http://www.scidev.net) that provides a
> regularly updated source of news, views and information on topics
> ranging from climate change and genetically modified crops to intel> lectual property and the ethics of medical research.
> SciDev.Net was set up with the support of the journals Nature and
> Science, both of which allow us to provide free access to selected
articles each week. One important feature ot the website is 'dossi> ers' - collections of authoritative articles and background informa> tion on key science-related issues of direct interest to developing
> countries.
> Free weekly e-mail alert
> A free e-mail alert is available giving details of what's been posted
> on the website over the past week. To register tor this alert, go to:
> http: //www.scidev.net/register
> The website also provides information about other SciDev.Net activi> ties. These include the creation of regional networks in developing
> countries linking together individuals and institutions that share
> our goals, and training workshops addressing the task of capacity
> building in science and technology communication. To read an edito> rial summarising our activities in 2002 and our plans tor 2003, go
> to:
> h t tp: //www. scidev. net/arch! ves/edi torial /commen t44.h tml
> SciDev.Net is financed by grants from the UK Department for Interna.> tional Development (DFID), the Swedish International Development Co
if operation Agency (SIDA), and the International Development Research
> Centre (IDRC) in Canada. IL is also supported by the Third Woild
> A.cademy of Sciences.
> David Dickson
> Director, SciDev.Net
> mailto:info@SciDev.net
'^<2
PHA-Exchange is hosted on Kabissa - space for change in Africa
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5 of 3
12/13/02 10:02 AM
lofl
12/13/02 10:09 AM
Hzx Exchanges PHA-Exchange>Ainartaya Sen on Globalization
Subject: PliA-Exchangc> PLLA-Exchange>Ainartaya Sen on Globalization
Date: Mon. 16 Dec 2002 10:19:28 +0100
From: sv.nii.deepak@aifo.it
l OZ SViV3?Z’R£l!13Rl.VR. phH-CXChHRRCf^kubiSStl.OrC
Ths preussus scciicsf c_cbd i55.~ic?. sro eftsn ungainly, ill-tsmpsrsd,
simplistic, frenzied and frantic, even highly disruptive. And yet, they also
serve the function of questioning and disputing the unexamined contentment
about the world in which we live.
Amartya Sen
The world in which we live is both remarkably comfortable and thoroughly
miserable. There is unprecedented prosperity m the world, 'which is
incomparably richer than ever before. The massive command over resources,
knowledge and technology that we now take for granted would be hard for our
ancestors to imagine.
"ut ours is also a world of extraordinary deprivation and of staggering
inequality. An astonishing number of children are ill-nourished and
illiterate as well as ill-cared and needlessly ill. Millions perish every
week from diseases that can be completely eliminated, or at least prevented
from killinc usopls with abandon.
The dual presence of opulence and agony in the world that we inhabit makes
it hard to avoid fundamental cjuestions about the ethical acceptability of
the prevailing arrangements and about, onr own values and r.heir relevance and
r o a. ch
One ot the questions that we have to face immediately is this: given the
gravity and consequences or the contrasts between the comforts and the
miseries rh?.L we see in rhe worici, how do most of us manage to live
untroubled and unbothered lives ignoring altogether the inequities that
characterize our world?
Is the avoidance of
each other - a kind
fcfflict and distort
Explanation that is
and human values?
ethical scrutiny the result of our lack of sympathy for
of moral blindness or breathtaking egocentrism that
our thinking and actions? Or is there some other
consistent with a less negative view of human psychology
This is not an easy issue to settle, but let me begin by arguing that our
indifference and complacency may well be connected with a failure or our
understanding, rather than reflecting a basic lack of human sympathy. A
coanitive failure can arise both from unreasoned optimism and from
□roundless oessimism, and oddly enough, the two can sometimes unite.
To begin with the forme r, the obdurate optimist tends to hope, if only
implicitly, that tnings will get better soon enough. The combination of
processes, such as the flourishing market economy, that has led to the
prosperity of some in t he world will presently lead to similar prosperity
for all. In this glowin g perspective, the doubters tend to appear to be soft
in head, whether or not t’ney are kind in heart.'"Give us time - don't be so
impatient, ” asserts the voice of contented optimist.
On the other side, the st unborn pessimists acknowledge - indeed emphasize the continuing misery in the world. But they arc, frequently enough, also
pessimistic about our aox lily Lo change the world significantly. "We should
but to be realistic, we really cannot," goes that
and often does - lead to a quiet acceptance of a
<»P9
12/17/02 1:57 PM
PHA-Exchange> PHA-ExdttneoAmartay a
Svii on Globalization
As sir Thomas Browne put it more than three and half centuries ago (in
1643), "the world....is not an inn, but a hospital." People can learn to
live happily in a hospital, full of ailing patients, and manage to avoid
There is, thus, a partial but effective congruence between the stubborn
optimist and the incorrigib-is pessimist. The optimist finds resistance
unnecessary whereas the pessimist finds it to he useless. As James Branch
Cabell put it (reacting to a very different manifestation of this
conundrum), "The optimist proclaims that we live in the best of all possible
worlds; and the pessimist fears this is true."
The opposing viewpoints unite in resignation. Global passiveness is, thus,
fed not “iust cy moral blindness, ano by apathy and egocentrism, but also by
a conservati^70 un.’ty
radical opposites. Persuaded - or at least comforted
- by our alleged inability to do any good (either because it is not needed
or because we cannot make any difference anyway), we can lead our own lives,
minding our own business, and not see anything morally problematic in
cuietiv accepting the meguities that characterize our world.
Ethics can be jcillea by premature resignation.
It is in this general context that ws have to view the doubts about
globalization that we see in the world today, including the protest
movements which have made organized international meetings so hard to hold.
These protests have many features (some of them rather hard to tolerate,
including arrogance and violence), bur. they can be, at one level, seen as a
challenge to the ethical complacency and inaction generated by the coalitic
of optimists and pessimists.
The protest movements are often ungainly, ill-tempered, simplistic, frenzied
and frantic, and they can also be highly disruptive. And yet, at another
level, they also serve the function, I would argue, of questioning and
disputing the unexamined contentment about the world in which we live.
In this sense, the global doubts can help to broaden our attention and
avranH the rssch of r'>olicv dsbatss, by conf iron tine the status quo and by
contssuing gfobai resignation and acquisscsncc. Thau, it can argusd, is a
creative role of doubts, even if some of the presumptions and many of the
proposed remedies that go with the protest movements are themselves under
examined and unclear.
It is important to recognise that the question—mongering role of doubts can
ircojy be creative and productive, and we have to separate the disruptive
putts of the protest movements from their constructive function.
TVia
A
KT pa r-i i
- « *-* *—
a.■— of Globalization
The protest movements can, thus, be seen as expressing creative doubts. But
doubts about what? There is, I would argue, a serious interpretations! issue
here. The protesters often describe themselves as "anti-aloba1ization"? Ts
globalization a now folly? And arc the protestors really against
globalizaLion, as their rhetoric suggests?
The so-called anti-globalization protesters can hardly be, in general,
anti-globalization, since these protests are in fact among the most
global’zed events in the contemporary world. The protests in Seattle,
Melbourne Prague, Quebec arid elsewhere are not isolated or provincial
phenomena.
The protesters are not just local kids, but men and women from across the
world pouring into the location of the respective events to have their
of?
lA-Exchanzo PHA-Exchanaes-Amartaya Sen on Globalization
12/17/02 1:57 PM
qigbaj, voice V’Q»-\Xg■ - ~~~ interrelations can ha rdl17 be what the
protests Ksnt. ..... s-.-.y . *•••■•■- -hey ■.■■■;>-.. then, begin by stopping themselves.
Pieseni-xy coiue oacx co che question as to now we may sensibly view
wnar. me nror.ssr.s are anour., bur nefore r.nat, let me turn to r.he second
question: Is globalization a now folly? I would argue that globalization is
neither especially new, nor in general, a wily.
A historical understanding of the nature of globalization can be quite
useful here. Over thousands of years, globalization has contributed to the
progress of the world, through travel, trade, migration, spread of cultural
influences, and dissemination of knowledge and understanding (including of
science and technology). To have stopped globalization would have done
irreparable harm to the progress of humanity.
Furthermore, even though globalization is often seen these days as a
correlate of Western dominance, consideration of history can also help us to
understand that globalization can run in the opposite direction as well. To
illustrate, let us look back at the beginning of the last millennium rather
than at its end.
Around 1000 A.D., global spread of science, technology and mathematics was
changing the nature of the old world, but the dissemination then was, to a
great extent, in the opposite direction to what we see today. For example,
ths hicihi technolcqv in tns wo 2? Id of 1000 A.D. included pspsi? and pnintinc,
^he crossbow and gunpowder, trie clock and the iron chain suspension bridge,
!
the kite and the magnetic compass, the wheel barrow and the rotary fan. Each •
one of these examples of mqn technology of the world a millennium ago was
we i I-esr.ab i i sned ano extensively useo in China, and was practically unknown
elsewhere. Globalization spread them across the world,
including Europe.
A similar movement occurred in the Eastern influence on Western mathematics.
The decimax system emerqeu and became well developed in India between the
second and the sixth century, and was used extensively also by Arab
mathematicians soon thereafter. These mathematical innovations reached
Europe mainly in the last quarter of the tenth century, and began having its
major impact in the early years cf the last millennium, playing a major part
in the scientific revolution that helped to transform Europe.
Indeed, Europe would have been a lot poorer - economically, culturally and
scientifically - had it resisted the globalization of mathematics, science
and technology at that time. And the same applies - though in the reverse
direction - today. To reject globalization of science and technology on the
ground that this is Western influence would not only amount to overlooking
global contributions - drawn from many different parts of the world - that
(lie solidly behind so-called Western science and technology, but would also
be quite a daft practical decision, given the extent to which the whole
world stands to benefit from the process.
To identify this phenomenon with the "Western imperialism" of ideas and
beliefs (as the rhetoric often suggests) would be a serious and costly
error, in the same way that any European resistance to Eastern influence
would have been ar. the beginning of the last millennium. We must not, of
course overlook the fact that there arc issues related to globalization
i-hal do conned with the imperialism (the history of conquests, colonialism
ana alien rule remains relevant today in many different ways), but it would
be a great mistake to see globalization primarily as a feature of
imperialism, it is much bigger - much greater - than that.
The Well-frog and the Global World
T’ne polar opposite of globalization would be persistent separatism and
relentless autarxv. It is interesting here to recollect an image of
seclusion that was invoked with much anxiety in many old Sanskrit texts in
of 9
12/17/02 1:57 PM
HA-Exchaige> PHA-Exchme>Amarta>-a Sen on Globalization
and a half thousand years ago.
1'his is the storv of a ’.■.'ell-frog - the kupamanduka - which lives its whole
life within a well and is suspicious of everything outside it. Beginning
from about 500 R.C.. there are at least four Sanskrit texts, Ganapath,
Hitopadosh, Prasannaraghava,
and Bhattikavya,
that warn us not to bo
weJ 1-frogs.
The well-frog does, of course have a ’’world view,” but it is a world view
that is entirely confined to that little well. The scientific, cultural and
economic history of the wcrio would have been very liiuited had we lived like
well-frogs. This remains an important issue, since there are plenty of
well-frogs around today - and also, of course, many solicitors and advocates
of well-frogs.
The importance of global contact and interaction applies to economic
relations among others. Indeed, there is much evidence that the global
economy has brought prosperity to many different areas on the globe.
Pervasive poverty and "nasty, brutish and short" lives dominated the world a
few centuries ago, with only a few pockets of rare affluence.
overcoming that penury, modern technology, as well as economic
interrelations, has been influential. And they continue to remain important
today. The economic predicament of the poor across the world cannot be
reversed by withholding from them the great advantages of contemporary
technology, the v.’ej-l-established efficiency of international trade and
exchange, and the social as well as economic merits of living in open rather
than closed societies.
B.athor, the main issue is how to make good use of the remarkable benefits of
economic intercourse and technological progress in a way thal pays adequate
attention to the interests of the deprived and the underdog. That is, I
wouxa argue, tne principa± question cnat emerges from the anti—globalization
movements.
is, constitutively, not a question about globalization at all,
and the —mkage wirh globalization is only instrumental and contingent.
Nan-market Institutions and Equitable Sharing
What then is tne main point of contention? The principal challenge, I would
submit, relates, in one way or another, to inequality - international as
well as intranational. The inequalities that irk concern disparities in
'affluence, and also gross asymmetries in political, social and economic
cower. The issue of inequality relates centrally to the disputes over
globalization. A crucial question concerns the sharing of the potential
oains from glofaaiizacion, between rich and poor countries, and between
different groups within a country.
It is not adequate to understand that the poor of the world need
globalization as much as the rich do, it is also important to make sure that
they actually get what they need. This may require extensive institutional
reform, and that task has to be faced at very the same time when
globalization is defended.
Perhaps the most important thing on which to focus is the far-reaching role
of non-maxket institutions in determining the nature and extent of
inequalities. Indeed, political, social, legal and other institutions can be
critically significant in making good use even of the market mechanism
itself - in extending its reach and in facilitating its equitable use. Their
overwheItm importance arc relevant both for disparities between nations
and fox' inequalities within nations.
Distributional questions are far more complex and far-reaching than the
recoanition mat they typically get in the usual advocacy of globalization
and rhe championing of high rates of economic growth. Consider the on going
o.rg
12/17/02 2:02 PM
TA-E.wliaiigei. PHA-ExchangexXmartaya Szn on Globalization
debasefought
which < f
nar r ow ground.
It is obvious enough that economic growth can be extremely helpful in
removing noverrv. This is so bor.'n because the poor can directly share in the
increased wealth and income generated by economic growth, and also because
the overall Increase in national prosperity can help in the financing of
public services (including health care and education), which in turn can be
particularly useful for the poor and the deprived.
And yet the removal o~ poverty and deprivation cannot be seen to be an
automatic result of economic growth. The basic problem concerns not merely
the obvious point that it must make a difference how the new incomes
generated are distributed among the different classes.
But more fundamentally*, we nave to recognise tnat deprivation with which we
hsv= reasons ~o b<= ernrerrorf Is *^ot just the absolute lowness of income, but
different buz interrelated "unfreedoms," including the prevalence of
preventable illness, needless hunger, premature mortality, unceasing
illiteracv social exclusion, economic insecuritv and the denial of
political liberty, me income goino to the ooor is only one oetermining
influence azr.ong many otners in dealing with deprivation.
^^Institutional Bases of Participation and Security
A second issue concerns the process through which income is earned a^
economic growth occurs. The ability of the poor to participate in economic
growth depends on a variety of enabling social conditions. It is hard to
parti cipar.e in the expansionary process of rhe marker mechanism (especially
in a world o f global ■ z od t^ado^ i
one is iilit^r^tc and unschooled or if
one is bothered by undex'nouxishmerit and ill health, ox* if axtificial
barriers such as discrimination related to race or gender or social
background, exclude substantial parts of humanity from fair economic
participation.
Similarly, if one has no capital (not even a tiny plot of land in the
absence of land reform), and no access to microcredit (without the security
of collateral ownership), it is not easy for a person to show much economic
in ths market economy.
The benefits of the market economy can indeed be momentous, as the champions
of the market system rightly argue. But then the non-market arrangements for
the sharing of education, epidemiology, land reform, micro-credit
facilities, appropriate legal protections, '.".’omen's rights and other means of
emutow’erment must also be seen to be important — even as ways of spreading
access to rhe market economy (issues in which many market advocates take
astonishingly little interest).
Indeed manv advocates of the market economy don't seem to take the market
sufficiently seriously, because if they did, they would pay more attention
to snreadina the virtues of market-based opportunities co all. In the
absence of advancing these enabling conditions for widespread participation
in r.ns marker. economy, the advocacy of the marker, system end up being mere
conservatism, rather than supporting the promotion of market opportunities
as widely as possible. Institutional broadening needed for efficient access
to the market economy is no less important for the success of the market
economy than the removal of barriers to trade.
A third issue concerns the recognition that the fruits of economic growth
may not automatically expand the important social services; there is an
inescapable political process involved here. Decisions have to emerge at the
social and political level about the uses to which the newly generated
resources can bo pur.
5 of 9
^HA-Exchange> PHA-F.\'diari2e>.Ajiiartava Sen on Globalization
12/17/02 2:02 PM
- he route
■*-^dieted" advancement nay be full of promise and
favourable pr.-.su-ects for living conditions and freedoms of human beings, but
political and social stens have to be taken to realise that promise,
and to
secure those prospects.
For example, South Korea did much bettor than, say, Brazil (which too grow
very fast for many decades’, in channelling resources Lo education and health
tare, one this greatly helped South Korea to achieve participatory economic
growth and to raise the quality of life of its people.
On the ether hand, South Korea, too, continued to neglect arrangements for
social security and for safety nets needed to prevent destitution, thereby
remaining vulnerable to downside risks. It had to pay heavily, as a result
of this lacuna, when the Asian economic crisis of 1997 came. This was also
Lhs liin.'S' whsn ths voles that democracy givos to tho poor was tost inisssd,
and democracy os earns a major1 political cause m South Korea.
We need provisions for "downturn with security" as well as "growth with
equity," and also have to recognise the need for democracy for the provision
of political incentives (in addition to the intrinsic iiu^ozrtance of
democratic ricn~s' . The niarket economy inay be highly productive, but it
cannot substitute for other important institutions.
international Asymmetries and Institutions
^development of appropriate non-market institutions is important also for
tacklmcr inequalities between nations. The need for a crlobal commitment
democracy and to participatory governance can hardly be overstressed.
