Teen Photovoice Project Aids Spread Of Health Advocacy Message In Minority Communities:
Children's Memorial Hospital researcher has developed a powerful and innovative health advocacy program that uses photovoice, a combination of digital photography and storytelling, to empower minority teens to identify and address important health problems in their communities.
"Photovoice confronts a fundamental problem of community assessment: What professionals, researchers, specialists and outsiders think is important may completely fail to match what the community thinks is important," said Jonathan Necheles, MD, MPH, an attending physician at Children's Memorial Hospital and assistant professor of pediatrics at Northwestern University Feinberg School of Medicine.
"Photovoice goes beyond the conventional role of community assessment by inviting people to promote their own and their community's well-being," said Necheles, who described the photovoice project in and article in the Fall 2007 Volume 1.3 issue of the journal Progress in Community Health Partnerships: Research Education and Action.
For the first six months of the project, 13 youths aged 13 to 17 years who had been given a new digital camera took hundreds of pictures to capture images in their communities -- such as fast food, liquor stores, pollution -- they believed influenced their health behaviors.
At regular meetings, the teens shared their photographs and talked about common themes that arose. Two main themes developed: food and stress.
"Our discussions showed us that youth are concerned about the current obesity epidemic and want to effect change. They also worry about their stress levels in school and want to communicate this to school staff," Necheles said.
The youth then developed a series of posters aimed at educating their peers and others about health issues in their communities. One of the posters showed that in their neighborhoods and schools unhealthy foods were more readily available than healthier choices such as fresh fruit and salads. Another poster depicted images of major stressors in the teens' environment, such as traffic, school and pollution.
The posters were exhibited in a special show and then reproduced and distributed around the students' neighborhoods to promote change.
After the Teen Photovoice Project, several participants continued to develop their community advocacy interest through advocacy-related skill building activities, involvement in community organizations and college classes that address this topic. Necheles plans to engage more teens in the future to develop messages to influence peer behavior on eating and physical activity, and to evaluate the messages' efficacy.
Source: http://www.medicalnewstoday.com/articles/85359.php
Wednesday, April 30, 2008
Prisoners and transplants
A heart transplant performed on a prison inmate in California is creating a debate about whether prisoners deserve access to any and all medical care, and whether they should receive equal access to extremely scarce resources, such as organs for transplants.
As the prison population in the U.S. ages, demand for health care services will increase, just as it does in the rest of the population. The combination of high rates of chronic diseases that affect the kidneys and liver, and an aging prison population mean that more prisoners will need transplants to survive.
But should such scarce resources be offered to those who forfeit their rights as convicted criminals? How much health care should prisoners receive, and should their priority be different than those who are not incarcerated?
A right to health care?
Almost thirty years ago, the U.S. Supreme Court ruled that prisoners were entitled to receive adequate medical care, effectively creating prisoners' rights to health care. The irony is that there is no such right for law-abiding citizens, and in fact many inmates receive much better medical care when they are incarcerated than they had when they were free.
But what counts as "adequate" medical care for prisoners? Should they receive only basic care such as first aid and basic medications, all available treatments, or something in between?
Since prisoners forfeit many rights when they are convicted of committing crimes -- their freedom, the right to vote, etc. -- why should they gain a new right to health care when they are imprisoned?
One answer is that by using prison as a means of protecting the public, society creates an obligation to keep prisoners safe and treat them humanely, which ought to include health care.
The reality of prison medical care is that prisoners receive the same range of services available to anybody else. Politicians and prison officials recognize that providing health care is an expensive proposition, but have come to view it as a necessary cost of protecting society.
Past deeds and future desserts
But what should happen when prisoners and the people who are being protected from them are competing for the same scarce resources, like kidneys, livers, hearts or other organs for transplant? Should the fact that prisoners broke the law lower their priority compared to law-abiding patients? If so, on what grounds?
Any policy that would award lower priority to prisoners would be based on some sense that prisoners deserve less based on their value to society, and would introduce the notion of social worth to the entire transplant system.
While prisoners' actions may make them seem like less worthy transplant candidates than many other members of society, the same can be said for alcoholics whose actions lead to the destruction of their livers and who need a transplant to survive, or smokers who contract heart disease. Yet we don't base transplant priority on patients' lifestyle choices.
We put people in jail and take away their freedoms based on judgments about their unlawful actions, but that ought to be separate from making judgments about their social worth for access to organ transplant.
The truth is that if social worth becomes a criterion for judging who gets transplants first -- or maybe who gets them at all -- then we all had better take a hard look at our lifestyles and behaviors.
In the end, the fact that the system offers heart transplants to inmates says more about what's wrong with health care for people outside of prison that it says about how we treat those behind bars.
By Jeffrey P. Kahn, Ph.D., M.P.H.
Source: http://archives.cnn.com/2002/HEALTH/02/04/ethics.matters/index.html
As the prison population in the U.S. ages, demand for health care services will increase, just as it does in the rest of the population. The combination of high rates of chronic diseases that affect the kidneys and liver, and an aging prison population mean that more prisoners will need transplants to survive.
But should such scarce resources be offered to those who forfeit their rights as convicted criminals? How much health care should prisoners receive, and should their priority be different than those who are not incarcerated?
A right to health care?
Almost thirty years ago, the U.S. Supreme Court ruled that prisoners were entitled to receive adequate medical care, effectively creating prisoners' rights to health care. The irony is that there is no such right for law-abiding citizens, and in fact many inmates receive much better medical care when they are incarcerated than they had when they were free.