Contrary to an of r.en-repea red claim, there is no basic conflict between
promoting economic growth and supporting democracies and social rights, and
in fact democratic freedoms and social opportunities can contribute
substantial!v to economic development.
However, as George Soros has pointed out, international business concerns
often have a strong preference for working in orderly and highly organized
autocracies rather than in activist and less regimented democracies, and
this can be a regressive influence on equitable development.
Further, multinational firms can also exert their influence on the
priorities of public expenditure in less secure third-world countries in the
direction of giving preference to the safety and convenience of the
managerial classes ana of privileged workers over the removal of widespread
illiteracy, medical deprivation and other adversities of the underdoes of
society.
^Plhese possibilities do not, of course, impose any insurmountable barrier co
development, but it is important that the surmountable barriers be diagnosed
and actually be surmounted.
Aside from the impact or asymmetries in global economic power, the
distribution of the benefits of international interactions depends also on a
variety of global social arrangements, including trade agreements, patent
laws, medical initiatives, educational exchanges,
facilities for
technological dissemination, ecological and environmental restraints, and
fair Lrealnienl of accumulated debts (often incurred by irresponsible
military rulers of the past who were in many cases encouraged by one side or
the other in trie Cold War which was particularly active over Africa).
These issues urgently need global attention. Sc docs the issue of the
management of conflicts, local wars and global spending on armament (often
encouraged bv arms-selling rich countries). For example, as the Human
Development Report 199*1 of trie United Nations Development Programme pointed
out, not only were the top five arms-exporting countries in the world
precisely the five permanent members of the Security Council of the United
6 of 9
12/17/02 2:02 PM
n
PHA-Exdiange>Amartava Sen on Globalization
-■s-ions, but also they were, together, responsible for 86 per cent of all
' f'.e conventional weapons exported during the period studied. It is not
Attticult to understand why the Security Council has done so little to curb
and restrain the merchants of death.
Ethical Challenges and the Future Confrontations
it happens, the international economic, financial and political
architecture of the world, which we have inherited from the past (including
institutions such as the World Bank, the
and other institutions),
was largely set un in the 1940s, following the Bretton Woods Conference in
1944. ~he main challenge at that, time was to respond to what, were then seen
as the big problems of the post-war world.
in the middle 1940s, the bulk of Asia and Africa was still under imperialist
dominance of one kind or another, and was hardly in a position to challenge
the institutional divisions of power and authority that the allied powers
imposed on the world. Tolerance of economic insecurity and of poverty was
much greater then than it is today; the idea of human rights was still very
weak; the power of NGOs had not emerged yet; and democracy was definitely
not seen as a global entitlement.
,
The world is a very different place now from what it was then. The force of
global protests partly reflects a new mood and a fresh inclination to
challenge the world establishment, and it is, to a great extent, the global
equivalent of the within-nation protests associated with labour movements
and political radicalism.
Indeed, the recent outbursts of global doubts have something in common with
the spirit of an old American song - a defiant verse traced to the groat
Leadbelly:
In the home of the brave, land of the free,
I will not be put down by no bourgeoisie.
Tn fact, of course, radicalism was not really as powerful in America then as
the song suggests, but the determined spirit which it reflected contributed,
over Lime, to many practical changes, and even ultimately to the power of
organized labour about which so many industrialists complain so much today.
To some extent, there is a parallel here with global protest movements: they
^Bare not particularly powerful yet in organizational terms, but they are, to
a great extent, an intimation of things to come. Since the questions they
raise are real, adequate answers have to be sought, no matter how
unpolished, crude and breathless the protesters may look to the world
establishment.
There is a need for change. The world of Bretton Woods is definitely not the
world of today, and there is a strong case for far-reaching re-examination
of the institutional structure of the international world. Indeed, I do not
believe that the constructive possibilities of protest movements can be
harnessed, nor their destructive presence removed, without some kind of a
cisariy characterized institutional response.
To some extent, this lias begun to occur in the form of changing priorities
within international institutions. For example, even though the removal of
poverty~and*deprivation was not the major object of the Bretton Woods
resolutions, it has now become, at least formally,
principal goal of the World Bank.
the acknowledged
There is more rethinking on the burden of debts or poor countries, and also
on the older IMF-World Banx practice of imposing grossly formulated
"structural reforms" on poor countries often with damaging consequences on
social infrastructure. These are good directions for change, but much more
of 9
12/17/02 2.07 PM
a fc.whanse> PHA-Exchange>Amartaya Sen on Globalization
nssdsci ssc-?ci32.1 v in “sxtj.s of institutions! construction (for
tnrr■.j.l s■£111'/Io’ up d’sciicsted agencies to desl with olobsl eouity
environment;.
.'Jm , ft welcoming what is happening already in the established institutional
structure (such as the florid Bank), there has to be a clearer recognition of
one need lor a larger- departure from the International architecture
inherited from the Bretten Woods.
-he United Nations, including the Secretary-General's Office, can play a
much bigger part in forcing attention on these broader institutional, as
weii as policy, concerns, particularly if the u.N. is liberated from the
penury in which it has been typically kept by inadequate financial
provisions and by the refusal of some member countries to pay their dues.
These issues need urgent attention, and doubts provide a better starting
Point than compiacencv.
ude, there is a compelling need in the contemporary world to ask
s not only about the economics and politics of globalization, but
ur rhe values and ethics that shape our conception of the global
t as particularly important not to be overwhelmed by the mixture of
optimism and senseless pessimism that leads to global resignation
We have to think not only about the moral commitments of a global ethics,
but arsp about the practical need for extending the institutional provisions
in the world, and also of expanding enabling social
institution within each
country. It is particularly important to take note of the complementarity
oelween difrereni. institutions, including the market, but also democratic
systems, social opportunities, political liberties, and other institutional
features - old and new.
And newer institutional departures will be needed both to address the
substantive issues raised by global doubts, and to halt the cycle of
non-communication in which the pretest movements have increasingly tended to
confine themselves.
The global’protests of activists across the world can indeed play an
importantly constructive role. However, in order for that to happen, we have
to assess these movements and challenges in terms of the global questions
they pose, rather than for the apparently anti-globalization answers chat
their slogans offer. Indeed, the anti-globalization protests are themselves
part oz the general process of globalization, from which there is no escape
But while we have reason enough to support globalization in the best sense
cf that idea, there are also critically important ethical and practical
issues that need to be addressed at the same time. We need global ethics as
~ 2s global doubts. What we do not need is global complacency in the
iniquitous world of massive comfort and extreme misery in which we live. We
can
ana must - do better than that.
Amartva Sen is Nobel Laureate in Economics (1598) and Master at Trinity
College, Cambridge. This article was adapted from comments he gave at a
seminar on globalization arranged by the Falcone Foundation, in memory of
Antonio Falcone, on 23 Hay, 2001.
8 of?
PHA-Exchange> PHA-Exdim^AiBartaya Sea on Globalization
12/17/02 2:07 PM
~sr r an cr
ent '.<i~h: Yale Center for the Study of Globalization
You may be missing other accompanying blurbs, related stories, graphics
Link to this story as it appears on the site
It’s Right To Rebel
PHA-Exchange is hosted on Kabissa - Space for change in Africa
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9 of 9
12/17/02 2:07 PM
' PHA-Exc’ian2e> O?cford professor invents sclf-fbcusii^ j^issses
Subject: PHA-Exchange> Oxford professor invents self-focusing glasses
Date: Tue. 17 Dec 2002 12:04:43 -0700
From: "Aviva" <axiva@netnam.vn>
To: "pha-cxch" <pha-cxchange@kabissa.org>
CC: <coiiiniuHitx/-health-l^wv\rw.nishi.or<y^>
> Oxford professor invents seif-focusing glasses
> By Meg Kociemba and Jonathan Thompson
> lb December 2002
> Source: Independent U.K.
> http: //news. independen t. co. uk/uk/heal th/story. jsp?story=361 710
> An Oxford physics professor is selling 10 million pairs of rcvclub- tionary new spectacj.es to Africa which enable the users to wear them
> for a lifetime without ever going to an optician.
> The glasses could help the billion people around the world who are
> deprived of spectacles but suffer from long or near sight. Joshua
Silver's simple invention could in theory help to eradicate adult ilh't~r/=ri.
7n
-----------------j. : —
n'-atza
7 .'-in
7 nrr
rr.nn r r i a—q —
---------------.--------------------------
I
>
’
> Professor Silver's "adaptive glasses” look like ordinary ones except
> for the two knobs on either side of the frame that can adjust the
> curvature at the lens. It means that in countries where opticians are
> scarce, wearers can simply alter the focus as their eyesight deteriorates over time.
■
i
> Uncorrected poor vision is considered among the most serious problems
> in the developing world, holding back economies by forcing educated
> classes to retire early with failing eyesight. The World Health Or~
> ganisation (WHO) estimates one billion people worldwide need but do
> not have access to spectacles.
•
1
•
> The lenses are filled with silicon oil, controlled via a small pump
>■ on the frame. This alters the curvature of the lens, allowing the
> wearer to see clearly with ths simple turn of a knob. Through a deal
"> t.hrh th° WHO and the World Bank/ Prof Silver plans to sell up to
> 400/000 adaptive glasses in Ghana witn another deal for 9.3 million
> paiis in South Africa also in the pipeline. The glasses are sold at
> about GBP 6 through his company Adaptive hyecare, based in Oxford/
> http: //www. adaptive-eyecare, com/technology. him but cost less than
> that to make. With just 50 opticians in Ghana out of a population of
> almost 20 million, glasses that last a lifetime will prove a boon.
1
>
•
1
> "It would take on average about 200 years to be seen by an optome> trist in Gnanaf " explained Prof Silver. "But adaptive glasses obviate
> the need for a trip at all."
i
> technicrue of using liefuid in lenses dates back to the 10th century.
1
> "When I first started working with variable power lenses, it was sim> Ply to see it they could be made,." he said. "Then 1 realised that it
> I 'could build something with the potential to help millions of peo> pl^ 1 ought to just go out and give 1l a go.
> The professor began work on his invention 17 years ago
although the
1
1
I
1
I
Uofl
PHA-Exchanae Is hosted on Kabissa - Space for change in Africa
To post, write to: pnA-Excnangeiiicabissa.org
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12/18/02 11:36 AM
,II.A.-Excliaiige> U.S. Easts Drug-Patent Rules
Subject: PHA-Exchange> U.S. Eases Drug-Patent Rules
Date: Wed, 25 Dec 2002 17:23:25 +0700
From: "Aviva" <aviva@_netnani.vn>
To: "pha-cxch" <pha-cxchangc@kabissa.org>
CO: "afro-nets" <afro-nets@usaiealthnet.org>, <community-health-l@www.msh.org>
US EASES DRUG-PATENT RULES
Wall Street Journal
(12.23.02)
:Michael M. Phillips
The Bush administration scrambled to undo the public relations damage caused
when it blocked an international agreement to allow developing countries
easier access to generic versions of prescription drugs to coitibat AIDS,
malaria, cholera and other infectious diseases. Just hours after World Trade
Organization talks in Geneva broke down Late Fridav, us Trade Representative
ITobcft~^blTick announced that the United States would temporarily allow
nations uo override American drug company parents and export inexpensive,
generic versions of brand-name pharmaceuticals to help African and other
iravir
r>2 *• i z~>t> q
•
j
r - ------------------LIS trade officials had been working on the backup plan during the last week
negotiations, as it became apparent that Washington might soon find
itself m the position of being the sole obstacle to an agreement seen bv
many as a humanitarian imperative.
WTO members agreed in November 2001 that poor countries should, under
international rules, he able to produce their own generics to deal with
public health emergencies, without permission from the companies that hold
the patents. Many poor nations, however, argued they did not have the
industrial capacity to produce quality drugs, and asked that they be allowed
to import generics. WTO members pledged to resolve that issue bv the end of
The talks collapsed, however, over the issue of which diseases would be
eligible ror patent exemptions. Major developing nations, such as Brazil and
India, said drugs for a vast array of diseases, including cancer, heart
disease and asthma, should be covered by the exemptions. The United States,
pressed by the pharmaceutical industry, wanned to limit the list to
infectious diseases such as AIDS and tuberculosis.
Pharmaceutical companies warned that broader exemptions would cut profits to
such a degree that they would reduce their research into new drugs.
US plan - essentially a unilateral implementation of the American
negotiating position ~ will be m place until an agreement is reached, said
Zoellick. WTO members agreed to reconvene next year and try to reach a deal
by r'eo. 11.
TV I gMF —>>
PI -kF) £ yc h
PHA-Exchongo is hosted on Kabissa - Space for change in Africa
Topost, write to: FHA-Exchange@kabi33a.org
Website: http: z'/'www. lists■ kabissa.org/inailman/listinfo/pha-exchange
-<J
»'
i
,]w
1
12/28/02 11:37 AM
<e: Amartya Sen's piece (2)
Subject: Re: Amarty a Sen's piece (2)
Date: Wed, 25 Dec 2002 18:21:15 +0700
From: "Aviva" <aviva@netnam.vn>
To: "Ravi” <s(Khara@vsnl.com>
CC: <lmartin@uwc.ac.za>, "Maria Hamlin Zuniga" <iphc@cablenet.com.ni>,
<nadineg@ipas.org.mx>3 "niohan" <mohanrao@bo1.net.in>
--------- Original Message --------From: "HealthWrights" <healthwrights@igc.org >
To: "Aviva” <aviva@net.nam.vn>
Sent: Wednesday, December 18, 2002 10:26 AM
Subject: Re: PHA-Exchange> Amartya Sen’s piece (2)
> D°ar Claudio,
> Dr. Sen's piece, because it appears toothless to us radicals and takes
more
> of a mainstream middle ground, is far more powerful (and palatable) in
b> terms of reaching mainstream decision makers, as well as the politically
> undetermined, than is a lot of our more stident "preaching to the choir."
> If we want to reach a wider audience and win more people to our position,
> strategically we can learn a lot from Sen. There are a lot of people who
> will listen to his moderate rebelousness who will simple write off the
> delightfully iconoclastic writings of Arundrathl Hoy (which 1 love). both
> play an important role.
> Best wishes,
> David
> At 11:59 AM 12/17/2002 +0700, you wrote:
> >Dear pha-exchangers,
b- >Am I alone in finding this piece by Dr Sen
general and toothless? I
think
> >our People's Charter does better.
> >1 can agree with him that street protests have to go beyond mere slogans
and
> >have to build substance around them. There are many groups doing that;
ours
> >among them.
> >What do you think?
> >C1audio
> >(your modertor)
> >PHA-Exchange is hosted on Kabissa - Space for change in Africa
> >To post, write to: PHA-Exchanqe@kabissa.orq
> >Webs i fie: hr. fip://www. 1 isr.s. ka'nissa. orq/ma 1 lman/11 st.i nfo/pha-exchange
of]
12/26/02 1:58 PM
M Amartya Sen's piece (2')
Subject: Re: Amarty a Sen's piece (2)
Date: Wed, 25 Dec 2002 18:24:07 +0700
From: "Aviva" <aviva@netnam.vn>
To: "Ravi" <sochara@vsnl.com>
CC: <lmartin@uwc.ac.za>, <healthwrights@igc.org>, "mohan" <mohanrao@bol.net.in>,
"Maria Hamlin Zuniga" <iphc@cab1enet.com.ni>, <nadineg@ipas.org.mx>
---------- Original Message --------From: "Ipshita" <ipsita@bol.net.in>
To: "Aviva" <aviva@netnam.vn>
Cc: "pha” <pha-ncc@yahoogroups.com>
Sent: Wednesday, November 27, 2002 12:36 PM
Subject: Re: PHA-Exchange> Amartya Sen's piece (2)
> Dear Dr Claudio
> I am fully in agreement with you on your assessment of Amartya Sen's
> lecture. This is not the first time that he has presented such half baked
> ideas. His lecture to the World Health Assembly after he got the Nobel
Prize
.> is an example of confused and self contradictory thinking which is
"> comulflaged in pseudo-radical rhetoric. Sen perfectly meets the needs of
the
> wafer-thin rich of the world, who consume more than four-fifths of the
world
> resources. That is why he is so much in demand in the right quarters.
> Thanks for your crying our. that the emperor has no clothes.
> Regards,
> Sincerely yours,
> D Banerji, New Delhi
> ---- Original Message ---> From: Aviva <aviva@netnam. vn>
> To: pha exch <pha exchange@kabissu.org>
> Sent: Tuesday, December 17, 2002 10:29 AM
> Subject: PHA-Exchange> Amartya Sen's piece (2)
> > Dear pha exchangers,
> > Am 1 alone in finding this piece by Dr Sen
> > Claudio
Jfl
general and toothless?
12/26/02 2:02 PM
•■lA-Exchango More Than Words to Fi
Subject: PHA-Exchange> More Than Words to Fight AIDS
Date: Fri, 27 Dec 2002 12:10:05 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch” <pha-exchange@kabissa.org>
CC: "afro-nets" <afro-nets@usa.healthnet.org>, <coinmunity-health-l@www.msh.org>
16
2002
Earlier wins month Colin Powsll and. Tommy Thompson paohoi'cd xspxoson'c.a'civcs
from So countries to lecture them on the importance of political leadership
in righting .AIDS. Make AIDS a global priority, said Secretary or State
Powell. Invest in global health, implored Health Secretary Thompson. Their
message was important and well timed - but should have been directed at
Washington.
The administration is not blind to the catastrophe. The president and his
ton officials speak about AIDS in the most apocalyptic terms, and Mr. Powell
called the disease a more important challenge than terrorism. But when it
comes to financing, urgency vanishes. Mr. Bush is likely to visit Atrica
next month. He should be currying with him an AIDS initiative backed with
I real money.
The Global Fund to Fight AIDS Tuberculosis end Malaria hes ^ust stsrted to
give out its first grants and is already broke. As Washington and other
donors demanded, the fund has designed a rigorous process and has received
dozens of well-designed proposals to fight disease. But it must now tell
countries there is no money to finance them. The administration makes much
of the fact that the United States, which has pledged $500 million over two
years, is the largest donor. But when measured by the size of the economy,
it is actually giving half as much as Europe. Washington's contribution
needs to be $2.5 billion a vear to make a difference.
The administration's showpiece program on AIDS this year was an initiative
to combat the transmission of the disease from mothers to babies. That has
only served to undercut a better proposal within Congress. Mr. Bush's plan
superseded a Senate proposal, backed by Jesse Helms, that would have spent
S500 million on these programs. Then the president vetoed the appropriation
containing the first year's payment. Politicians lament the tragedy of
babies with AIDS, but their concern has so far produced not a cent of new
money. And shamefully, on the last day of the Congressional session, Senate
Republicans kinec a bill agreed on unanimously m the House and Senate that
would have provided S4 billion over two years Lo light global AIDS.
Administration officials and members of Congress argue that there are other
things to spend money on. None are more urgent. The Central Intelligence
Agency is warning that AIDS in China, India and Russia, as weil as in
Africa, is a mounting security threat for the United States. AIDS is already
destabilizing .Africa. It is a major cause of a hunger crisis now affecting
30 million Africans. The world, and the United States, cannot afford to let
Mr. Busi; go Lo Africa wiLhoul a real plan lo pul cash behind Lhe
administration's statements on AIDS. American officials should not be giving
anyone lectures while Washington's response to the major catastrophe of our
time remains limited largely to words.
Copyright © The New York Times
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ofl
12,30/02 2.04 PM
PHA-] .xchange> UNESCAP Plan ofAction - US alone on the opposite side
Subject: PHA-Exehange> UNESOAP Plan of Action - US alone on the opposite side
Date: Wed. 25 Dec 2002 18:16:16 -t-0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-cxch" <pha-cxchangc@kabissa.org>
: * * afro-nets'' ^Bfro-ne is fizjusa.he nlthnet or cP*, om mn n i !i c a! th -1 (g).ww\v jbsIi org^
Sent ‘ Wecmesdev
December 18
2002 8:16 PM
PleaSc ROue
Chat the most recent UNESCAP's Plan of Action "as approved aims
to fight poverty throughout the world by focusing on 12 areas, including
-t-ami i y plerniinc*,
qnnriar arm a i i +* v
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MTV /
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nrotranbiQn
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r TC4£T*Tr[G.'n+-”
T'no
US io the only country reject the plan. But what really
aiiiazGcl the world is that other countries could hold together and to be so
strong to oppose the US in this marter.
ALL PARTICIPANTS EXCEPT UNITED STATES REAFFIRM FAMILY PLANNING, HIV/AIDS
PREVENTION LANGUAGE TN BANGKOK CONFERENCE PLAN OF ACTION
Access this story and related links online:
b http://w^»7w.kaisernetwork.org/*daily reports/rep index.cfni?DR ID—15148
The Fifth -Asian and Pacific Population Conference ended yesterday in
Bangkok, Thailand, with the reaffirmation of a 1994 international family
planning and population agreement by all of the participating countries.
except the 77rv‘f.eo. States, which continued to oppose language in the
conference's Plan of A_ct2.cn, the Jakarta Post reports (YuLiandini, Jakarta
Poor, 12/18).
The Bush administration has said that portions of the Program
of Action adopted at the 1554 International Conference of Population and
Development in Cairo, Egypt — specifically the phrases "reproductive health
services” and “reproductive rights” — promote abortion (Dao, New York
Timos, 12/18).
The U.S. delegation previously said it would not "reaffirm”
provisions from past agreements on reproductive health and family planning
and instead would only "take note of, acknowledge, or recall" the
commitments agreed to at previous conferences, including the Cairo meeting
(Kaiser Daily Reproductive Health Report, 12/17).
Conference attendees
yesterday rejected the U.S. delegation's proposed changes to the draft in
two votes of 31-1 and 32-1, the New York Times reports (New York Times,
12/18).
The action was “virtually unorocedontad" for a United Nations
meeting, which generally operate on consensus.
The United States, which
abandoned its "demand for extensive amendements" and called tor the vote.
.registered the only opposing vole, Agence France-Bresse reports (Agenoe
lyrance—Bresse, 12/17) .
The plan as approved aims to fight poverty
throughout the world by focusing on 12 areas, including family planning,
gender eguality and HIV/AIDS prevention and treatment, the AF/Fort
Lauderdale Sun-Sentinel reports.
The approved 22-page Plan of Action also
calls for "consistent condom use," a pnrase the U.S. delegation had asked to
be removed, to help reduce the spread of HIV infection.
The document states
that population policies "must encompass the principle of voluntary and
informed decision making and choices, .the preservation and protection of
human rights, including the matters related to reproductive rights and
reproductive health services" (Joshi, AP/Fort Lauderdale Sun-Sontinol,
12/18) .
The conference outcome "shows that the countries [participating! have acted
iiideuendentl v
looking al their own laws and sovereignly and abiding by
ttair m.m nrlnr-i t-jos " united Nations Population Fund Executive Director
Thera”"' ow-'d said.
She added, "Even though the U.S. was the only
dissenting voice in the meeting it did join tue consensus au me end."
Assistant Secretary of Stale Eugene Dewey, the U.S. conference delegate,
said, "There should be no inference drawn from the tact that everyone else
seems to be very happy with the language — and the U.S. is trying to
improve the language in some cases — that we have a great gulf between us
and Lite oilier representatives here who share the objectives that we share"
(Acjence “'rarirp-wrcss?, 12/17) .
’rhe U.S. deleterion lodged a. reservation.
^,-23-02 Jh30AIv{
A-Exchanee> UNESCAP Plan of Action - US alone on the opposite side
wttn the Plan ox Action, saying it was "deeply disappointed, " according to
the South China Morning Post.
"Our proposals wore rejected without any
serious attempt to bridge the gulf through normal compromises ... these
matters reach into the heart of the very nature of life itself," it said
(Fngiane, South China Morning Post, 12/18).
Terri Bartlett, vice president
of Population Action International, said, "Delegations came here prepared to
strengthen language in the Flan of Action on areas of joint concern — from
women's rights, HIV/AIDS, migration and most of all, the elimination of
poverty.
Instead they were met with roadblock after roadblock erected bv
the U.S. delegation in its singular determination to export a domestic
pol-tical agenda to a region chouoando Oi miles awav." She added, "At the
°nd of five ... days, the U.S. delegation then expressed its reservation
about the weakness or the document on several kew issues vjhile
in realit'7
NPP.’s "All Things Considered" yesterday reported on the conclusion of the
conference.
The segment includes comments from Francoiso Girard of the
International Women’s Health Coalition and Lalaine Viado of me Netwerk or
Asia Pacific Youth (Wilson, "All Things Con.-.-ie.x seament is available m
------ _ - - ... pcs.,
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c.. _. .1 • s sa — ou _-.ee x or change in Africa
> i---- xcnai.g^t <aci ssa .org
v:: :;„iscs. kabissa. org/mai Iman/list into/pha-ey.change
12/28/02 11:30 AM
..v<_uange> Food for thought for an agenda in the new year
Subject: PHA-Exchange> Food for thought for an agenda in the new year
Date: Wed, 1 Jan 2003 16:08:00 +0700
From: "Aviva" <aviva@nctnani.Wi>
To: "jamie" <jamie@netnam.vn>
Human Rights Reader 33 (re-started after a long silence and a 2003 new
year's resolution).
Human Rights arc very much on the agenda of development work:
"The sovereignty of States must no longer be used as a shield for gross
violations or Human Rights".
(Kofi Anan, Nobel lecture, Dec 2001).
1. Betting on the invisible hand of the market and ignoring the needs and
rights of the socially excluded is just dangerous and morally unacceptable.
2. It is therefore that the macroeconomic policies insisted-on by the IMF do
not simply have a negative social impact,' their design embodies a profoundly
unjust social content giving the financial rights of creditors priority over
Human Rights or the people; the IMF chooses to prioritize the interests or
fche creditors.
3. Rights can be usefully seen as the codification of needs. Reformulating
needs as ethical and legal norms implies a duty on the part of those with
the newer to provide all the means necessary to make sure those needs are
4. Without Political and Civil Rights, there is no guarantee that other
rights
—even when they are inscribed in laws and constitutions— will
be made effective; the lack of citizens' power to make governments
accountable and responsible to them is perhaps the greatest obstacle to all
ricilits—bsssd agsndss.
5. But d6in.ocj?auxc elections (siiGgsdly giving citizens oif—end-on, periodic
power) do neither guarantee state responses to collective needs, nor the
participation or civix society in decision-makdng, nor, ror that matter,
guarantee greater social and political accountability.
6. On the other hand, claims are sometimes wrongfully made that universal
riab.ts are a form of Western hegemony; the caveat in this assertion is that
a richt is a rioht only when it is universal; otherwise it is a privilege.
r7. There is also the wrong belief that Lhe Human. Rights approach is
’political’ while the humanitarian approach is not...and is therefore ’safe’
; others phrase the same groundless fear saying that applying the Human
Rights approach compromises one's 'neutrality'.
8. The reality is that any legal Human Rights system (including
humanitarianism) is indeed (and must be) related to political theory and
social values.
y. Nevertheless, let us not forget, international Human Rights Law only
recognizes the obligations and duties of States (!) . To cover the entire web
of interrelated Human Rights violations, there is indeed a need to extend
the same obligations and duties to other subjects at sub-national level.
10. This because Human Rights obligations are closely linked to a
multi-layered system of accountabilities. For a duty bearer to be
accountable.
three conditions axe needed.
-the person must accept the responsibi .ity and obligation to uphold Human
Rights ('should act');
-the person must have the authority to act ('may act'); and
-the cersori must control the resources needed to act ('can act').
Resoonsibil it'//authority./resources are necessary components of a capacity to
act. Often lack of action is due tc a lack of capacity rather than
negligence" or ill-will. It, therefore, behooves us to identify capacity gaps
HA-Exchange> Food for thought for an agenda in the new war
of a-11 dutv b^^’-er^' wb.“r° dutv bearers are intentionally violating rights,
different types cf~"interventions will be required os lack of capacity is
not the problem.
Taken from: UNRiSD News,
CARE’S
' Promoting Rights and Responsibilities'
Newsletter and SCN News (Jonsson, Levine and Young, ’’’he Rioht to Nutrition
in Conflict Situation^'
>.e
co c-egin —...<mg _n human rights terms; we have to bring HR to a
lever or everyday impertinent consciousness; collect and share these
segments.
To post, 'write to: r.-!?.- Exchange iBkctbissa. org
W e b s i t e: http: //www. lists. kabissa. org/mailman/listinfo/pha-exchange
Zof 2
1/3/03 9;55 AM
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l. S '03 11:55 AM
FindiMrael 2003 SEAM Conference
Subject: lindia-drug] 2903 SEAM Conference
Date: Wed, S Jan 2003 05:20:35 -0500 (ESI )
From: "Dr. Leela McCullough" <!eela@usa.healthnet.org>
Reply-To: india-drug@usa.healthnet.org
To: india-drug@usa.healthnet.org
2003 SEAM Conference: Targeting Improved Access to Essential Medicines
Dar es Salaam. United Republic of Tanzania
June 16 18, 2003
The 2003 Conference for the Strategies for Enhancing Access to
Medicines (SEAM) Program will be held in Dar es Salaam, United Republic
of Tanzania, June 16—18, 2003. Funded by the Bill & Melinda Gates
Foundation and presented m collaboration with the Ministry of Health
of the united Republic of Tanzania, the World Health Organizations
Department of Essential Drugs and Medicines Policy, the Rockefeller
^Foundation, the International Network for Rational Use of Drugs, and
Mslihcgiiiszt_ Scisncss foz? Hsslthi HcLtioxicil PliHz?in.a.c©Litical ManacjGir.sn't Plus
rroQzaiu {f unci cd
iJSAxD) f tire 2003 ConxGZGnce will serve as a xoruiii
for discussion of a wide range of pnarmaceuti ca 1 s-re'i area i nr.erventi on
strategics that arc of concern to developing nations. The conference
will also provide the opportunity to share information about Lhe
activities of the SEAM Program, which focus on enhancing access to
essential medicines through collaboration between the private and
public sectors.
The conference will feature plenary and parallel track presentations on
six major topics, followed by roundtable discussion groups for each
topic.
Poster presentations will provide the opportunity for conference
participants to share information about their initiatives, research,
and experience. Parallel topic tracks will include
* Pharmaceutical product prices, including country-level
determinants, dynamics, monitoring, and policy
* Pharmaceutical procurement, including national and cross-national
(^Le. toe.
c
&
pooled procurement strategics
* Pharmaceutical product quality assurance, focusing on strategies
for resource-limited settings, including prequalification of products
and suppliers and the role of identification (screening) tests and
52r’n?-COT?o<?2.?.l uionogzapli izesizing
* Pharmaceutical distribution systems, focusing on strategies for
ensuring access to essential medicines in rural and peri-urban areas
* Rational use of medicines, including information access, product
selection, and appropriate prescribing and patient use
* Human resources for the pharmaceutical sector, including new
approaches to staffing and training in health product supply management
Although the majority of participants will attend the conference by
invitation, a number of open registration slots will be available on a
first-come, first-served basis. Individuals interested in attending
should submit a registration request as early as possible. All
registration requests will be placed, in the order received, on the
Conference priority list. For further information about the
registration process, please visit the SEAM Web site
(<http://www.msh.org/soaBiXwww.msh.org/seam) after January 10, 2003.
Information on abstract submissions for poster presentations will also
1/9/03 12:08 PM
india-drug] 2003 SEAM Conference
be^available on the SEAM Web site after January 10. Individuals
interested in submitting poster abstracts for consideration by the
tzss should plsn Oheir submissions around ono of tho six
lioceu aboVG alid be picpaicu to SUblTilu an abstlaCt by' F’ebxUar'y
/003.
For further information on the conference, please contact John Vivalo
(a I
• -S rr "J vr a •
H
1
Missed your favourite TV serial last night? Try the new, Yahoo! TV.
visit http://in.tv.vahoo.com
The INDIA-DRUG discussion group is a partnership between SA.TELLIFE
(www.healthnet.org), WHO Essential Drugs and Medicines Policy
(www.who.ch), and the Delhi Society for the Promotion of the
Rational Use of Drugs (DSPRUD) in India.
To
To
H.n
To
2oC2
send a message to india-drug, write to: india-drug@usa.healthnet.org
subscribe or unsubscribe, write to: majordomo@usa.healthnet.org
the body of che message type: subscribe india-drug OR unsubscribe india-drug
contact a person, send a message to: india-drug-help@usa.healthnet.org
1/9/03 12:08 PM
’HA'Exchme> Miscellaneous of interest
Subject: PHA-Exchange> Miscellaneous of interest
Date: Tue, 14 Jan 2003 16:11:52 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-cxch" <pha-cxchaagc@kabissa.org >
CC: <dahigren38(a>teiia.com>
From:
EQUINET-NewsletterlSequinetatrica. org
13 JANUARY 2003
WHAT CAN BE DONE ABOUT THE PRIVATE HEALTH SECTOR IN LOW-INCOME COUNTRIES?
http://www.who. int/bulletin/pdt/2002/buL-4-E-2002/00 (4) 325-330.pdt
Improving the quality of private health care provision in developing
countries is of major importance to the livelihoods of poor people.
This article was published in the 'Bulletin of the World Health
Organisation' and summarises how the activities of the private health
sector in low-incomc countries can be influenced so that national
health objectives are met. The article begins with an overview of the
characteristics of the private health sector in developing countries.
It continues with a summary ot hoi-/ to improve both the supply and the
demand for private health care. To close, the authors list the
^possibilities available to governments for improved stewardship of the
"private sector.
DYING FOR CHANGE: FOOR PEOPLES EXPERIENCE OF HEALTH AND ILL-HEALTH
http: //www.worl dbank. org/poverty/voices/reports/dying/index. htm
Poverty and health are closely linked. .As people consider disease and
ill health to be a cause of poverty; they also consider good health of
themselves and of the family breadwinner to be essential for economic
survival and as a route out of poverty. This is one of the findings of
a study produced as part of a collaboration between the World Bank and
the World Health Organisation (WHO). The Voices of the Poor study also
found that poor peoples values, networks and support mechanisms are
being eroded by the strain of increasing poverty and urbanisation. In
addition, poor people olten leel that their voices are excluded or
marginalised when considerations are made for improving public health
and health services.