But what counts as "adequate" medical care for prisoners? Should they receive only basic care such as first aid and basic medications, all available treatments, or something in between?
Since prisoners forfeit many rights when they are convicted of committing crimes -- their freedom, the right to vote, etc. -- why should they gain a new right to health care when they are imprisoned?
One answer is that by using prison as a means of protecting the public, society creates an obligation to keep prisoners safe and treat them humanely, which ought to include health care.
The reality of prison medical care is that prisoners receive the same range of services available to anybody else. Politicians and prison officials recognize that providing health care is an expensive proposition, but have come to view it as a necessary cost of protecting society.
Past deeds and future desserts
But what should happen when prisoners and the people who are being protected from them are competing for the same scarce resources, like kidneys, livers, hearts or other organs for transplant? Should the fact that prisoners broke the law lower their priority compared to law-abiding patients? If so, on what grounds?
Any policy that would award lower priority to prisoners would be based on some sense that prisoners deserve less based on their value to society, and would introduce the notion of social worth to the entire transplant system.
While prisoners' actions may make them seem like less worthy transplant candidates than many other members of society, the same can be said for alcoholics whose actions lead to the destruction of their livers and who need a transplant to survive, or smokers who contract heart disease. Yet we don't base transplant priority on patients' lifestyle choices.
We put people in jail and take away their freedoms based on judgments about their unlawful actions, but that ought to be separate from making judgments about their social worth for access to organ transplant.
The truth is that if social worth becomes a criterion for judging who gets transplants first -- or maybe who gets them at all -- then we all had better take a hard look at our lifestyles and behaviors.
In the end, the fact that the system offers heart transplants to inmates says more about what's wrong with health care for people outside of prison that it says about how we treat those behind bars.
By Jeffrey P. Kahn, Ph.D., M.P.H.
Source: http://archives.cnn.com/2002/HEALTH/02/04/ethics.matters/index.html
Public-Private Partnerships to Battle Malaria
On April 25, as the United States marked its first Malaria Awareness Day and commemorated Africa Malaria Day, the U.S. Government announced three public-private partnerships to battle malaria. The announcement came on the day we stand in solidarity with people and communities across the globe in the fight against this disease, with great hope for a better future for African children and families.
In June 2005, President Bush revitalized the U.S. global malaria strategy through the President’s Malaria Initiative (PMI) and committed an additional $1.2 billion over five years to fight malaria. The goals of PMI are ambitious – reduce by 50 percent the number of deaths from malaria in 15 target countries by reaching 85 percent of the most vulnerable groups (children under 5 years of age and pregnant women) with proven and effective prevention and treatment measures.
Partnerships are at the heart of PMI’s strategy. Given the enormous burden of malaria and the ambitious target of reducing malaria deaths by half by 2010, effective partnerships, particularly at the country level, are essential to reach the maximum number of people. Community, faith-based, and nongovernmental organizations (NGOs) are crucial to the success of malaria control efforts, and PMI is already working with 29 NGOs and local organizations.
At the White House Summit on Malaria last December 14, First Lady Laura Bush announced the Malaria Communities Program (MCP), a new grants program to provide $30 million over four years to new partners in order to support the efforts of communities and indigenous organizations to combat malaria at the local level in the 15 PMI focus countries with the goal of building sustainable malaria control programs in Africa.
At the Summit, President Bush also designated April 25, 2007, as "Malaria Awareness Day." The three new and unique partnerships announced as part of the Day’s observance will save lives and gift the gift of growing up to millions of people.
Uganda Long-Lasting Net (LLIN) Distribution
PMI, Malaria No More, and the Ugandan Ministry of Health announced a partnership to distribute 570,000 long-lasting insecticide-treated mosquito nets (LLINs) to pregnant women, children under age 5, and other vulnerable populations in 26 districts in Uganda plagued by malaria.
Malaria is the leading cause of illness and death in Uganda, responsible for 40 percent of all outpatient hospital visits and 25 percent of all hospital admissions. Almost half of the inpatient hospital deaths of children under age 5 are due to malaria.
Those distributing the LLINs will also provide education and information to ensure that the nets are used properly to repel malaria-transmitting mosquitoes. The LLINs will be distributed with 1.8 million nets provided by the Global Fund to Fight AIDS, Tuberculosis and Malaria in a national distribution campaign in support of the Ugandan Ministry of Health and the National Malaria Control Program. This campaign to deliver nearly 2.4 million nets will protect over 3.6 million Ugandans and significantly raise household ownership of an insecticide-treated mosquito net from the present rate of 15 percent to about 50 percent.
Zambia LLIN Distribution
The U.S. Government and the Global Business Coalition on HIV/AIDS, Tuberculosis, and Malaria (GBC) announced a partnership to distribute more than 500,000 LLINs to some of the most vulnerable households in Zambia. Through PMI and the U.S. President’s Emergency Plan for AIDS Relief, the American people have joined with the GBC and the Zambian government to provide protection against malaria for approximately 1 million Zambians with these nets.