HEALTH AND PRSPS: AN EARLY EXPERIENCE
http:// www.healthsystemsrc.org/Pdfs/Health PRSPs.pdf
As Poverty Reduction Strategy Papers (PRSPs) have become a prominent
development tool it is important to consider how health is addressed in
|the PH.SP process. This is examined in an issues paper produced on
behalf the UK Department for International Development (DFID) by the
DFID Health Systems Resource Centre (HSRC). The paper aims to provide a
briefina on the PRSP process, discussing their role, the guidance on
PRSP preparation related to health, and reviewing some recent
experience. The PRSP precess has typically been handled at a senior
level and has led to a shift in responsibility for poverty issues to
the Ministry of Finance. This lias improved the potential to link
poverty work to broader resource allocation decisions. However, while
the PRSP process has high principles for country ownership and the
participation of civil society, many civil society organisations (CSOs)
and non-aovernmental organisations (NGOs) are disappointed with the
extent and nature or participation. The paper also stresses that the
health sections of the PRSPs tend to be brief and contain standard
types of statements of policy and strategy but they can have a major
influence on health status and health services.
DO HUMAN RIGHTS HAVE A. ROLE IN PUBLIC HEALTH WORK?
httn“7/wi.r7t i-'eiancet. com/journal/journal ■ isa
Wh^L role do human rights have in public health work? It has been asserted
tnat public health policies must
incorporate human rights norms and standards. Lack of respect for human
rights has hampered development in health care. The underlying assumption is
that in a human
.
. ,
,
rights based approach, individual rights are protected at all costs—even
1/16/03 10:34 AM
PHA-Exchange> Miscellaneous of interest
despite adverse effects on the public's health. Yet a rights-based
approach docs not privilege protection of individual rights over the
public good. This apparent tension must be addressed to enable the
creation of sound public health policies and programmes.
II INTERNATIONAL FORUM FOR THE ADVOCACY OF PEOPLES' HEALTH
Porto Alegre, January 20th - 23rd, 2003
Four hundred participants of the I International Forum for the Advocacy
of Peoples' Health, held in Porto Alegre in January 2002, soon
before the II World Social Forum (WSF), recommended the accomplishment
of a II International Forum for the Advocacy of Peoples' Health
preceding the ITT WSF in January 2003. This will allow a widened
participation ot all those interested, a preparation ot the
contributions on health issues for the III WSF, and, at the same time,
to raise the health theme to a power in the several activities within
the WSF itself. Conclusions of the I International Forum, available
through the link below, summarize the objective and the motivation for
this II Forum, whore wc want to build an International Agenda on the
Defense of the Health Right, as well as to launch the basis for an
international call for the accomplishment of the I World Forum for the
Advocacy ot Health, in Porto Alegre — Brazil, in the tirst semester ot
Further details;
htrp: z’/www. eauineraf rica■org/newsletter/newsletter.php?id=1025
PHA.-Excb.ange is hosted on Kabissa - Space tor change in A.trica
To post, write to: PHA-Exchange@kabissa.org
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Jf2
1/16/03 10:34 AM
Exchango Reproductive Health Outlook 2002-3
Subject: PHA-ExchangO Reproductive Health Outlook 2002-3
Date: Sat IS Jan 2003 12:41:46 -0600
From: "George(s) Lessard" <media@web.net>
Organization: hnp:/7www.mediamentor.ca
To: creative-radio@egroups.com , pha-exchange@kabissa.org
--------------Forwarded message follows---------------Date sent:
Thu, 16 Jan 2003 15:35:26 +0100
From:
mburnsSpath.org
To:
hif-net@who.int
Subject:
[HTF-net at WHO] Reproductive Health
Outlook 2002 3
Greetings,
The Winter 2002/2003 edition of the Reproductive Health Outlook
(RIIO)
website has just been published. In addition to many substantive
Alpdates,
|Lhe new edition introduces the Spanish translation of six topic areas.
bJa
invits you to sxplorG the site and to stare this notice with interested
col 1 eagiies.
Besl regards.
Miche1e Burns
PATH'S Reproductive Health Outlook (RHO): Winter 2002/2003
Edi Lion
The RIIO website (http://www.rho.org) is designed for reproductive
health
program managers and decision-makers working in developing
countries and
low-resource settings. RHO provides up-to-date summaries of
research
findings, program experience, and clinical guidelines related to key
reproductive health topics.
Spanish Edition Now Online
With this site update, the RHO team is pleased to introduce the
Spanish
edition of six topic areas:
*
*
Adolescent Reproductive Health
Cervical Cancer
Contraceptive Methods
’
HTV/ATDS
*
Reproductive Tract Infections
*
Safe Motherhood
To access Spanish RHO directly, please visit
http://www.rhoespanol.org/ ■
Section Updates
Substantive updates have also been made throughout the English
edition.
'pU'Pl
HA-Exchange> Reproductive Health Outlook 2002-3
During the latest update, the following sections have been
expanded:
HIV/AIDS
*
Family Planning Program Tssiies
*
*
Reproductive Tract Infections
Harmful Health Practices
*
*
*
*
Mq
t* H o H
neU aiiu Reproductive Health
Refugee Reproductive Health
Cervical Cancer
Check out the "What’s Mow" page
http;//www. xho.vxg/huul/whalanew .hint
to learn about the many new content areas, program descriptions,
and
resources that have been added to the site.
Available on CD-ROM
The Winter 2002/2003 edition of RHO is also available on CD-ROM
of
^^harge. Find out more at
^Pitrp://www.rho.org/html/cd rom.htm.
Visit RHO at www.rho.org!
We invite you to come and explore the site. Send your comments
and
suggestions to rho@path.org
RHO is ’'reduced b” PATH
http: / /wnvi. path. org
Michele Burns
Publications Officer,
PATH
(HIF-net at WHO profile: Michele Burns is the editor of the
Reproductive
Health Outlook (RHO) website, produced by PATH (Program for
Annrorriafp
Technology in Health), an international NGO based in Seattle, US.
"H0 is
esigned for programme managers and policy makers working in
developing
countries and low-resource settings; the site contains extensive
resources
on 12 reproductive health topics, including adolescent reproductive
health,
HIV/AIDS, cervical cancer, safe motherhood, and family planning.
<mburns@path.org>]
«
[ Via / From / Thanks to
and / or excerpted
from the following :
]
'HIF-nct at WHO*: working together to improve access to reliable
information for healthcare workers and health professionals in
developin'* and transitional countries.
Send list messages to <hifnet@who int> To ioin the list, send an email to <health@inasp.info>
with name, organization, country, and brief description of
nrofessional interests.
1 of 3
■Exchange* Rewoductive Health Outlook 2002-3
1/20/03 12:38 PM
End of forwarded message ------------------
■ —} Message ends, Signature begins (—:
oeorge Lessard, living S 61.1CN 94.05W
Comments should he sent, r.o modi a<<'_no_spam_web.net
[Remove _no_spam_ from addresses to e-mail]
"Only those who will risk, going Loo far can possibly
bind cut hew far one can go." T.S. Eliot...
"If you think you are too small to make a difference,
try sleeping in a closed room with a mosquito..." African Proverb
****************************************
TCQ # 8501081
McdiaMcntor Weblog
http://www.eGroups.com/iist/mediamentor
Homepages http://mediaO'JZ ■ tripod, com
Caveat Lector, Disclaimers & (c) info
http://members,tripod.com/~media002/disclaimer.htm
Semi-random signature quotes follow:
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3of3
1/20/03 12:38 PM
SA~Exchange> UNFPA's State of World Population 2002
Subject: PHA-Exchangc> UNFPA's State of World Population 2002
Bate: Wed, 15 Jan 2003 17:53:22 +0700
From: "Aviva" <aviva@nemam.vn>
To: "pha-exch" <pha-exchange@kabissa.org>
> People, Poverty and possibilities: Making Development Work for the Poor
UNFPA's State of World Population 2002
> December 3, 2002
> Available online at: <http://www. unfpa. org/swp/swpmain.htm>
>
> To reduce poverty in developing countries, urgent action is needed to
combat
> Dortr r'artroriiinr i
> health, help women avoid unwanted pregnancies, and eliminate Illiteracy
and
gender discriminationf
> warns The State of World Population 2002 report from UNFPA, the United
> ”Mb
i- -i nr> -yr>nn7ari^r
k'linri■ ----------x------- --- - ------q
PHA—Exchange is hosted on Kabissa - Space for change in Africa
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PM a) Eye
lofl
—o
1/16/03 11:30 AM
T
COMMUNICATION - El
Dear PHM friend®,
Greetings for the New Year from the PHM Secretariat,that has moved to CHC
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evolution, mat begins in 2003 with me Alma Ata Declaration Anniversary year.
1.
Die opportunity io become the focal jxiint of the new Secretarial in 2003 has been
a great honour and milestone^esnecially since this is our 20“ year,for- CHC. For
those who do not know us — wo arc a smsdl community health resource group — a
society of health professionals and health activists, who, for the last twenty years
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civil societies, and state governments, networks and people's movements. Having
worked closeb' with and throu0^ the medico friend circle the Voluntary Health
Association of India, me Christian Medical Association of India, me Catholic
Health Association of India, the AH India Dnig Action Network, the Asian
Community Health Action Network and the All India People’s Science Network
till 1999, it was our privilege to participate actively in_thcj>rc PHA mobilization
process uiHi miOiiglit together 18x4atioiial Networks^ to l<miich the Health for All
Now campaign. 2500 health professionals and activists came alter 6 months of
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acuvciy nivoiveu in lauiiiuttiiig aii^in is^sincc it was a symiMiiic expression oi inc
ooal we had set ourselves when CHC was initiated in 19R4 — to sunnort
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me People s Health Charter bv convening the WHO-WHA lobby circle and also
by fairing PHMXPHC to a wide range of public health institutions and community'
health groups through meetings and workshops and publications. The highlight of
our involvement in 7007 was the travelling workshop through Norway, Sweden,
Denmark, Netherlands, Germany enroute to the PHM Geneva jStaSnl at WHA
2002 in MayyafiSShc travelling workshops through Kenya, Uganda and Tanzania
enroute to the Global Forum for Health Research — Forum 6 meeting at Arusha,
1 anzama^ffielma and 1 lomed Zaiarullah, David, Mwajuma and Sudarshan m
ensuring a strong PH presence at Forum 6.
The first two weeks haw been hectic at the new Secretariat. Soon after the shift
we siwni a week in Hyderabad attending the Asia Social Forum — a precursor'
event to the World Social Forum in Porto Allegre. later this month. Over 14000
participants from all over India and many parts of Asia gathered for a five day
celebration on the theme ‘Another World is possible! Another Asia is possible!’.
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Two large pienaries (2
th
and 7
January), 8 conferences, 160 seminars, 164
workshops, cultural programmes and film festival; market place and street events
brought together all of us in a great spirit of collectivity and celebration — no
longer as victims of globalisation but as protagonists of alternative development
and alternative policies. The gathering had a large presence of youth, women and
India’s marginalised - both dalits and the adivasis, which was a sign of hope. 1 he
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participated in- the c Right to Health Seminar’d/a^d y^ii the PHMi delegates
participated actively in two workshop faciiiiaied by CHC on behalf of JSA / PHM
entitled ‘Taking the PHM Forward’ and the ‘Alma Ata Anniversary Workshop ~
Looking back, looking ahead'. The highlight of the foiiner workshops from
Bangladesh and India who highlighted the constraints and challenges of primary
OGxnijimiity lovclri
;b signature campaign Health for All was launched
on 5“ January at the Asia Social Forum (separate press release) and on 7“ January
PHM also released a rv?st A ST? nress release entitled"*
All of us returned home with our batteries charged and full of hone and
CnthuSiaSui.
mv
Bangladesh) the outgoing Coordinator and Prem John (ACHAN), members of the
■fimdinrr errmw vxHirx cnpni ** dotr finolicinn th a nl^n nf ortinn hndnAt pgfitnatng and
outer niny griny required io operationalise ail our plans which had been discussed
at the fir«t full core group meeting of PHM at GK Savar frotnl9-2,2“ November
2003. The cote group now rechristened the ‘Steering group’ will continue to
support the Secretariat giving us advise anc^dircction. The next newsbrief will
cany the main decisions and developments in HM relevant to all our members and
contacts. Zafaruilah (Bangladesh) also visited us to discuss various initiatives of
mutual interest for CHC, GK-Savar and PHM.
4. This year is a very special year for PHM since it is the Alma Ata Anniversary year
and the Steering group has decided to use anniversary reflections and events to
reiterate our commitment to Health for All goal all over the world. Next week I
shall send further details about the evolving plans and initiatives - including the
signature campaigns (already launched); the Alma Ata film - reviving the dream;
T
4
the country and regional reflections, the people’s health awars and the position
paper and report on Alma Ata - at the 25th milestone.
This communication was primarily to say hello to all of you/' welcome you an an
active interactive collaboration with the PHM Secretariat./ Do acknolwcdgc this
communication and let us know your ideas and plans and initiatives so that we can
build PHM together and collectively as we enter 2003.
In solidarity,
Ravi Narayan,
Coordinator,
PHM Secretariat,
367 ‘Srinivasa Nilaya’,
Jakkasandra I Main, I Block, Koramangala,
Bangalore - 560 034, India.
Tel: 091-80-553 15 18
Telefax ; 091 - 80 - 552 53 72
Email : sochara@vsnl.com
Website; www.Sochara.org
iA-Exchange> All men cho^
Director.General race
Subject: P11A-Exchange> AU men choices in WHO Director-General race
Date: Wed, 22 Jan 2003 09:37:34 +0700
Erom: "Aviva" <aviva@netnam.vn>
To: "pha-exch" <pha-exchange@kabissa.org>
From:
<johannc.sundby@samfunnsmcd.uio.no>
> h’.HO-DG: Gender ci candidates? As usual, (exception: Gro Harlem
> Brundtland) no women runner ups, or what? So let's at least get a
> women's health friendly one. Challenge them on that issue too; refer
> to Kofi Annan's statement in New York Times!
> Johanne Sundby
PHA-Exchange is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-Exchangc@kabissa.org
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*1 Communication. £;
Subject: PHM Communication - El
JJate: Wed, 22 Jan 2003 17:27:29 +0530
From: Community Health Cell <sochara@vsnl.com>
To: Claudio Schuftan <aviva@netnam.vn>
CC: Qasem Chowdhary <gksavar@citechco.net>, Prem John <hariprem@eth.net>,
PHM Steering group <PHM_Sleemig_Cnoup_02-0.3@yabooyroups.com>
For PHA Exchange
COMMUNICATION - El
Dear PHM friends,
Greetings for the New Year from the PHM Secretariat that has moved to CHC Bangalore, India, from
GK-Savar, Bangladesh, on 1st January 2003. As the next coordinator of the PHM Secretariat, 1 look forward
to an interesting and meaningful partnership with all of you in the next phase of the People’s Health
Movement evolution, that begins in 2003 with the Alma Ata Declaration Anniversary year.
^The opportunity to become the focal point of the new Secretariat in 2003 has been a great honour and
milestone for CHC especially since this is our 20th year. For those who do not know us — we are a
community' health resource group a society' of health professionals and health activists, who, for the last
twenty years have been supporting community health action orientation of voluntary' agencies, civil
societies, and state governments, networks and people’s movements. Having worked closely with and
through the medico friend circle, the Voluntary Health Association of India, the Christian Medical
Association of India, the Catholic Health Association of India, the All India Drug Action Network, the Asian
Community Health Action Network and the All India People’s Science Network till 1999, it was our
privilege to participate actively in the pre PHA mobilization process that brought together 18 National
Networks in India to launch the Health for All Now campaign. 2500 health professionals and activists came
after 6 months of mobilization in four people’s health trams to the first National People’s Health Assembly
al Kolkata to evolve the Indian People’s Health Charter. Then nearly 300 members from PHM India
participated in the PHA at GK Savar. CHC was actively involved in facilitating all this building on our
network of contacts since it was a symbolic expression of the goal we had set ourselves when CHC was
initiated in 1984 to support a people’s health movement.
2. Since PHA. and especially in 2002, CHC has been deeply involved in promoting the People’s Health
Charter by convening the WHO-WHA lobby circle and also by taking PHM/PHC to a wide range of public
health institutions and community health groups through meetings and workshops and publications. The
highlight of our involvement in 2002 was the travelling workshop through Norway, Sweden, Denmark,
Netherlands, Germany enroute to the PHM Geneva input at WHA 2002 in May; and the travelling
workshops through Kenya, Uganda and Tanzania enroute to the Global Forum for Health Research - Forum
6 meeting at Arusha, Tanzania, where Thelma and I joined Zafarullah, David, Mwajuma and Sudarshan in
ensuring, a strong PHM presence al Forum 6.
3. The first two weeks have been hectic at the new Secretariat. Soon after the shift, we spent a week in
Hyderabad attending the Asia Social Forum - a precursor event to the World Social Forum in Porto Allegre,
later this month. Over 14000 participants from all over India and many parts of Asia gathered for a five day
celebration on the theme ’Another World is possible! Another Asia is possible!’.