This partnership will address critical linkages between malaria and HIV/AIDS in Zambia, which has prevalences for both diseases that are among the highest in the world. Malaria prevalence in Zambia has tripled over the past three decades. In a population of 10.2 million, there are up to 4 million clinical cases of malaria per year, accounting for 40 percent of outpatient visits and admissions to health care facilities, and as many as 50,000 deaths per year. People living with HIV/AIDS are extremely vulnerable to malaria and face an increased likelihood of death and debilitating illness. In 2005, an estimated 1.1 million adults and children were living with HIV in Zambia. An estimated 98,000 adults and children died from AIDS, leaving behind a growing number of AIDS orphans, whose numbers are currently estimated at 710,000.
The partnership will build on an existing HIV/AIDS platform, RAPIDS (Reaching HIV-Affected People with Integrated Development and Support), a consortium of six organizations that provides an integrated package of community-based prevention, treatment, and care support to orphans and vulnerable children and people living with HIV/AIDS in all nine provinces of Zambia. Consortium members include World Vision, Africare, CARE, Catholic Relief Services, the Salvation Army Zambia, and the Expanded Church Response. RAPIDS reaches more than 154,000 Zambian households through its network of 12,000 volunteer Zambian caregivers.
RAPIDS will use its established network of caregivers and its household approach to distribute and follow up on the LLINs. Through this partnership, all nets will be distributed before November – the beginning of the malaria season in Zambia. The RAPIDS home-based care program also will provide personal weekly or biweekly follow-up to check on the health of each patient and ensure the nets are being used properly.
Madagascar Integrated Measles/Malaria Campaign
In Madagascar, the U.S. Government, the American Red Cross, and Malaria No More announced a partnership to add mosquito nets to a planned integrated measles campaign and to provide community-based education for malaria prevention and proper use of nets to give the gift of growing up to nearly 1.4 million under age 5 on the island.
The unique partnership supports the Madagascar government’s integrated campaign and the Measles Initiative Partners – American Red Cross, the Centers for Disease Control and Prevention (CDC), the World Health Organization, the United Nations Children’s Fund, and the United Nations Foundation – along with the Canadian Red Cross, the International Federation of Red Cross and Red Crescent Societies, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. PMI and Malaria No More will support this campaign by filling essential gaps in the comprehensive campaign plan, which includes LLINs, logistics, and monitoring and evaluation.
The integrated campaign will deliver measles vaccine, medication, polio vaccine, and now insecticide-treated mosquito nets for malaria prevention to pregnant women, children, and their mothers during this mass health campaign.
PMI is an interagency initiative led by USAID, with the Department of Health and Human Services (HHS), CDC, as key partner. The goal of PMI is to assist national malaria control programs in cutting malaria-related deaths by 50 percent in the 15 focus countries in Africa by supporting a comprehensive malaria control effort led by national malaria control programs.
Source: http://www.pmi.gov/news/factsheet042607.html
In June 2005, President Bush revitalized the U.S. global malaria strategy through the President’s Malaria Initiative (PMI) and committed an additional $1.2 billion over five years to fight malaria. The goals of PMI are ambitious – reduce by 50 percent the number of deaths from malaria in 15 target countries by reaching 85 percent of the most vulnerable groups (children under 5 years of age and pregnant women) with proven and effective prevention and treatment measures.
Partnerships are at the heart of PMI’s strategy. Given the enormous burden of malaria and the ambitious target of reducing malaria deaths by half by 2010, effective partnerships, particularly at the country level, are essential to reach the maximum number of people. Community, faith-based, and nongovernmental organizations (NGOs) are crucial to the success of malaria control efforts, and PMI is already working with 29 NGOs and local organizations.
At the White House Summit on Malaria last December 14, First Lady Laura Bush announced the Malaria Communities Program (MCP), a new grants program to provide $30 million over four years to new partners in order to support the efforts of communities and indigenous organizations to combat malaria at the local level in the 15 PMI focus countries with the goal of building sustainable malaria control programs in Africa.
At the Summit, President Bush also designated April 25, 2007, as "Malaria Awareness Day." The three new and unique partnerships announced as part of the Day’s observance will save lives and gift the gift of growing up to millions of people.
Uganda Long-Lasting Net (LLIN) Distribution
PMI, Malaria No More, and the Ugandan Ministry of Health announced a partnership to distribute 570,000 long-lasting insecticide-treated mosquito nets (LLINs) to pregnant women, children under age 5, and other vulnerable populations in 26 districts in Uganda plagued by malaria.
Malaria is the leading cause of illness and death in Uganda, responsible for 40 percent of all outpatient hospital visits and 25 percent of all hospital admissions. Almost half of the inpatient hospital deaths of children under age 5 are due to malaria.
Those distributing the LLINs will also provide education and information to ensure that the nets are used properly to repel malaria-transmitting mosquitoes. The LLINs will be distributed with 1.8 million nets provided by the Global Fund to Fight AIDS, Tuberculosis and Malaria in a national distribution campaign in support of the Ugandan Ministry of Health and the National Malaria Control Program. This campaign to deliver nearly 2.4 million nets will protect over 3.6 million Ugandans and significantly raise household ownership of an insecticide-treated mosquito net from the present rate of 15 percent to about 50 percent.
Zambia LLIN Distribution
The U.S. Government and the Global Business Coalition on HIV/AIDS, Tuberculosis, and Malaria (GBC) announced a partnership to distribute more than 500,000 LLINs to some of the most vulnerable households in Zambia. Through PMI and the U.S. President’s Emergency Plan for AIDS Relief, the American people have joined with the GBC and the Zambian government to provide protection against malaria for approximately 1 million Zambians with these nets.
This partnership will address critical linkages between malaria and HIV/AIDS in Zambia, which has prevalences for both diseases that are among the highest in the world. Malaria prevalence in Zambia has tripled over the past three decades. In a population of 10.2 million, there are up to 4 million clinical cases of malaria per year, accounting for 40 percent of outpatient visits and admissions to health care facilities, and as many as 50,000 deaths per year. People living with HIV/AIDS are extremely vulnerable to malaria and face an increased likelihood of death and debilitating illness. In 2005, an estimated 1.1 million adults and children were living with HIV in Zambia. An estimated 98,000 adults and children died from AIDS, leaving behind a growing number of AIDS orphans, whose numbers are currently estimated at 710,000.
The partnership will build on an existing HIV/AIDS platform, RAPIDS (Reaching HIV-Affected People with Integrated Development and Support), a consortium of six organizations that provides an integrated package of community-based prevention, treatment, and care support to orphans and vulnerable children and people living with HIV/AIDS in all nine provinces of Zambia. Consortium members include World Vision, Africare, CARE, Catholic Relief Services, the Salvation Army Zambia, and the Expanded Church Response. RAPIDS reaches more than 154,000 Zambian households through its network of 12,000 volunteer Zambian caregivers.
RAPIDS will use its established network of caregivers and its household approach to distribute and follow up on the LLINs. Through this partnership, all nets will be distributed before November – the beginning of the malaria season in Zambia. The RAPIDS home-based care program also will provide personal weekly or biweekly follow-up to check on the health of each patient and ensure the nets are being used properly.
Madagascar Integrated Measles/Malaria Campaign
In Madagascar, the U.S. Government, the American Red Cross, and Malaria No More announced a partnership to add mosquito nets to a planned integrated measles campaign and to provide community-based education for malaria prevention and proper use of nets to give the gift of growing up to nearly 1.4 million under age 5 on the island.
The unique partnership supports the Madagascar government’s integrated campaign and the Measles Initiative Partners – American Red Cross, the Centers for Disease Control and Prevention (CDC), the World Health Organization, the United Nations Children’s Fund, and the United Nations Foundation – along with the Canadian Red Cross, the International Federation of Red Cross and Red Crescent Societies, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. PMI and Malaria No More will support this campaign by filling essential gaps in the comprehensive campaign plan, which includes LLINs, logistics, and monitoring and evaluation.
The integrated campaign will deliver measles vaccine, medication, polio vaccine, and now insecticide-treated mosquito nets for malaria prevention to pregnant women, children, and their mothers during this mass health campaign.
PMI is an interagency initiative led by USAID, with the Department of Health and Human Services (HHS), CDC, as key partner. The goal of PMI is to assist national malaria control programs in cutting malaria-related deaths by 50 percent in the 15 focus countries in Africa by supporting a comprehensive malaria control effort led by national malaria control programs.
Source: http://www.pmi.gov/news/factsheet042607.html
Healthcare Funding
Hawaii spends more money on public health per person than any other state, according to a new study released by the nonprofit Trust for America's Health.
"Hawaii is good," Jeffrey Levi, executive director of the organization and one of the report's authors, said in a telephone interview. "Public health is a priority in the state, at least with the state Legislature."
Hawaii led the nation with the highest state public health funding per person in the last fiscal year -- a total of nearly $196 million -- an average of about $152.66 per person, the report said.
But that figure reflects funding only for certain programs the Trust for America's Health is interested in, said state Health Director Chiyome Fukino. The state general fund budget for the Health Department totaled $397.4 million last year for all services.
It is a big budget based on the state's small population because certain infrastructure is needed to run health services throughout the islands, and there are no county health departments, she said. "It doesn't mean we have everything we need or are the best equipped of all states in terms of public health services."
The 50th State ranks 13th among states for federal funding from the U.S. Centers for Disease Control and Prevention based on figures for the 2007 federal fiscal year, ending in September, it said.
The analysis, "Shortchanging America's Health: A State-by-State Look at How Federal Public Health Dollars Are Spent -- 2008," shows how much money states are receiving and spending for public health.
"One of the concerns we have is the relatively low money spent for prevention," Levi said. "We're investing a lot of money in health care and not enough in prevention and health."
He said this is reflected in CDC funding, which has declined in the past four years for prevention activities.
The authors of the study said it is easier to compare federal investments across states than state spending from one to another, Fukino noted.
There are many issues to consider, she said, such as population size, different structures, public health services and budget reporting methods. "It's like apples and oranges."
Hawaii's CDC funding totaled about $34 million in the 2007 federal fiscal year -- $26.45 per person, compared with a national average of $17.23 per person.
Hawaii also did well in two other areas, Levi noted.
The state ranked third in the nation with nearly $41.7 million in federal funding, $32.53 per person, from the Health Resources and Services Administration. This includes money for community health centers and programs such as HIV/AIDS under the Ryan White CARE Act.
Federal funding of $2.1 million, or $1.66 per person, for the hospital preparedness program put Hawaii in ninth place nationally. Hawaii had a perfect score of 10 for emergency preparedness indicators in 2007.
Hawaii ranked 49th in the nation with a low 8.8 percent of population who are uninsured.
But the state did not fare well in all areas.
It had the nation's highest asthma rate of 30.4 percent among high school students in 2005. It was fourth for adult asthma rates of 14.6 percent, a 2004-2006 average.