Two large plenaries (2nd and 7th January'), 8 conferences, 160 seminars, 164 workshops, cultural
programmes and film festival; market place and street events brought together all of us in a great spirit of
collectivity' and celebration no longer as victims of globalization but as protagonists of alternative
development and alternative policies. The gathering had a large presence of youth, women and India’s
marginalised - both dalits and the adivasis, which was a sign of hope. The people’s health movement
contingent consisted of over a 100 people from the Jana Swasthya Abhiyan (PHM India); 19 delegates from
PHM Bangladesh; and a few from Sri Lanka, Philippines and other countries.
if 2
| > Ib
1/22/03 5:27 PM
M Communication - El
PHM participants spoke in the conference on social infrastructure including health; on the people’s panel
for the seminar ‘Environment and Health : A people’s campaign’, participated in the workshop on ‘War,
Conflict and Disaster’ and Disaster Watch; participated in the ‘Right to Health Seminar and in a workshop
on ‘Action towards a tobacco free world’
Al! the PHM delegates participated actively in two workshop facilitated by CHC on behalf of JSA / PHM
entitled - Taking the PHM Forward’ and the ‘Alma Ata Anniversary Workshop - Looking back, looking
ahead’. The hiuhlight of the former workshop was feedback from grassroots workers from Bangladesh and
India who liighiighted the constraints and challenges of primary health care innovation at community level.
The Alma Ata anniversary web signature campaign Health for All was launched on 5th January at the Asia
Social Forum (separate press release) and on 7th January- PHM also released a post ASF press release.
All of us returned home with our batteries charged and full of hope and enthusiasm.
4. In the following week, the Secretariat had three visitors - Qasem (GK, Bangladesh) the outgoing
Coordinator and Prom John (ACHAN), members of the funding group, who spent a day finalizing the plan
of action, budget estimates and other nitty- gritty- required to operationalize all our plans which had been
discussed at the first full core group meeting of PHM at GK Savar froml9-22nd November 2003. The core
jroup now rechristened the ‘Steering group’ will continue to support the Secreiariai giving us advise and
direction. The next news brief will cany the main decisions and developments in PHM relevant to all outmembers and contacts. Zafarullah (Bangladesh) also visited us to discuss various initiatives of mutual
interest for CHC. GK-Savar and PHM.
5. This year is a very- special year for PHM since it is the Alma Ata Anniversary year and the Steering group
has decided to use anniversary- reflections and events to reiterate our commitment to Health for All goal all
over the world. Next week T shall send further details about the evolving plans and initiatives — including
the signature campaigns (already launched); the Alma Ata film - reviving the dream; the country and
regional reflections, the people’s health awards and the position paper and report on Alma Ata - at the 25th
milestone.
I his communication was primarily
? to say hello to all of yon
? welcome you an active interactive collaboration with the PHM Secretariat.
Do acknowledge this communication and let us know your ideas and plans and initiatives so that we can
■build PHM together and collectively as we enter 2003.
Tn solidarity.
Ravi Narayan,
Coordinator,
PHM Secretariat,
367 ‘Srinivasa Nilaya',
Jakkasandra I Main, T Block, Koramangala,
Bangalore — 560 034, India.
Tel ~091 - 80 - 553 15 18
Telefax : 091 - 80 - 552 53 72
Email: sochara@vsnl.com
Website: www.Sochara.org
2
1/22/03 5:27 PM
COMMUNICATION - El
. (Pint- r yChwc
Dear PHM friends.
Greetings for the New Year from the PHM Secretariat that has moved to CHC
Bangalore. India, from GK-Savar, Bangladesh, on Is' January 2003. As the next
coordinator of the PHM Secretariat, 1 look forward to an interesting and meaningful
partnership with all of you in the next phase of the People’s Health Movement
evolution, that begins in 2003 with the Alma Ata Declaration Anniversary year.
1.
The opportunity to become the focal point of the new Secretariat in 2003 has been
a great honour and milestone for CHC especially since this is our 20lh year. For
those w ho do not know us - we are a community health resource group - a society
of health professionals and health activists, who, for the last twenty years have
been supporting community health action orientation of voluntary agencies, civil
societies, and state governments, networks and people’s movements. Having
worked closely with and through the medico friend circle, the Voluntary Health
Association of India, the Christian Medical Association of India, the Catholic
Health Association of India, the All India Drug Action Network, the Asian
Community Health Action Network and the All India People’s Science Network
till 1999. it was our privilege to participate actively in the pre PHA mobilization
process that brought together 18 National Networks in India to launch the Health
for All Now campaign. 2500 health professionals and activists came after 6
months of mobilization in four people’s health trains to the first National People’s
Health Assembly at Kolkata to evolve the Indian People’s Health Charter. Then
nearly 300 members from PHM India participated in the PHA at GK Savar. CHC
was actively involved in facilitating all this building on our network of contacts
since it was a symbolic expression of the goal we had set ourselves when CHC
was initiated in 1984 - to support a people’s health movement.
2.
Since PHA and especially in 2002, CHC has been deeply involved in promoting
the People's Health Charter by convening the WHO-WHA lobby circle and also
by taking PHM/PHC to a wide range of public health institutions and community
health groups through meetings and workshops and publications. The highlight of
our involvement in 2002 was the travelling workshop through Norway, Sweden.
Denmark, Netherlands, Germany enroute to the PHM Geneva input at WHA 2002
in May; and the travelling workshops through Kenya, Uganda and Tanzania
enroute to the Global Forum for Health Research - Forum 6 meeting at Arusha,
Tanzania, where Thelma and I joined Zafarullah, David, Mwajuma and Sudarshan
in ensuring a strong PH^resence at Forum 6.
3
The first two weeks have been hectic at the new Secretariat. Soon after (he shift,
we spent a week in Hyderabad attending the Asia Social Forum
a precursor
event to the World Social Forum in Porto Allegfe, later this month. Over 14000
participants from all over India and many parts of Asia gathered for a five day
celebration on the theme ‘Another World is possible! Another Asia is possible!’.
Two large plenaries (2nd and 7lh January), 8 conferences, 160 seminars, 164
workshops, cultural programmes and film festival; market place and street events
brought together all of us in a great spirit of collectivity and celebration
no
longer as victims of globalisation but as protagonists of alternative development
and alternative policies. The gathering had a large presence of youth, women and
India’s marginalised - both dalits and the adivasis, which was a sign of hope. The
people’s health movement contingent consisted of over a 100 people from the
Jana Swasthya Abhiyan (PHM India); 19 delegates from PHM Bangladesh; and a
few from Sri Lanka, Philippines and other countries.
PHM participants spoke in the conference on social infrastructure including
health; on the people’s panel for the seminar ‘Environment and Health : A
people’s campaign’, participated in the workshop on ‘War, Conflict and Disaster’
and Disaster Watch; participated in the ‘Right to Health Seminar/
All the PHM delegates participated actively in two workshop facilitated by CHC
on behalf of .ISA / PHM entitled ‘Taking the PHM Forward’ and the ‘Alma Ala
Anniversary Workshop - Looking back, looking ahead’. The highlight of the
former workshop was feedback from grassroots workers from Bangladesh and
India who highlighted the constraints and challenges of primary health care
innovation at community level.
The Alma Ata anniversary web signature
campaign Health for All was launched on 5lh January at the Asia Social Forum
(separate press release) and on 7lh January PHM also released a post ASF press
release.
All of us returned home with our batteries charged and full of hope and
enthusiasm.
4.
In the following week, the Secretariat had three visitors - Qasem (GK,
Bangladesh) the outgoing Coordinator and Prem John (ACHAN), members of the
funding group, who spent a day finalising the plan of action, budget estimates and
other nitty gritty required to operationalise all our plans which had been discussed
at the first full core group meeting of PHM al GK Savar froml9-22"d November
2003. The core group now rechristened the ‘Steering group’ will continue to
support the Secretariat giving us advise and direction. The next newsbrief will
carry the main decisions and developments in PHM relevant to all our members
and contacts. Zafarullah (Bangladesh) also visited us to discuss various initiatives
of mutual interest for CHC, GK-Savar and PHM.
5.
This year is a very special year for PHM since it is the Alma Ata Anniversary year
and the Steering group has decided to use anniversary reflections and events to
reiterate our commitment to Health for All goal all over the world. Next week 1
shall send further details about the evolving plans and initiatives
including the
signature campaigns (already launched); the Alma Ata film - reviving the dream;
the country and regional reflections, the people’s health awards and the position
paper and report on Alma Ata - at the 25th milestone.
This communication was primarily
■ to say hello to all of you
• welcome you an an active interactive collaboration with the PHM Secretarial.
Do acknolwedge this communication and let us know your ideas and plans and
initiatives so that we can build PHM together and collectively as we enter 2003.
In solidarity,
Ravi Narayan.
Coordinator.
PHM Secretariat,
367 ’Srinivasa Nilaya’,
Jakkasandra I Main, I Block, Koramangala,
Bangalore - 560 034, India.
Tel : 091 - 80 - 553 15 18
Telefax : 091 - 80 - 552 53 72
Email : sochaiatavsnl.com
Website : www.Sochara.org
~“ar+e> Health Micro-Insurance Schemes
Subject: PHA-Exchangc> Health Micro-lnsurancc Schemes
Date: Fri, 24 Jan 2003 12:01:41 +0700
brom: "Aviva" <aviva@lnetnam.vn>
To: <4ah1rrren3S^Teli3 com>
From:
"Celine Peyron" <C.Pevron@itcilo.it>
> Background
> Today, in most African countries, only limited public health expendi> tures reach the poor. Decreasing social and health budgets, often in
> adequate and poor quality health services, as well as cultural prob> lems, are major constraints for many poor to gain access to health
> care services.
> 5oc^a_ protection is, first and foremost, the legitimate right or
> orrery individual. It is also a condition for social and economic pro> gross. In many developing countries formal social security systems
> are often not giving adequate coverage to people working In the in& formal economy, even if the legislation promotes social protection
" for all. The issue of identifying ways to extend social protection to
> workers in the informal economy is a new challenge and little practi> cal experience in this field exists. There is a need to determine ap> propriate mechanisms for providing social protection, especially in.
> health, and to test them. Micro-insurance has been identified as one
> of many ways to provide better access to health care services for the
> C.omwunir.y-nased health micro-insurance schemes combine the fundamen> tai principles of insurance, participation and solidarity. They use
> the basic principles of insurance because, by paying contributions,
> the members receive service - from the group as a whole - when they
> fall ill. The micro-insurance concept is also based on the solidarity
> principle as all the members contribute, but only those affected by
> an event covered by the scheme benefit from financial support. These
> schemes promote participation because membership is voluntary and all
> members have the right to participate directly or indirectly, in
> various decision-making bodies and to control the operation of their
> micro-insurance scheme.
pifp> kcyCCf-LC^-
Several micro-insurance schemes have been created in Africa to en> nance access cc health services for the most vulnerable. Micro> insurance refers to the different insurance systems, which can reach
> poor people on the basis of an ethic of mutual aid and the collective
> pooling of health risks, and in which the members participate in its
> management. A number of recent studies confirm their potential to en> banco access to health care, which has attracted growing interest
> from the oeneral public, governments and their partners.
x There is a need for capacity building on the design and the manage> msnr of micro-insurance schemes. To strengthen transparency and deci> 3ion making, member's skills, especially those of managers, should be
> reinforced with respect to the management of administrative and fi-
PHA-Excnanae is hosr.ee on Kabissa - Space for change in Africa
To post, write to: PHA-Exchangc@kabissa.org
Webs lie: hLLo:/ /www .lists ■ kabissa.org/iiiailman/lisLinIo/ pha-exchange
1/27/03 1.12 PM
•i-Exdiango Food for an obscene thought
Subject: PHA-Exchangc> Food for an obscene thought
Bate: Sat, 25 Jan 2003 10:37:25 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch" <pha-exchange@kabissa.org>
Human Right Reader 35
'CHARITY IS OBSCENE FROM A HUMAN RIGHTS PERSPECTIVE'
(Immanuel Kant)
1.In many communities, Human Rights (HR) values still need, to be promoted
from above, because they have not yet been internalised by unknowing,
potential claim holders. This promotion from above is far removed from
traditional charity approaches (*) to development though.
■ *: Charity is here seen as "love and the right feeling towards one's fellow
human being").
/. 171 r 1 mars i y,
hh
cannot he imposed; they must be sought/pursued from within,
cine* only be suppcir'ccd fjroiu oucsicic.
I^.in oui? work, it is priiusnily this (majoritv) doo 2? i vs b/poo 27 pooplo (**) who
Wire the main holders of rights; our HR work with them is to have them
9ip.power rheinsol ves ro claim their rights and to choose their own development
path (i.e., circumstances and chance should no longer dominate their lives).
[*A: Poverty is here seen as a lack of choice and minimum control of
resources].
4. HR are thus to be seen as what they really are, namely, the leaal
expression of our human dignity. Because of that, HR are universal; they are
indivisible; and they are interdependent. There is nothing like ’basic
rights’.
b.But HR. do not yet feature explicitly (***) in the charters or mission
statements of many international private voluntary organizations
(importantly those NGOs traditionally involved in mostly charity-type work);
we all need to become more vocal in demanding this be done.
[***: Or may have been added lately without those organizations having
operational!zed these principles in their field work yetj.
6.Participation, you may not know, is a HP. per-se; it should be treated as a
^lecessary outcome of development work and has to become a necessary part of
"-.he process. Charity may share this concept, but definitely does not share
the HR perspective that it is inescapable to directly address the
basic/sLructuial causes of rights violations (see below).
pUP) /=Z>C-Fl Crv+>
7.So, what is then involved in a truly participatory HR-based planning and
programming? And who is to do at?
8.To start with, UN and bilateral agencies and NGOs with active programs in
the field should already be applying HR-based programming —with the
barticination of their respective constituencies' National governments
should ' ideally, follow suit as a way to concretize their commitment to HR
(this can therefore, at the same time, be a test of commitment).
9.Participatory HR-based planning has several recognized steps:
A. Participatory Causality Analysis:
Before anything, communities must first recognize they have problems,
and
then characterize them; they must then collectively identify the causes of
the same. (Without a reasonable consensus on the causes of the problems at
hand, it is not likely that there will be a consensus laLer-on about how Lo
solve the same). Any causality analysis is greatly helped by an explicit
Conceptual Framework (e.g., the one UNICEF uses since 1990 for the causes of
1/27/03 1.07 PM
A-Exchange> Food for an obscene rhr.ngh?
preven~ able ill-health, malnutrition and deaths). Planning in a HR context
inquires a ful2 understanding of the causes at all levels (immediate,
underlying and basic) ■•.,ith simultaneous attention being given to addressing
tne causes at different levels. Causes of problems related to the violation
or peop'A's rights that, are 4 rienr.i f i ed with the help of the framework need
to bo analyzed for each violation at each level of causality; then, a quail
ana auaiiliLalive relationships must be established among them. This is to be
rellowed ny reaching consensus regarding the most important determinants
affecting the realization of those rights found to be violated.
The Causality Analysis will thus produce a list of rights that are being
violated together with the major causes of these violations.
E. Participatory Pattern Analysis:
This step explores the relationships between claim holders and duty bearers;
these relationships torm a pattern. The work to identify duty bearers for
each particular rignt benefits from the earlier causality analysis in that
one can identify duty bearers at different levels. One has to insist that,
at this point, it is necessary to focus on priority problems to reduce the
analysis to a limited set of claim-duty relationships that are likely to be
the most critical in the given situation; if not limited, one risks ending
up with a very j.arge number or such relationships that we will not be able
to tackle and a number of actors too large to involve and support (i.e., the
situation analysis should cover all rights while programming will address
fcpe most relevant violations first) .
pattern Analysis thus arrives at a list of the most crucial claim-duty
relationships ror each particular set of rights violations selected.
C. Paruicipauory Capacity Analysis:
This next, step is about analizing why duty bearers do not seem to be able
(or capable) to perform their duties as is expected from them. It s about
Identifying their shortcomings and confronting them with such evidence. As
>-'dnted out m HP. Header 33
this anal',sis looks at the
responsibility/authority/"resources components of capacity (or about how
duty hearers should act, may act,
and can act). The importance of two-way
communication systems are to be recognized here so as to put resources to
really work for the benefit of claim holders.
Capacity Analysis thus ultimately identifies capacity gaps of each duty
bearex for each identified rights violation to be redressed (also see HR
Reader 33)
u. Participatory Selection of a Strategy and Best Actions:
Here, actions arc selected to help close capacity gaps identified in the
previous step.
fchis step thus results in a list of candidate actions organized into a draft
otrateav.
E. Partnership Analysis:
At this point, discussions are held with key partners/strategic allies with
the aim of reaching agreements on who will do what, how, where and when.
Hrogr ammino:
s final step aggregates all activities m the strategy into
(a)
program(s) and/or project(s). No general advice is sensible enough hers to
proscribe how best to do this. Groups involved in the planning will have to
learn from practice on how to best cluster activities for maximum results
(by sector, by theme, by geographical location, by level of causality, etc).
10.as can be seen, HR are thus not to be treated as a 'separate' concern of
development planning; they arc an integral part of it. Without explicitly
addressing HP.
the problems of economic underdevelopment and poverty will
never be rully solved. (*»*«)
[***»; T;-ie principle of 'low cost - high impact' pursued in traditional
development plannina is merely utilitarian; in HR-based planning it must
thus sometimes be rejected. Simply put, morality often leads to a different
1/27/03 1:07 PM
t-Exchange> Food for an obscene thought
set Ot» priorities than those of an economic analysis].
lx.But, beware, the HR approach is not a magic panacea either, it will not
see resources and policies and power instantly transferred to the poor and
vulnerable... Keen in mind that --unlike the WTO-- the UN or any other
international body have no practicable way of imposing punishment or fines
on governments that violate or ignore their internationally sanctioned
commitments to HR; we ail need to contribute our grain ot salt to help
empower people to stop these violations.