Among public health indicators, the study looked at shortage areas of health professionals in fiscal 2007. Hawaii placed 23rd in the nation with an estimated shortage of 4,500 nurses by 2010. It was among states with the lowest shortage rates for primary care, mental health and dental care professionals.
Isles rank 13th for CDC Funding
State rankings for funding from Centers for Disease Control per capita:
1. Alaska $69.76
2. Georgia $52.56
3. Maryland $49.35
13. Hawaii $26.45
48. Florida $14.06
49. Indiana $13.69
50. Kansas $13.61
Source:Hawaii spends more money on public health per person than any other state, according to a new study released by the nonprofit Trust for America's Health.
"Hawaii is good," Jeffrey Levi, executive director of the organization and one of the report's authors, said in a telephone interview. "Public health is a priority in the state, at least with the state Legislature."
Hawaii led the nation with the highest state public health funding per person in the last fiscal year -- a total of nearly $196 million -- an average of about $152.66 per person, the report said.
But that figure reflects funding only for certain programs the Trust for America's Health is interested in, said state Health Director Chiyome Fukino. The state general fund budget for the Health Department totaled $397.4 million last year for all services.
It is a big budget based on the state's small population because certain infrastructure is needed to run health services throughout the islands, and there are no county health departments, she said. "It doesn't mean we have everything we need or are the best equipped of all states in terms of public health services."
The 50th State ranks 13th among states for federal funding from the U.S. Centers for Disease Control and Prevention based on figures for the 2007 federal fiscal year, ending in September, it said.
The analysis, "Shortchanging America's Health: A State-by-State Look at How Federal Public Health Dollars Are Spent -- 2008," shows how much money states are receiving and spending for public health.
"One of the concerns we have is the relatively low money spent for prevention," Levi said. "We're investing a lot of money in health care and not enough in prevention and health."
He said this is reflected in CDC funding, which has declined in the past four years for prevention activities.
The authors of the study said it is easier to compare federal investments across states than state spending from one to another, Fukino noted.
There are many issues to consider, she said, such as population size, different structures, public health services and budget reporting methods. "It's like apples and oranges."
Hawaii's CDC funding totaled about $34 million in the 2007 federal fiscal year -- $26.45 per person, compared with a national average of $17.23 per person.
Hawaii also did well in two other areas, Levi noted.
The state ranked third in the nation with nearly $41.7 million in federal funding, $32.53 per person, from the Health Resources and Services Administration. This includes money for community health centers and programs such as HIV/AIDS under the Ryan White CARE Act.
Federal funding of $2.1 million, or $1.66 per person, for the hospital preparedness program put Hawaii in ninth place nationally. Hawaii had a perfect score of 10 for emergency preparedness indicators in 2007.
Hawaii ranked 49th in the nation with a low 8.8 percent of population who are uninsured.
But the state did not fare well in all areas.
It had the nation's highest asthma rate of 30.4 percent among high school students in 2005. It was fourth for adult asthma rates of 14.6 percent, a 2004-2006 average.
Among public health indicators, the study looked at shortage areas of health professionals in fiscal 2007. Hawaii placed 23rd in the nation with an estimated shortage of 4,500 nurses by 2010. It was among states with the lowest shortage rates for primary care, mental health and dental care professionals.
Isles rank 13th for CDC Funding
State rankings for funding from Centers for Disease Control per capita:
1. Alaska $69.76
2. Georgia $52.56
3. Maryland $49.35
13. Hawaii $26.45
48. Florida $14.06
49. Indiana $13.69
50. Kansas $13.61
Source:http://starbulletin.com/2008/04/03/news/story08.html
"Hawaii is good," Jeffrey Levi, executive director of the organization and one of the report's authors, said in a telephone interview. "Public health is a priority in the state, at least with the state Legislature."
Hawaii led the nation with the highest state public health funding per person in the last fiscal year -- a total of nearly $196 million -- an average of about $152.66 per person, the report said.
But that figure reflects funding only for certain programs the Trust for America's Health is interested in, said state Health Director Chiyome Fukino. The state general fund budget for the Health Department totaled $397.4 million last year for all services.
It is a big budget based on the state's small population because certain infrastructure is needed to run health services throughout the islands, and there are no county health departments, she said. "It doesn't mean we have everything we need or are the best equipped of all states in terms of public health services."
The 50th State ranks 13th among states for federal funding from the U.S. Centers for Disease Control and Prevention based on figures for the 2007 federal fiscal year, ending in September, it said.
The analysis, "Shortchanging America's Health: A State-by-State Look at How Federal Public Health Dollars Are Spent -- 2008," shows how much money states are receiving and spending for public health.
"One of the concerns we have is the relatively low money spent for prevention," Levi said. "We're investing a lot of money in health care and not enough in prevention and health."
He said this is reflected in CDC funding, which has declined in the past four years for prevention activities.
The authors of the study said it is easier to compare federal investments across states than state spending from one to another, Fukino noted.
There are many issues to consider, she said, such as population size, different structures, public health services and budget reporting methods. "It's like apples and oranges."
Hawaii's CDC funding totaled about $34 million in the 2007 federal fiscal year -- $26.45 per person, compared with a national average of $17.23 per person.
Hawaii also did well in two other areas, Levi noted.