Mostly taken from Jonsson U., An approach to HR based programming in UNICEF
ESARO, SCN News No.20, pp.6-9. July 20001.
Claudio Schuftan, no Cni idinh City
aviva@netnam.vn
PHA-Exchanae is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-Exchange@kabissa.org
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1/27/03 1:07 PM
.IA-Exchange> From the IMF?
Subject: PHA-Exchange> From the IMF?
Date: Sat 4 Jan 2003 11:11:46 -0700
From: "Aviva" <aviva@nemam.vn>
To: ”pha-exch" ^pha^xchangeYckabissa.org^*
The following arc statements wo could find in any publication coming from a
’progressive' group yet, -o and behold, they come from Finance and
Development (June and Sept. 2002), the official publication of the IMF. Thev
may be
cited out of context, but are still mostly verbatim Quotes.
AGRICULTURAL SUBSIDIES AND THE THIRD WORLD:
In recent years, industrial country leaders have boosted their pledge of aid
and debt relief for the ooorest countries, but what thev have given with one
hand they have taken away witn tne other. For example, industrial countries
spent U$50 billion in foreign aid in 2001 (*), yet they provided six times
this amount in agricultural support (to their own farmers), which depressed
world prices and hurt income orospects in ooor countries b’r
Agricultural exports out of rich cour.tr-'r:t-...."
---v.-
industrial countrie
_..iy
.re--.-
....j.
’
global
lead .
way: opening thei
...ark.
--and thus neap aectuce poverty— it would
also br-ng nreacer staoiiity co the global economy, ensuring a healthier
international financial system. Opening up of industrial country markets to
tne products of the develooinc countries is thus as essential as additional
UNFAIR TARIFFS LEVIED ON THIRD WORLD GOODS:
Although in 200, 1 clothes and shoes accounted for only 6.5% of US imports,
in value to rm s t h v b
' erh t n nearly half of the U $2Q billion of US t ar i f f
revenue. Tariffs applied to consumer goods are often higher than those on
luxury gooas. The US collects more tariffs on imports from Bangladesh than
on imports from France. [Ref cited: 'America's hidden tax on the poor’,
E,Gresser, Progressive Policy Institute Policy Report (Washington), 2002].
ON GLOBALIZATION:
Globalization drives down wages and exports jobs co low-wage economies.
Critics see the creation of a global ’sweat-shop economy’ in which
corporations pit workers around the world against each other in a race to
ithe bottom to see '..'no wi__ accept tne ^.owect wages and benefits.
Most variation in the income of the poor comes as a result of changes in
average income, not changes in income distribution. So the trade
liberalization associated with globalization may have a positive overall
effect on orowth, .out is most nrobablv not good for poverty reduction since
it worsens income distribution. A more egalitarian income distribution has
to antecede (or be concomitant with) growth to have an impact on the rate of
poverty.
Priority continues to be given to the relationship between economic growth
and oovertv but no consideration is being given to income redistribution.
Poverty alleviation is tnus only attempted by secondary trickle-down
effects. It can then be predicted chat poverty will not be reduced by the
taraeted amount (by 2015). (Pro-poor growth addresses neither the political
nor the economic causes of poverty).
CMP —5 /
l
(*);
Tf industrial countries increased ODn to 0.7% oz GNP, financial aid
would increase to about U$175 billion, roughly three times its current
(2002)
1 of 2
level.
1.6'03 1.01 PM
.iA-Exchanao From t! e D IF?
PHA-Exchar.ae is h:sted ?n Kabissa - Space for change in Africa
-1?
z
2.~ G
“C i
'i-
— 5og . 02. Cf
website : hctp]/^.V^ ijsts.kabissa.org/maiiman/listinfo/pha-excnange
IpHA'ExdtangO Pearls of wisdom on HCF (3)
Subject: 1’HA-ExchangO Pearls of wisdom on HCF (3)
Date: Sat, 11 Jan 2003 10:30:46 +0700
From: "Aviva" <aviva@netnam.vn>
To: "afro-nets" <afro-nets@usa.healthnet.org>
From: "gorald moorc" <gmoorol2@compuscrvo.com>
The "pearls ot wisdom” were much appreciated and are very
much in line with my own thinking. Some of the principles however are, as
you know,
difficult to implement in practice, for a variety of reasons.
One problem is that in some developing countries the services which should
be provided free, in a fee for service system, often make up the majority
of services provided, eg under-5, maternal and child health, preventive,
chronic diseases, STD/Aids etc. Then there are exemptions for the very
poor. So when one adds all these up, one might find that fees are being
collected from a small proportion of the patient population that is not
enough to make the service financially viable or to plough back enough
funds into improving the system, Lopping up salaries etc.
Assessing users/payers socio-economic situation and ability to pay is also
difficult (points 10,11), particularly in a rural setting. How does
one really know? In my experience, sometimes the poorest-looking farmer may
have quite a decent income. One possible way is to strengthen the system of
indigent-registration by village chiefs, which is utilized in Ethiopia and
Laos. This enables the poorest in a village to have a card or letter
whiich. gns.zra.ntLS os tLh-sir. tzr??
csrs. ( Point 3) .
Points 14-18 are very important, as is the need to train health workers in
basic planning, accounr.ing,
inventory management, and budgetary control, a
very high workload in addition to their provision of care and health
educational activities. Do we expect a nurse or medical assistant in a
rural health centre to do too much? Often just caring tor the sick and
doing the basic recording paperwork is a full-time job for them, not to
mention looking after finances, accounts and stock control.
To be efficient, any fee for service, cost sharing or cost recovery system
would optimally require trained accounting and stores personnel in every
health facility. Even it they could be found and trained, this adds to
personnel and administration costs. However if the system works well, they
could be provided for out of revenue gained.
^oint 25 sums up the basic problem in health care very well.
Much to discuss: Each pearl is almost a topic in itself.
Gerald Moore
PHA-Exchange is hosted on Kabissa - Space for change in Africa
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1/14/03 9:30 AM
Exchanged Training Manual on Effective Writing available online
Subject: l’HA-Exchange> t raining Manual on Effective Writing available online
Date: Thu, 23 Jan 2003 10:38:09 4-0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch" <pha-exchanse@kabissa.org>
From: "Patrick Burnett" <patrick8fahamu.org.za>
> Training Manual on Effective Writing available online
> FAHAMU - Learning
> TRAINING MANUAL ON EFFECTIVE WRITING AVAILABLE ONLINE
> "" Do you find writing a chore? Do you spend hours looking at a blank
k sheet of paper, wondering how to start? Then Writing for Change can
k help. **
major training resource designed to help those working in the notfor-profit sector hone their writing skills in order to influence,
persuade and bring about positive social change has been made avail> able free of charge on the internet, thanks to the support of IDRC.
> "The CD-ROM version has been so popular," said Firoze Manji, Director
of Rcthcanu, TT TDRC
Rsh.s^.ti c*Qcd-clQcl to iciciko l.Iig .Esso'drcs 3rvrsd.J-3bJ.& d.n
k the public domain as well."
> Writing for Change, originally published as an interactive CD-ROM by
> Fahamu and the international Development Research Centre (TDRC), is
> designed primarily for people working in the not-for-profit sector,
> including researchers, scientists, project managers, team members,
> campaigners, fundraisers, social activists and writers. Available in
k English, French and Spanish from Fahamu's web site:
> <http://www.fahamu.org> the resource is thought to be one of the most
> comprehensive available, running at about 900 pages per language.
> Writing for Change is unique as a training resource because it con> tains major sections devoted not only to the core skills of writing,
dkbut also to the two crucial specialised areas of writing - scientific
y papers for publication in journals and documents to help campaign or
> persuade.
k People working in research and advocacy organisations need to do lots
> of writing in the form of project documents, articles for magazines,
> oarers for publication in scientific journals, proposals and newslet> tars - the list can '<=« endless. Many able and committed people find
> writing time-consuming, boring and difficult. Rather than sitting at
> a desk, they would prefer to be doing the real work of setting up the
> next experiment, conducting the field research, lobbying politicians
k or engaging with communities. Yet the world will only know about the
> quality and significance of their work through the documents that exk plain or promote it. Success depends on the ability to communicate
k ideas to others - often on paper. Writing for Change can help achieve
k that success.
k Writing for Change comprises three sections:
> * Effective Writing: core skills, Writing for Science, and Writing
k
for Advocacv. Core skills helps r.o develop the skills needed to write
k
clearly and purposefully, organise ideas and express them well.
k * Writing for Science shows how to produce writing tor publication in
k
specialist journals. It teaches how to build on the core skills of
1/24/03 10:56 AM
k-ExJiange> Training Manual on Effective Writing available online
-v
>
>
>
effective writing and add further skills that apply to this specialised type of writing. This section gives a better chance of getting
published, discusses the ethics of authorship, how to respond to ediuors and correct proora.
> * Writing for Advocacy contains a wealth of advice on how to win
>
hearts and minds and how to adapt core writing skills to lobbying or
>
campaigning documents. The section looks at articles, leaflets, news>
letters, pamphlets, press releases and posters.
> Extra features of 'Writing for Change' include a resource centre with
> suggestions for further reading and links to useful web sites and re> sources.
> "fve supported "Writing for Change' so that our partners would have a
> tool to build their capacity to communicate research results in ways
> that promote action based on evidence and social relevance. The guide
> focuses on effective writing, important both for communicating sci> ence and advocacy work," said Daniel Buckles from the International
> Development Research Centre. "The combination of guidance on core
> writing skills, writing for science and writing for advocacy makes
> this pzociuct unique. ~
can honestly say it is one of the best training programmes I have
> seen. It is very well set out and easy to navigate. It also follows a
> logical progression, there were no missing steps, and it went into
> sufficient detail to provide concrete, practical guidance. 1 was
> never left thinking, 'But how exactly would I do such and such?'
> Sarah Ar.ewel 1, World Vision.
> Writing for change continues to be available on CD-ROM; Price GB Pounds
PHA-Exchanae is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-Exchange2kabissa.org
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1/24/03 10:56 AM
■lessagc from Colin Powell to state department offices
Subject: hr: Message from Colin Powell to state department offices
Date: Thu, 23 Jan 2003 10:35:31 +0700
From: "Aviva" <aviva@netnam.vn>
To: "Ravi" <sochara@vsnl.com>
--------- Original Message --------From: "JVNET" <jvneLSnelnam.vn>
tq ■ ,,-iTrng+”
vti©t(sristnsni. vn^
Sent: Thursday, January 23, 200o 8:43 AM
Subject: Message from Colin Powell to state department offices
Messaae from Colin Powell to state department offices
THIS TS AN ACTION CABLE FROM THE ADMINISTRATOR - SEE SECTIONS 4,
5, AND 6.
1. SUMMARY: I CONTINUE TO PLACE A TOP PRIORITY ON IMPLEMENTATION OF HIV/AIDS
ifcXPANDED RESPONSE
UNCLASSIFIED
UNCLASSIFIED
PAGE 02
STATE
267675
301708Z
.ACTIVITIES, INCLUDING THE PRESIDENT'S INITIATIVE TO DECREASE MOTHER TO CHILD
TRANSMISSION.
IN MANY COUNTRIES, HIV/AIDS HAS REACHED SUCH CATASTROPHIC
LEVELS THAT IT TS DECIMATING ENTIRE SOCIETIES, DEVASTATING FAMILIES,
CREATING MILLIONS OF ORPHANS AND SETTING BACK SOCIAL AND ECONOMIC
DEVELOPMENT.
IN 2002, USAID MADE GREAT STRIDES AND WE WILL CONTINUE TO
STRIVE TO BE A. GLOBAL LEADER IN THE FIGHT AGAINST HIV/AIDS.
2. WHERE THERE ARE GENERALIZED EPIDEMICS, A FULLY BALANCED APPROACH TO THE
ABCS
ABSTINENCE, BEING FAITHFUL, AND CONDOMS
SHOULD BE IMPLEMENTED.
EMPFRTCAL EVIDENCE SHOWS THAT SUCCESSFUL PROGRAMS SUPPORT A STRONG EMPHASIS
ON CAMPAIGNS THAT PROMOTE ABSTINENCE, FAITHFULNESS AND REDUCTION OF THE
NUMBER OF PARTNERS.
IN ADDITION, INCREASED ATTENTION TO SUPPORTING CHILDREN
AFFECTED BY HIV/AIDS IS IMPORTANT. FAITH-BASED AND COMMUNITY ORGANIZATIONS
OULD BE ENGAGED IN USAID'S FIGHT AGAINST HIV/AIDS. (NOTE: ON DECEMBER 12,
E PRESIDENT ISSUED EXECUTIVE ORDERS
13279 AND 13280 TO ENHANCE THE PARTICIPATION OF FAITH-BASED AND COMMUNITY
ORGANIZATIONS IN U.S. GOVERNMENT FUNDED PROGRAMS. END NOTE) USAID MISSIONS
SHOULD SEEK TO INCREASE THE NUMBER OF NEW IMPLEMENTING PARTNERS BY ENSURING
THE COMPETITIVE BIDDING AND REBIDDING OF CONTRACTS AND COOPERATIVE
AGREEMENTS.
«
3.
POLICY AND COMMUNICATIONS:
WE NEED YOUR ATTENTION
UNCLASSIFIED
UNCLASSIFIED
PAGE 03
STATE
267675 301708Z
FOCUSSED ON IMPLEMENTING OUR HIV/AIDS PROGRAM IN ACCORDANCE WITH
ADMINISTRATION AND AGENCY POLICIES.
THERE IS CLEAR EVIDENCE THAT THE
.ACCOMPLISHMENTS TO DATE AND THOSE PLANNED REQUIRE INTERVENTIONS THAT STEM
THE TRANSMISSION OF HIV/AIDS AMONG HIGH RISK GROUPS SUCH AS PROSTITUTES AND
INJECTING DRUG USERS. THESE ACTIVITIES AND RELATED COMMUNICATIONS MUST RE
MANAGED SENSITIVELY.
EXISTING USAID POLICY, SET FORTH IN THE AGENCY'S FY
2002 GUIDANCE ON THE DEFINITION AND USE OF THE CHILD SURVIVAL AND HEALTH
PROGRAMS FUND PROHIBITS THE USE OF RESOUP.CES TO SUPPOP.T NEEDLE EXCHaNGF
PROGRAMS.
IN ADDITION, ORGANIZATIONS ADVOCATING PROSTITUTION AS AN
1/24/03 10:43 AM
Message 8® Colin Powell to state department offices
EMPLOYMENT CHOICE OR WHICH ADVOCATE OR SUPPORT THE LEGALIZATION OF
PROSTITUTION ARE NOT APPROPRIATE PARTNERS FOR USAID ANTI-TRAFFICKING GRANTS
AND CONTRACTS, OR SUS-GRANTS AND SUB-CONTRACTS.
(NOTE: USAID'S
ANTI-TRAFFICKING STRATEGY WILL BE RELEASED DURING THE FIRST WEEK OF JANUARY.
END NOTE).
4. ALL OPERATING UNITS SHOULD ENSURE THAT USAID-FUNDED PROGRAMS AND
PUBLICATIONS REFLECT APPROPRIATELY THE POLICIES OF THE BUSH ADMINISTRATION.
CAREFUL REVIEW
OF ALL PROGRAMS AND PUBLICATIONS SHOULD ENSURE THAT USAID IS NOT PERCEIVED
AS USING U.S. TAXPAYER FUNDS TO SUPPORT ACTIVITIES THAT CONTRADICT OUR LAWS
OR POLICIES, INCLUDING TRAFFICKING OF WOMEN AND GIRLS, LEGALIZATION OF
DRUGS, INJECTING DRUG USE, AND ABORTION.
UNCLASSIFIED
UNCLASSIFIED
PAGE 04
STATE
267675 301708Z
5. WEBSITES: ALL OPERATING UNITS SHOULD REVIEW THEIR OWN WEBSITES AND ANY
WEBSITES FULLY OR PARTIALLY FUNDED BY USAID TO ENSURE THE APPROPRIATENESS OF
MATERIAL. (NOTE: ADS 557.5.3 REQUIRES THAT MATERIALS FINANCED BY THE AGENCY
fcUST BE REVIEWED BY LPA PRIOR TO POSTING ON THE WEB. END NOTE) YOU SHOULD
vlLSO REVIEW THE APPROPRIA.TNESS OF MESSAGES ON THE WEBSITES OF OUR.
COOPERATING PARTNERS WHICH RECEIVE SOME PORTION OF THEIR FUNDING FROM USAID.
6. MISSIONS ARE REQUESTED TO RESPOND TO THIS CABLE WITH CONFIRMATION OF
ACTIONS TAKEN RY JANUARY 31, 2003.
7. IF YOU HAVE ANY QUESTIONS, OR WISH TO REQUEST ASSISTANCE IN POLICY OR
COMMUNICATIONS DETERMINATIONS, PLEASE CONTACT THE SENIOR DEPUTY ASSISTANT
ADMINISTRATOR IN YOUR RESPECTIVE BUREAU.
FOR LEGAL DETERMINATIONS AND
ADVICE, PLEASE CONTACT YOUR COGNIZANT REGIONAL LEGAL ADVISOR.
8. WITH YOUR CONTINUED EFFORTS, USAID CAN SUBSTANTIALLY CONTRIBUTE TO
WINNING THE FIGHT AGAINST HIV/AIDS AND FURTHERING INTERNATIONAL DEVELOPMENT.