The state ranked third in the nation with nearly $41.7 million in federal funding, $32.53 per person, from the Health Resources and Services Administration. This includes money for community health centers and programs such as HIV/AIDS under the Ryan White CARE Act.
Federal funding of $2.1 million, or $1.66 per person, for the hospital preparedness program put Hawaii in ninth place nationally. Hawaii had a perfect score of 10 for emergency preparedness indicators in 2007.
Hawaii ranked 49th in the nation with a low 8.8 percent of population who are uninsured.
But the state did not fare well in all areas.
It had the nation's highest asthma rate of 30.4 percent among high school students in 2005. It was fourth for adult asthma rates of 14.6 percent, a 2004-2006 average.
Among public health indicators, the study looked at shortage areas of health professionals in fiscal 2007. Hawaii placed 23rd in the nation with an estimated shortage of 4,500 nurses by 2010. It was among states with the lowest shortage rates for primary care, mental health and dental care professionals.
Isles rank 13th for CDC Funding
State rankings for funding from Centers for Disease Control per capita:
1. Alaska $69.76
2. Georgia $52.56
3. Maryland $49.35
13. Hawaii $26.45
48. Florida $14.06
49. Indiana $13.69
50. Kansas $13.61
Source:Hawaii spends more money on public health per person than any other state, according to a new study released by the nonprofit Trust for America's Health.
"Hawaii is good," Jeffrey Levi, executive director of the organization and one of the report's authors, said in a telephone interview. "Public health is a priority in the state, at least with the state Legislature."
Hawaii led the nation with the highest state public health funding per person in the last fiscal year -- a total of nearly $196 million -- an average of about $152.66 per person, the report said.
But that figure reflects funding only for certain programs the Trust for America's Health is interested in, said state Health Director Chiyome Fukino. The state general fund budget for the Health Department totaled $397.4 million last year for all services.
It is a big budget based on the state's small population because certain infrastructure is needed to run health services throughout the islands, and there are no county health departments, she said. "It doesn't mean we have everything we need or are the best equipped of all states in terms of public health services."
The 50th State ranks 13th among states for federal funding from the U.S. Centers for Disease Control and Prevention based on figures for the 2007 federal fiscal year, ending in September, it said.
The analysis, "Shortchanging America's Health: A State-by-State Look at How Federal Public Health Dollars Are Spent -- 2008," shows how much money states are receiving and spending for public health.
"One of the concerns we have is the relatively low money spent for prevention," Levi said. "We're investing a lot of money in health care and not enough in prevention and health."
He said this is reflected in CDC funding, which has declined in the past four years for prevention activities.
The authors of the study said it is easier to compare federal investments across states than state spending from one to another, Fukino noted.
There are many issues to consider, she said, such as population size, different structures, public health services and budget reporting methods. "It's like apples and oranges."
Hawaii's CDC funding totaled about $34 million in the 2007 federal fiscal year -- $26.45 per person, compared with a national average of $17.23 per person.
Hawaii also did well in two other areas, Levi noted.
The state ranked third in the nation with nearly $41.7 million in federal funding, $32.53 per person, from the Health Resources and Services Administration. This includes money for community health centers and programs such as HIV/AIDS under the Ryan White CARE Act.
Federal funding of $2.1 million, or $1.66 per person, for the hospital preparedness program put Hawaii in ninth place nationally. Hawaii had a perfect score of 10 for emergency preparedness indicators in 2007.
Hawaii ranked 49th in the nation with a low 8.8 percent of population who are uninsured.
But the state did not fare well in all areas.
It had the nation's highest asthma rate of 30.4 percent among high school students in 2005. It was fourth for adult asthma rates of 14.6 percent, a 2004-2006 average.
Among public health indicators, the study looked at shortage areas of health professionals in fiscal 2007. Hawaii placed 23rd in the nation with an estimated shortage of 4,500 nurses by 2010. It was among states with the lowest shortage rates for primary care, mental health and dental care professionals.
Isles rank 13th for CDC Funding
State rankings for funding from Centers for Disease Control per capita:
1. Alaska $69.76
2. Georgia $52.56
3. Maryland $49.35
13. Hawaii $26.45
48. Florida $14.06
49. Indiana $13.69
50. Kansas $13.61
Source:http://starbulletin.com/2008/04/03/news/story08.html
Friday, March 28, 2008
Thailand's defence against bird flu
THAILAND: Building strong defences against bird flu
BANGKOK, 19 February 2008 (IRIN) - As avian influenza continues to surface in poultry farms across northern Thailand, health officials say they are fully prepared. “Right now we are ready for the pandemic virus,” Thawat Suntrajarn, director-general of the Disease Control Department, told IRIN. “We are sure the pandemic strain will not originate in Thailand.”
Even though, despite this confidence, nobody knows when or where the pandemic strain will originate, local and international specialists agree Thailand deserves credit for its preparedness measures.
Bird flu outbreaks on poultry farms have been confirmed in Nakhon Sawan and Phichit provinces and are suspected elsewhere, killing thousands of birds and leaving several people under surveillance for possible infection.
Nonetheless, the last confirmed human case of bird flu in Thailand was in August 2006. In the three years before that, 25 Thais were infected, with 17 dying from the virus.
However, the foundation for the country’s success in fighting bird flu was laid nearly two decades before, when the government set up a network of about 800,000 trained volunteers across the country to provide free medical advice to villagers and information on sanitation, HIV/AIDS and malnutrition.