POWELL
UNCLASSIFIED
2
1/24/03 10.43 AM
xchange> George Bush's War on Women
Subject: PHA-Exchange> George Bush's War on Women
Date: Fri, 24 Jan 2003 11:45:46 -t-0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-cxch" <pha-exchange@kabissa.org>
Bush's secret war
IPPF, 22 January, 2003
London - Shielded by the smokescreen of an imminent war, President George
Bush is waging another stealth campaign, systematically working to undermine
reproductive freedom around the world, claims The International Planned
Parenthood Federation (IPPF).
Today marks the third anniversary of the beginning of this cultural battle.
On this day in 2001, in one of his first actions on taking office, President
Bush reinstated the Global Gag Rule — or Mexico City Policy — which cut off
U.S. international aid money from any family planning organization that
^■jaged, directly or indirectly, in abortion-related activities. The cost to
li’PF -was devastating - $13 million lost, clinics closed, essential
reproductive health denied or delayed.
This unjust policy has actually
increased the number of unintended pregnancies and illegal, unsafe abortions
and consequently needless deaths.
Since then, usinc every means available uo him, Bush has formulated a
strategy to stifle reproductive rights and access to reproductive health
care services. They include: instituting gag rules that censor free speech;
supporting legislation that limits access to family planning and abortion
services; sinking large sums of money into medically unproven
abstinence-only sexuality education; nominating religious ideologues to
important scientific posts and decrying the use of condoms.
IPPF Director General Dr Steven Binding said: "We are using this, the third
anniversary of the Global Gag Rule, to draw
the world's attention to a chronology of events (see separate War on Women
Chronology below] which show George Bush's seemingly single-minded
determination to strip women of reproductive rights and access to
reoroduclive health services - not just abortion but even family planning
ana sex education.
^Bnese acts are a testament to the Bush administration's war against women
and his overall contempt for their fundamental civil and human rights."
For further information contact:
Email: fsalter@ippf.org
Gsorcj© SusbTs W-22? on Wozusnz A chronology
Reducing access to lamily planning
» On his first day in office, the 28th anniversary of Roe v. Wade, Bush
restores the Reagan-era global gag rule on international family planning
assistance (See also Censoring free speech) - January 22, 2001
" President Bush moves to increase "abstinence-only" education funding Octobs1" — 2002
t House passes the "Child Custody Protection Act" - April 17, 2002
» m di ad.n; n i si ration representatives fiuht sexualitv education and opoose
condoms "O’- hiv/AIL'S prevention at the ijn children's Summit (see also
Replacing'science with right-wing ideology) - May 2002
* President Bush withholds S34 million in funding for birth control,
maternal and child ileal th care, and HxV/AIDS prevention from the United
Nations Population Fund (UNFPA) (see also Replacing science with right-wing
ideology)'- July'22, 2002
’ President Bush does an about-face on support of women's rights treaty. The
^-Exchange* George Bush's War on Women
Convention on the Elimination or All Forms of Discrimination Against Women
CEDAR - July 26, 2002
’ House passes the so-called "Abortion Non-Discrimination Act" (see also:
Building the platform to outlaw abortion) - September 25, 2002
* Bush administration Wen sites remove medically accurate intormation (see
also Reducing access to family planning) - October 2002
* HHS announces "abstinence-only" advocate to oversee nation’s family
planning program (see also Replacing science with right-wing ideology) October 7, 2002
* Bush administration reverses U.S. position in support of 1994 global
agreement that affirms the right of all couples and individuals to determine
freely and responsibly the number and spacing of their children and to have
the information and means to do so (United Nations, 1994)
Censoring free speech)
November 2, 2002
(see also
Building the platform to outlaw abortion
* House passes the "Child Custody Protection Act" (sec also Reducing access
to family planning) - April 17, 2CC2
* House passes the so-called "Unborn Victims of Violence Act" (see also
Redefining the legal status or the fetus) - April 26, 2001
’ President Bush does an about-face on support of women's rights treaty, The
Convention on the Elimination of All Forms of Discrimination Against Women
(CEDAW) (see also Reducing access to family planning) - July 26, 2002
^House passes the so-called "Abortion Non-Discrimination Act" (see also
Redefining the legal status of the fetus) - September 25, 2002
* Bush administration gives embryos new status in the HHS Secretary's
Advisory Committee on Human Research Protection Charter - October 2002
’ Bush Administration -Advances position that lite begins at conception at
regional population conference in Asia - December 11-17, 2002
Replacing science with right-wing ideology
* President Bush considers nominating John Klink - an ardent opponent of
birth control and a spokesperson for the Vatican's opposition to condom
use - to oversee the United States' global population program - May 23, 2001
’ House passes the "Human Cloning Prohibition .Act of 2001" - July 31, 2001
’ President Bush prevents taxpayer funding for additional stem cells beyond
existing stem cell lines, placing severe limits on stem cell research August 9, 2001
’ President Bush moves to increase "abstinence-only" education funding October 11, 2001
’ Bush administration representatives fight sexuality education and oppose
condoms for HIV/AIDS prevention at the UN Children's Summit (see also
Reducing access to family planning) - May 2002
^President Bush withholds $34 million in funding for birth control,
BLternai and child health care, and HIV/AIDS prevention from the United
Nations Population Fund (UNFPA.) (see also Reducing access to family
planning) - July 22, 2002
’ President Bush withholds more than $200 million in funding for programs to
support women and address HIV/AIDS in Afghanistan - August 2, 2002
» President Bush Freezes $3 million in funding to the World Health
Organization (WHO) in response co anti-choice objections to the WHO's human
reproduction research program - October 2002
* Bush administration Web sites remove medically accurate information (see
also Censorinc free speech, Reducing access to family planning) - October
2002
’ HHS announces "abstinence-only" advocate to oversee nation's family
planning program (see also Reducing access to family planning) - October 7,
2002
’ Family planning roe Rep. Chris Smith calls on USAID to exclude
reproductive health organizations in developing countries from receiving
HIV/AIDS funding - October 24, 2002
Censoring free speech
* Bush administration Web sites remove medically accurate information October 2002
» Bush administration reverses U.S. position in support of 1994 global
1/27/03 11:02 AM
A-Exchanpe> fienree Rush's War nn Women
agreement that affirms the rioht of all couples and individuals to determine
freely and responsibly the number and spacing of their children and to have
information and naans to do so (United Nations, 1994) (see also Reducing
access to family planning) - November 2, 2002
’ The Centers tor Disease Control and Prevention (CDC) Web site posted
"revised" fact sheet downplaying condom effectiveness - December 2, 2002
* At an international conference in Bangkok, U.S. officials demanded the
deletion of a recommendation for "consistent condom use" to fight AIDS and
59XUS1 dis98ses. One study
tne University of California at BerJcelev found
condom distribution to be astonishingly cost-effective, costing just $3.50
per year of lite saved. In contrast, antiretroviral therapy cost
almost $1,050. Yet the U.S. is now donating only 300 million condoms
annually, down from about 800 million at the end or the first President
’with thanks to Planned Parenthood Federation of America
www. pl annedoarenthood. ore
’ IPPF is the largest voluntary organization working towards healthier
sexual and reproductive lives for everyone. Founded 50 years ago in India,
IPPF now works in 182 countries to fight against poverty, ignorance and
misery by providing more people with choices about their lives, offering
sexual and reproductive health and family planning information and services,
and working to prevent the spread of HIV7AIDS and other infections.
“A-Exchange is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-Exchan.ge8kabissa.org
Website: http://www.lists.kabissa.org/mailman/listinfo/pha-exchange
1/27/03 11:02 AM
VExchange>Davos
Subject: iJHA-Exchange> Davos
Date: Mon. 27 Jan 2003 16:36:03 -0700
■From: “Aviva" <aviva@netnam.vn>
To: "pha-exch" <nha-exchan2S@.kabissa.orgt>
> Davos again Saturday, repression if anything worse than two years ago.
Let me share with you my thoughts after we got home having been prevented in
> of world's most democratic countries from demonstrating against violence
and
> injustice and even having been attacked by the police regularly throughout
> the day and the evening.
Why
Whst
W1X9 XI
W179 2? 9
Recause T am safe, we’’ fed and in good health, I can TRY to demonstrate
against a system in which half the people in this world of plenty are not
^afe, do not eat enough, and are in poor health .... So much so that
.000 of them die everv dav of avoidable causes.
Because political and economic decisions affecting people everywhere, in the
■world are taken in a small mountain resort called Davos in Switzerland. Here
leaders of multinational corporations dictate to our "elected leaders"
mostly behind closed doors. For example, the UK (represented by British
Petroleum) and the Netherlands (represented by Shell) decide how to dispose
of Nigeria’s oil reserves. Meanwhile Nigerians live (and die) in poverty.
Yesterday, on the 25th of January 2003, T tried with thousands of others to
demonstrate for democracy, peace and social justice.
At Landqart and Berne, we were gassed, nosed, sprayed with rubber bullets,
herded into enclosures, made to stand for hours in the cold, marched along
rail tracks to reach our destination, put on and off trains, chased up and
down streets, running, frightened, outraged.
BUT we had the luxury of transport home in a warm, comfortable train where
we ate snacks, looked after our headaches and stinging eyes, and thought
^bout what went wrong.
That luxury is the right of every human being on earth.
Next week, hundreds of thousands of Iraqi families may be attacked; thev
nave been bombed senseless since 1991. They will also be on the move but
without food, water or aspirins. if this happens, many or them will die.
PHA Exchange is hosted on Kabissa - Space for change in Africa
To post, write to: PHA-ExchangelSkabissa.org
Website: http://www.lists■kabissa.org/mailman/listinfo/pha-exchange
fl
1/28/03 11:07 AM
From:
aviva <aviva@ne:nam vn>
: ony Biair, impiying thay wara racists intant on war with irac- anc?
sarV'iicunri
;-\;C2;r f~-.r
cjr<.or■ o. 'n’cr -.o'^rAr'.r'c:ir\iJ"h,' cic: nrimo nninkrar ’n
---------------- ....;v;r
----------------•---------- -------------- ----- -- ------ -------- r..------------------------------- .......---------- ----
.Amarics.
ivff. ivianUSla urged ii le Auie: iCen peOpie io jC’iu pfOiebiS
u jS
SSCufiiy CC-uHCii. iC- ’JFiiie IC* GppOSe nirfi.
tiieii
■-Exchange WHO candidates debate last Sunday in Gva
Subject: PHA-Exchangc> 'A HO candidates debate last Sunday in Gva
Date: Fri 24 Jan 2003 12:12:45 +0700
From: "Aviva" <aviva@netnam.vn>
To: "pha-exch" <pha-exchance@kabissa.org>
—
OTTi "
11 C o» —
1 X.*
o •-
= • * z-J
-XZ- V*
X-*
11
S 3 '3 J"* . ’T’ 3 — Q
@ C?-1
Q
i rj
C
>*
n. Sunday, 19 January 2003 (at 3 pm
ns went to all the Candidates, all the
all Geneva-based organisations and
to 5:35
members
e.
The debate was
six channels of the Worldspace
ganised under
G I. ooa L
No member of the
(mostly WHO and NGOs staff) attended
idates who participated were (in surname
> Dr Pascoal Manuel Mocumbi, Mozambique
> Dr Tsmall Sal lam. Egypt
> Dr Joseph Williams, Cock island
> Dr Mocumbi and Dr Sallam were in Geneva, and Dr Williams was on Video
> Conference link from Aukland, New Zealand.
> The event was not intended as a debate between the candidates, nor an
> interview of the candidates, but an opportunity for the Global Health
sector
> to and listen to and question the Candidates on their Vision, Priorities
and
^Intended method of their directing WHO
with particular emphasis on the
> needs and the true involvement of the poor communities and the
rnaustrz.aj._y
> developing countries.
Questions to the candidates were fielded via Video
> Audio links, and through the internet, from over 70 health institutions m
> ovar 70 countri ae.
> it was an excellent event and the "debate" fullv met its objectives,
aibeit
.
,
.
..
.
> with only three of the seven candidates participating.
. '
T had the honour
> chairing the Debate at the invitation of the main organisers:
the
> international Health Network, Exchange, The People's Health Movement and
The
7 Academy of International Health Philanthropy.
An archive of the
> video-streaming, together with a transcript and a summary of the event
will
-----------GeV a
7 shortly be available (www.ihn.org).
c—^r,
Salah Kandil
Geneva
1/27/03 1:04 Plvi
Pxclianse> WHO candidates debate last Sunday :n Gva
fHA-Exchange is hosted on .-Cabissa - Space for change in Africa
To post, write to: piiA-Exchanceckaoissa.org
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1/27/03 1.04 PM
>f2
Page 1 of 4
Community Health Cel!
From:
Sent:
Attach:
Subject:
Maria Hamiin Zuniga <iphc@cablenet com ni>
Pha-Exchange <PHA-Exchange@kabissa.org>
Wednesday, February 12, 2003 12:46 AM
Dr_ Mirta Roses Sets Commitments as New Director of PAHO.doc
PHA-Exchange> New Director of PAHO sets Commitments
We are committed to health for ail, to the strategy of primary health care,
to health promotion, and to the reduction of inequities and social
exclusion Dr. Mirta Roses.
Dr. Mirta Roses Sets Commitments as New Director of PAHO
News and Public information
Dr. Mirta Roses Sets Commitments as New Director of PAHO
Washington, January 30. 2003 (PAHO) - Renewing her commitment to
work for public health in the Americas, Dr. Mina Roses Periago
was
sworn in today as the new director of the Pan American Health
Organization (PAHO), becoming the first Argentine and first
woman to
lead the Organization.
committed to hcQlth for sll to the strategy of primary
health care strategy, to health promotion, and to the reduction
”\a/q
inequities and social exclusion." Dr. Roses said. She said her
commitments would include:
Restore the Pan American Health Organization as the main forum
for
health in the Americas, opening it to participation by all
sectors
OT SOCiGiy.
Build consensus and forge alliances, strengthening the
continental
and global solidarity, and gaining new social actors to defend
Address the new dimensions of health in the processes of the
economic, social and political integration of the continent.
Advocate continuous improvement in health systems, promoting
/3/2J
rapid
progress in access to health sei vices and extending social
orotection in accordance with the mandates of the summits of
presidents and heads of state.
Renew the commitment and pride of all health workers and
organizations, emphasizing the importance of quality of care,
accountability, and evidence-based practices.
Convert PAHO into the preeminent health information reference
2/13/03
Page 2 of 4
center, facilitating access to knowledge using ail means
available including modern information systems and mass
communication.
The inauguration was held at the headquarters of PAHO, which
just
celebrated its Centennial, with the children's choir of the
Washington International School and the PAHO choir singing
folkloric
songs of the Americas. In her first address as director, Dr.
Roses
spoke to health ministers, ambassadors and PAHO staff. But she
also
addressed indigenous and religious leaders, women who work in
assembly plants, and the centenarians of Dominica and other
©Idorly
persons, telling them, "This Director and her team will be
defending
your health"
After thanking outgoing Director Dr. George Alleyne, World
Health
Organization Director Dr. Gro Harlem Brundtland, the Vice
President
of Ecuador, Dr. Alfredo Palacio, the Minister of Health of
Ecuador,
Dr. Francisco Andino, and representatives of the Organization of
y&fngriQan ststss 2nd of ths Dspsrtmsnt of Hsolth snd Humsn
Services
of the United Ststes Dr. Roses seid thet "I reeffirm mv
commitment
with emotion and pride as the first woman to assume the
direction of
this centenary and prestigious Organization and to guide it at
the
beginning of this new Millennium."
Dr. Roses said, "The focus of my attention will be working in
and
with the countries. Faithful to my profession as an
epidemiologist,
I will seek contact with the communities and observe the
projects in
the field."
She pointed out the importance of communication and of
information
exchange, noting that "This will be the century of networks, of
connectivity and interdependence, which will make it possible
for us
to overcome barriers of space and of time and open possibilities
that were unimaginable to humankind." She added "If we promote
those
networks so that they multiply exponentially the available
social
capital, so they link people and institutions to support and
2/13/03
Page 3 of4
ssj ths naonia nf the continent we will have fgken a
fundamental
step for knowledge and experience in new ways to exchange
technical
cooperation for sustainable human development."
In a diverse continent, she said, the countries face difficult
scenarios, including "Unfavorable economic conditions with
increases
in poverty, aging of populations, rapid and disorderly
urbanization
and environmental degradation, which makes them highly
v u 1 n e ra b I s
Each day more people live below the poverty line, and
Hifforpnmc
between rich and poor are growing in many countries, communities
and
groups."
Dr. Roses said "environmental risks are more threatening every
day,
and the current course of globalization is producing unequal
benefits that contribute to increasing inequities among the
countries. In this framework, those of us who consider health as
social product, can bo proud of achieving and sustaining
imoressive
gains in public health and in the extension of life expectancy
in
most countries, despite successive and prolonged economic and
political crises."
"Even in critical periods, such as the so-called lost decade,
with
ruptures in democracy and economic stagnation, we have achieved
the
elimination of polio, the near- disappearance of measles, and
reductions in infant mortality," she said.
Dr. Roses said she will give special importance to the fight
against
the AIDS epidemic, focusing on the countries of the Caribbean,
and
to improvements in health conditions in priority countries,
particularly Haiti, she said.