The system was used effectively during the outbreak of severe acute respiratory syndrome (SARS) in 2003, and then for bird flu. Now the network allows officials to quickly respond to any suspected outbreaks among animals or humans.
Rapid response
“This is the strength of the Thai system, that we have a well-established surveillance network so we know rapidly if there are any sick chickens,” Thawat said. “We use this information to immediately send out a report to people.”
Government officials and scientists now say speedy information sharing is essential to keep the virus in check. Yet when SARS first hit, the government, led by deposed Prime Minister Thaksin Shinawatra, tried to control information.
“When bird flu happened, people were thinking the crisis could be managed using a top-down approach, that some wise guys know how things should be done,” said Prasit Palittapongarnpim, deputy director of the National Center for Genetic Engineering and Biotechnology (Biotec). “But we found from SARS that it seemed not to be the case, because the top doesn’t know much about this. So we think there was more of a need to strengthen the bottom-up approach to deal with the disease.”
Now when bird flu breaks out, the government immediately publicises the information. A team of doctors, veterinarians and local officials went to the scene of the recent outbreak; experts culled sick animals, gave suspected patients oseltamivir (Tamiflu) and sprayed the area with disinfectant.
Provinces where humans have died from bird flu are declared “red zones”, in which local officials must carry out drills for responding to avian flu every three months. Areas where only animals have died are “yellow zones”, where practice runs are conducted every six months.
Thailand’s quick-response system not only helps save lives, but can also rapidly cull chickens, which helps to prevent the virus from mutating into the human-to-human pandemic strain.
Countries without strong preparedness systems, such as Vietnam and Indonesia, provide the virus with more opportunities to mutate, scientists say.
Blueprint for continuity
In addition to the rapid response system, government officials possess a blueprint for dealing with a pandemic to ensure hospitals function and that the economy, including public services, communication networks and the electric grid, does not shut down in the event of a full-scale health crisis.
Thailand is stockpiling Tamiflu and building a factory that would help produce a vaccine for seasonal flu. Its scientists are also sharing flu virus samples with the World Health Organization (WHO) so companies can develop vaccines, and hopes to secure access to such vaccines if commercially developed.
Virologist Pilaipan Puthavathana cautioned that the virus could become resistant to Tamiflu if the drug is overused. “It’s like antibiotics; the more people use them the more the disease will become resistant,” she said.
However, even though Thailand appears well prepared, the best efforts may prove fruitless depending on the virility of the strain. It could break out anywhere at any time, and it would take at least six months thereafter to develop a vaccine, according to Thai specialists.
“It’s like you’re playing a slot machine; the jackpot could happen at any time,” said Somchai Peerapakorn, a medical officer for WHO Thailand, referring to the pandemic strain.
Source: http://www.globalsecurity.org/security/library/news/2008/02/sec-080219-irin01.htm
“If we think globally, then the chain is only as strong as its weakest link,” he added. “We can’t let any country be the weakest link.”
BANGKOK, 19 February 2008 (IRIN) - As avian influenza continues to surface in poultry farms across northern Thailand, health officials say they are fully prepared. “Right now we are ready for the pandemic virus,” Thawat Suntrajarn, director-general of the Disease Control Department, told IRIN. “We are sure the pandemic strain will not originate in Thailand.”
Even though, despite this confidence, nobody knows when or where the pandemic strain will originate, local and international specialists agree Thailand deserves credit for its preparedness measures.
Bird flu outbreaks on poultry farms have been confirmed in Nakhon Sawan and Phichit provinces and are suspected elsewhere, killing thousands of birds and leaving several people under surveillance for possible infection.
Nonetheless, the last confirmed human case of bird flu in Thailand was in August 2006. In the three years before that, 25 Thais were infected, with 17 dying from the virus.
However, the foundation for the country’s success in fighting bird flu was laid nearly two decades before, when the government set up a network of about 800,000 trained volunteers across the country to provide free medical advice to villagers and information on sanitation, HIV/AIDS and malnutrition.
The system was used effectively during the outbreak of severe acute respiratory syndrome (SARS) in 2003, and then for bird flu. Now the network allows officials to quickly respond to any suspected outbreaks among animals or humans.
Rapid response
“This is the strength of the Thai system, that we have a well-established surveillance network so we know rapidly if there are any sick chickens,” Thawat said. “We use this information to immediately send out a report to people.”
Government officials and scientists now say speedy information sharing is essential to keep the virus in check. Yet when SARS first hit, the government, led by deposed Prime Minister Thaksin Shinawatra, tried to control information.
“When bird flu happened, people were thinking the crisis could be managed using a top-down approach, that some wise guys know how things should be done,” said Prasit Palittapongarnpim, deputy director of the National Center for Genetic Engineering and Biotechnology (Biotec). “But we found from SARS that it seemed not to be the case, because the top doesn’t know much about this. So we think there was more of a need to strengthen the bottom-up approach to deal with the disease.”
Now when bird flu breaks out, the government immediately publicises the information. A team of doctors, veterinarians and local officials went to the scene of the recent outbreak; experts culled sick animals, gave suspected patients oseltamivir (Tamiflu) and sprayed the area with disinfectant.
Provinces where humans have died from bird flu are declared “red zones”, in which local officials must carry out drills for responding to avian flu every three months. Areas where only animals have died are “yellow zones”, where practice runs are conducted every six months.