Dr. Roses recalled her first paid public health job as a
door-to-door vaccinator in the smallpox eradication campaign of
1965. "I feel very moved after 38 years to continue serving
i icaili i
in the Americas and to be able to pay tribute to community and
volunteer health workers on this 25th anniversary' of the
Conference
of Alma Ata," she said, concluded.
2/13/03
Page 4 of 4
serves
PAHO. established in 1902,works with al! the countries of the
Americas to improve the health and living standards of ail their
peoples. The oldest health organization in the world, it also
as the Regional Office for the Americas of the World Health
Organization.
oses Sets Commitments as New Director of PAHO
and Public Information
Dr. Mirta Roses Sets Commitments as New Director of PAHO
Wcishixiyton, January 30, 2003 (PAHO) - Renewing her commitment to
work tor public health in the Americas, Dr. Mirta P.oses Periago was
sworn in today as ths new director of the Pan American Health
Organization (PAHO), becoming the first Argentine and first woman Lo
lead the Organization.
"We are committed to health for all, to the strategy of primary
health care strategy, to health promotion, and to the reduction of
inequities and social exclusion." Dr. Roses said. She said her
commitments would include:
Restore the Pan American Health Organization as the main forum for
health in the Americas, opening it to participation by all sectors
■—'A.
&CC —
V. v •
Build consensus and forge alliances, strengthening the continental
and global solidarity, and gaining new social actors to defend
A.ddress the new dimensions of health in the processes of the
economic, social and political integration of the continent.
Advocate continuous improvement in health systems, promoting rapid
progress in access to health services and extending social
protection in accordance with the mandates of the summits of
presidents and heads of state.
Renew the commitment and pride of all health workers and
organizations, emphasizing the importance of quality of care,
accountability, and evidence-based practices.
Convert PAHO into the preeminent health information reference
center, facilitating access to knowledge using all means
available, including modern information systems and mass
icat 1 or
-he inauguration was hold at ths headquarters of PAIiO, which just
celebrated its Centennial, with the children's choir of the
Washington International School and the PAHO choir singing folkloric
songs of the Americas. In her first address as director, Dr. Roses
spoke to health ministers, ambassadors and PAHO staff. Rut she also
addressed indigenous and religious leaders, women who work in
assembly plants, and the centenarians of Dominica and other elderly
persons, telling them, "This Director and her team will be defending
your health"
After thanking outgoing Director Dr. George Alleyne, World Health
Organization Director Dr. Gro Harlem Brundtland, the Vice President
of Ecuador, Dr. Alfredo Palacio, the Minister of Health of Ecuador,
Dr. Francisco Andino, and representatives of the Organization of
American States and of the Department or Health and Human Services
of the united States, Dr. Roses said that "I reaffirm my commitment
with emotion and pride as the first woman to assume the direction of
this centenary and prestigious Organization and to guide it at the
becinning of this new Millennium."
Dr. P.oses said, "The focus of my attention will be working in and
with the countries. Faithful to my profession as an epidemiologist,
I will seek contact with lhe communi Lies and observe Lhe projects in
the field."
She pointed CUt the impOrtance of Communication QUO of information
exchange. noting that "This will be the century of networks, of
ivitv sno interdependence, which will make it possible tor us
to overcome carriers of space and of time and open possibilities
r.har were unimaginable to humankind." She added "Tf we promote r.hose
networks so that they multiply exponentially the available social
capital, so they link people and institutions to support and include
all the feoole of the continent we will have taken a fundamental
step for knowledge and experience in new ways to exchange technical
cooperation for sustainable human development."
in a diverse continent she said the countries face difficult
scenarios, including "Unfavorable economic conditions with increases
in po er~y, aging of populations, rapid and disorderly urbanization
and environmental degradation, which makes them highly vulnerable.
Sacn day more people live below the poverty line, and differences
between rich and poor are growing in many countries, communities and
Dr. Roses said "environmental risks are more threatening every day,
and thp currant course of globalization is producing unequal
benefits that contribute to increasing inequities among the
countries. In this framework, those of us who consider health as a
social product, can be proud of achieving and sustaining impressive
gains in public health and in the extension of life expectancy in
most countries, despite successive and prolonged economic and
political crises."
"Even in critical periods, such as the so-called lost decade, with
ruptures in democracy and economic stagnation, we have achieved the
elimination of polio, the near- disappearance of measles, and
reductions in infant mortality," she said.
Dr. Poses said she will give special importance to the fight against
the AIDS epidemic, focusing on the countries of the Caribbean, and
to improvements in health conditions in priority countries,
particularly Haiti, she said.
Dr. Roses recalled her first paid public health job as a
door-to-door vaccinator in the smallpox eradication campaign of
1965. "I feel very moved after 38 years to continue serving health
in the Americas and to be able to pay tribute to community and
volunteer health workers on this 2 5 til anniversary of the Conference
of Alma Ata," she said, concluded
BAHO>
established in 1902,works with all the countries of the
Americas r.o improve v.he health and living standards of all their
peoples. The oldest health organization in the world, it also serves
as the Regional Office for the Americas of the World Health
Organization.
Page 1 of2
Communitv Health Cejl
From:
Aviva <tBviva@netnam vn>
To:
Dolor Vasari <dolar.vasani@rovib.nl>
Sent:
Subject:
Sunday February 16 7003 7z1 AM
PHA-Exchar.ge> Food for a powerful thought
Human Kights Header 36
PERSPECTIVES ON HUMAN RIGHTS: FURTHERING THE DEBATE.
Gn power end Human Rights:
1 .To be a fully empowered ciaim holder is to have the ability to compel the
performance of some obligation; before being empowered, people are unable to
compel important others to perform their obligations.
2.This, because in our societies, having a right means having the power to
command respect, to make claims and to have them heard and acted upon. Put
another way. to have a right is to have a power; to have to obtain a right
is to be powerless.
3.That in these same societies some are powerful, dialectically suggests
that others are powerless. So, any coherent notion of rights must,
therefore, recognize this connection between power, respect and inequality
in our societies.
4.Seen from such an angle, our performance in the Human Rights (HR) arena is
still largely inadequate, because so far, it has failed to reverse the
powerlessness of the poor. This failure of ours is coupled to our continued
choice of rather paternalistic interventions. (How many of us are aware
that, in our work, rather than empowering the poor, we may be empowering
ourselves to intervene in their lives?).
5.Power and powerlessness are fundamental dialectical opposites in society;
they reguiaie the interactions between individuals, the state, and its
citizen, it is inconceivable io imagine a world without power —and utopian
to believe that such a world might exist.
(A rights theory which envisions what should be, rather than what is, lacks
the force and persuasiveness to effect true change): Rights must be tied to
the notion or power and powerlessness.
6. What this means is that a HR-based approach will indeed challenge patterns
of authontv and power. Hlacing claims does not grant equality per-se, but
merely grants equality of attention; it is a first step in challenging
existing Hierarchies: placing claims is pari of a slow historical process
that will eventually lead to a better life for the poor.
7.But a caveat is caiiad for: Rights arguments are also increasingly being
used ‘(0 justify particular Sets of policies imposed On the poor. HR
arguments may actually be used against them.
2 17'03
8.HR can contribute (positively or negatively) to the power struggles of the
poor: they can be used as much in defense of privileges and the powerful in
society, as 'hey can be used to advance the interests of the poor and
marginalized. Economic rights of the haves (e.g., to property) are often
used against the interests of the deprived majorities, as much as legitimate
rights of people (e.g., to information, to assembly) are not infrequently
contested in iitigalioir or simply trampled using brutal repression.
3.If HR-based interventions prioritize the needs of the poor and
marginalized, rights can become powerful tools to advance democracy provided
they do nc-t ignore the power imbalances that exist between and within
countries. This, because rights are easily co-opted to serve those who
already benefit from inequity and imbalances of power.
10.So, how do rights-based interventions put the poor first?
An active pro-poor civil society has a key role to play here. Their social
mobilization activities have to aim for the structural changes needed for
meaningful and sustainable changes that will discriminate in favor of the
poor. In some countries, Human Rights Commissions have been put in place,
but are no panacea if they ignore tying rights to the notion of power and
powerlessness in the country.
11 .While Western preoccupation with good governance makes a misnomer of what
good governance should be, it is only active grassroots everyday public
participation (and not 'democratic, often rigged, elections in which only a
minority votes) that can really influence governments. Using a HR approach
to foster such an active participation is paramount -remembering that
individual rights and group rights are naturally compatible.
12.The success cf the HR approach should thus be judged by its capacity to
strengthen the least powerful m society to act in their own interest.
individually and collectively (indirectly leading to better governance).
13.We have to better understand HR and the role they can play in the context
in which each of us works and in which these HR are to be applied; therein
lies the immediate challenge.
[Mostly taken from L. London, email, Univ, of Cape Town, Oct.5, 2002, and
from K.H. Federle, Rights flow downhill, The inti J of Children's Rights, 2:
343-368, 19941.
Claudio Schuftan, Ho Chi Minh City
aviva@ netna m vn
PHA-Exohangc is hosted on Kabissa - Space for change in Africa
To post, write to; PHR-Exchange@kabissa.org
Website: httb://www.iists.kabissa.orq/maiiman/iistinfozpha-exchange
2/17 03
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xc^ange is hosted on Kabissa - Space for change in Africa
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Subject:
PHA-Exchange> Food for an urgent agenda's thoughts
Human Hights Header 3/
Pu : i iNG tulii. Y AND HUMAN RIGHT S IN HEAL i H ON THt AGENDA: THE ROLE
or MQf)S
i.Eci'jity and Human Rights (HRs) are by no means new concepts to NGOs.
Moreover, equity and HRs are inseparately linked since equity is key to
these two concepts in the reaim ot their work in health and nutrition.
3.A paradigm shift is cieariy in the making in development and in
■
— ••• Nmw models are more no!ifica!!v driven in a direction
ii ;Si n sneers one namc-ers ihe resolution ot The prooiems qi nand. i hereiore,
these davs. r?c;'s end more NGOs are discussing 2nd trvinc to c-nsrsticnedizs
ine eguii■. ariu ntiinan .
> ipproacn to apply it to theh wofK.
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have become very specialized and contribute marginally to
most NGCs today
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undermining the struggle of the people to emancipate themselves from
c-ncressior. Promsms d-’ivered bv these NGOs do not real!'/ seek to redress
•.no social oi.''cumsiance5 mai cause impovensriment/preveniaDie iu-neaim
^nri rn^lrutrh’on. The development discourse is framed not in the ianouace of
Cmf—
01 iiu; sUipaLU!I O- jUSi’ce, GUI USii’iCj lhe VOCaOUiciiy Oi ufiusiiy, lecuiHcai
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evood'se. neutrality and oaternaiism. NGO proqrams have often worked to
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in which ins State exercise? its power. NGOs work is limited io project
and standing uo against violations ot HRs. Many NGOs were co-opted by
■
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i-e KooH h pr-H PUtrit.'On
wo;a done io so; uo 'safety nets' for ihe poor). NGOs have become an
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a missicnary' position, h Nl^Os stand in Tav'or ot
eman?!nat:o"'
tne focus cf their work has invariably to be in the
c'OUr.yjriXo, pu..LiU-u. Coniciin, suppoiiiiig those sociai movernenis -.n-ai SeeK io
challenge a socie’ svsiom that benefits a few and impoverishes the many'"
\Pv1aHji and l/Os. ,..
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Page 2 oi 5
-
on the issues that are before them, and forget
away: sue,; hidden trains have to be brought io the
' st NG Ds tend to wo
inose ma; ace
ffQnf
je issues of voice power, risk and neglect are
essential in a HRs discourse —as difficult to surface as they may be.
S
faPrioy
-,c;<a”y needs io be uprooted is that health programs
addressing >he >. ■ jeri needs of women and children implicitly address human
he i IRs approach, nothing is left implicit; without an explicit
retooling to a HRs focus, such ciaims remain but hot air: they are hollow
com litments to HRs that allow controlling hierarchies to persist.
7-NGOs have ample accumulated knowledge of what is going on ...and have just
begun to realize ihax. if they do not act on that knowledge, they are not
really serving the people of the communities that they work with to the
fullest.
o. i here is a neeu. mem :u< t. more determined commitment io pro-poor social
policies and programs (including health)and an increase in the funding for
such an approach. Activities are to concentrate on institutional capacity
building to better promote education and consciousness-raising at the
community level. A key question is to give advocacy tasks more prominence so
as to hold governments more accountable.
The conceot of Human Rights in health and why it is used:
9. in contrast to a ’oeficit-fiiiing approach’ io poverty and preventable
iii-health alleviation, the Equity/Human Rights-based approach (E/HRs-based
appieach) defines poverty as social exclusion, instead of focusing on
oreaiT'g an inventory ?•? nubfic goods or services that must be provided and
theh se eking tc fill the deficit via foreign aid, the rights-based approach
focuses-on t-ylcg to Identify the critical exclusionary mechanisms. This.
eca tse work in health and development is about assisting poor communities
overcome oostacles. rather than about the endless pursuit of grant aid for
social goods.
i he tz/HKs-based accroach enables NGOs to see much more cleariy the kinds of
power relations arid systemic forces that drive and perpetuate poverty.
But the transition to mainstreaming a rights-based approach into the
c y anizational structure of NGOs is a complex enterprise; it cannot simply
ce decreed and implemented.
■ 3.The EnriS-based approach asserts ihai. Work in health should be seen as a
-’■cccss that unequivocally leads tn people fully realizing all their human
rights (and not only their right to health); the approach should thus bo
reflected both >n the processes engaged and the outcomes pursued by NGOs.
it .More importantly, the E>HRs-based approach sees iii-health. malnutrition
and poverty as ? denial of human dignity, i.e. as an important part of the
deniai of people s economic, social, cultural, civil ana political rights.
Ar / these rights are more than just moral principles and norms governing
numac oenavic-r... ;■■■=• are international iegai standards.
p-■ rerty itself is seen as an abuse of HRs... The poor and marginalized are
not wncrc tr.c ■ ■_,
•«n Because
is not ;i.e exclusive ousiness of governments, this broad
each definitely brings an added value to immunities and to NGOs when
sitting
ana-;.;
ana widi government representatives to jointly
'
——-s
Health
it hrirsri^ jtnmpthinn
uiuereni a sc
powenui to existing efforts by aii actors in
their efforts to overcome ill-health. malnutrition and poverty in a more
„;.s;to vtoto .--.a.
i3.The ; i iciples of equity in health (and prominently those related to
gender equaiity) are not currently codified in any way to aiiow monitoring
" to''' mentation; more often than not, they are lost when implementing
heaito. sector reform or macro-economic corrective measures.
" ric hts on the other hand, are enshrined in legal covenants that
protect human dignity and place obligations (or duties) on providers and
t—
-rno stete. While NGOs do have the
to .
to toilers, it is nOw widely accepted
ihs' states nave ve-y ss>Wit: totiigtotons (o respect, protect and fulfill
<h;-nutrition.
14.lt is thus timely for NGOs to use the equity and human rights-based
approach -to apply the internationally agreed human rights standards to
slth ; olicy and practice- emphasizing active grassroots participation and
the right of peooic to choose their own path.
15.When doing so, priority is to be given to the poor, the marginalized and
the vulnerable -those currently most denied their rights due to their lack
of choice, of control and of resources.
13. i he conceptual basis that justifies (and prescribes) the use of an Equity
and Human Rights-based Approach in the health and nutrition work of NGOs
the following:
? HRs are entitlements all people have, to develop their full potential;
they are valid for everyone -they are universal (A right is a right only
when b is u?:vors2': ntoerwise it is a privilege).
? There is a cilftorencs between just delivering services ana making ciear to
beneficia des that they are legally
to specific services and can go
somewhere to complain if they do not receive what is due them.
----—-r -r
problems at hand, but to make them
.. ...to.., to..:: to to. tor rotos.
?hai meto be met fqr people to have the opportunity
to live ,-' fu dignify, ' ill health and self-worth.
? HRs lac* cultural legitimacy in many parts of the world: communities are
traditio. more concerned with needs than with rights; that is why NGOs
neve -.a
<rom peooie s o'..,., iniiiai understanding of ineir rights land
the issues of po' ;■ to then support a battom-up dialogue that deepens the
ownersnio oi HRs -_>v the beneficiaries they work with. ( Without concerned
citizen sotto -> to- utoto’d ^Rs close to home, we shall look in vain for
progress).
R;ghts are d.iXto:-eto Horn needs; rights are relational: where someone has
3 ciuty or rcsponsioiiity to honor and satisfy that
•h-r
jitn beneficiaries hold claims aaainst
roole can only realize their riahts in
they
are empowered to claim and fulfill the rights
ano moonize oeopi
non
till:
srstood as generating several forms of power: seif-respe
cohesion (cower with\ and a clear agenda for
•03:
yina power relationships between riahts-holders and authority
in reiatior
no.
includes HGO
”■'< so."t. addressing the root causes of oovertv/iii-heaith
tiv.
must work tn concert with others embarked in
iy /.-x ~r- 't ’
*■>
71 r\<‘
Jhe.e-« )ee:
~i cans ror a purposeful and transoarent
t in snort
is remaining steadfast allies o
in ini
shiti fowar
?SSeG appiOcCf! SifiC-y Ihs pci: ciGSgniallC-
globally with the force of
,!W
and opoortunities,
^though focusing or? health. NGC
1.4C»-
5-7.-
^grunc
cnalieng
Position: 1122 (7 views)