Thailand’s quick-response system not only helps save lives, but can also rapidly cull chickens, which helps to prevent the virus from mutating into the human-to-human pandemic strain.
Countries without strong preparedness systems, such as Vietnam and Indonesia, provide the virus with more opportunities to mutate, scientists say.
Blueprint for continuity
In addition to the rapid response system, government officials possess a blueprint for dealing with a pandemic to ensure hospitals function and that the economy, including public services, communication networks and the electric grid, does not shut down in the event of a full-scale health crisis.
Thailand is stockpiling Tamiflu and building a factory that would help produce a vaccine for seasonal flu. Its scientists are also sharing flu virus samples with the World Health Organization (WHO) so companies can develop vaccines, and hopes to secure access to such vaccines if commercially developed.
Virologist Pilaipan Puthavathana cautioned that the virus could become resistant to Tamiflu if the drug is overused. “It’s like antibiotics; the more people use them the more the disease will become resistant,” she said.
However, even though Thailand appears well prepared, the best efforts may prove fruitless depending on the virility of the strain. It could break out anywhere at any time, and it would take at least six months thereafter to develop a vaccine, according to Thai specialists.
“It’s like you’re playing a slot machine; the jackpot could happen at any time,” said Somchai Peerapakorn, a medical officer for WHO Thailand, referring to the pandemic strain.
Source: http://www.globalsecurity.org/security/library/news/2008/02/sec-080219-irin01.htm
“If we think globally, then the chain is only as strong as its weakest link,” he added. “We can’t let any country be the weakest link.”
Sanitation issues and its consequences
There are many reasons for poor sanitation across the developing countries. Among them, lack of financial resources, lack of accountability, corruption, lack of stewardship, and failure to recognize its impact on the society are the prominent ones. To solve the problem of sanitation, sufficient funding is not the only critical solution, but immense significance needs to be placed on a demand based system rather than a supply based system. Also, there should be collaboration among the engineering field, the Public Health field and the local community which would further strive to improve access to basic and adequate sanitation.Below is an interesting article which explains the challenges and consequences of inadequate sanitation.
ScienceDaily (Mar. 21, 2008) — World Water Day, to be marked March 20, focuses this International Sanitation Year on the 2.6 billion people with inadequate access to toilets. Some argue that meeting the sanitation MDG is also a prerequisite to the goals of reducing global poverty.
Achieving the sanitation goal -- to simply halve the number of people without access to a toilet by 2015 -- would cost $38 billion, less than 1% of annual world military spending. That investment, however, would yield $347 billion worth of benefits -- much of it related to higher productivity and improved health. Experts estimate that $9 in productivity, health and other benefits are returned for every dollar invested installing toilets for people in countries that today are off-track in meeting the UN Millennium Development Goal (MDG) for sanitation.
According to UN figures, meeting the sanitation MDG target would add 3.2 billion annual working days worldwide. Universal coverage would add more than four times as many working days.
Some 2.6 billion people -- over a third of humanity -- lack access to adequate sanitation. Each of those devotes a conservatively estimated 30 minutes a day queuing for public toilets and / or seeking seclusion. The cumulative time involved equals about two working days per month.
A more drastic consequence, however, is the number of workdays lost to diarrhoeal disease -- either by ill workers or when she or he is caring for a sick child or relative.
In addition, many women avoid workdays during menstruation when workplaces have no toilets.
Health Impacts
Diarrhoeal disease is a leading cause of death and illness, killing 1.8 million people each year. Poor hygiene and lack of access to sanitation together contribute to 88 per cent of all deaths from diarrhoeal disease, with children paying the highest price: 5,000 deaths a day. Hundreds of millions of other children suffer reduced physical growth and impaired cognitive functions due to intestinal worms.
Improved access to sanitation would also lead to very high avoided health sector costs, according to UN research.
On a typical day in sub-Saharan Africa, for example, half the hospital beds are occupied by people afflicted with faecal-borne disease. Treating preventable infectious diarrhoea consumes 12 percent of the region's total health budget.
Globally, $552 million in direct treatment costs would be avoided by meeting the MDG sanitation target.
Around the world, an estimated 200 million tons of human waste and untold millions of tons of wastewater are discharged uncontained and untreated, into watercourses every year. As a result, humans are regularly exposed to bacteria, viruses and parasites -- spread through direct or indirect contact with these watercourses. Such exposure is the leading cause for diarrhoeal disease (including dysentery and cholera), parasitic infections, worm infestations and trachoma.
Sanitation and Children
Healthy children learn more than children suffering from worm infections, which sap nutrients and calories and lead to listlessness and trouble concentrating. Up to two thirds of all schoolchildren in some African countries are infected with parasitic worms.
Schools without private and separate sanitation facilities for boys and girls have higher incidence of diarrheal disease but also lower attendance and a higher dropout rate, especially for girls whose parents may remove them from the education system when they start menstruating. This fuels the discrepancy in primary school completion rates: one in four girls do not complete primary school, compared to one in seven boys.
More girls in school means higher rates of female literacy -- for every 10 percent increase in female literacy, a country's economy can grow by 0.3 percent.
UN experts estimate the reduction in diarrhea engendered by meeting the sanitation target would add an estimated 272 million days of school attendance.
Ensuring economic benefits
Many UN studies have shown that public- and private-sector investment into sanitation can lead to economic benefits for communities. In particular, small entrepreneurs can benefit from infrastructure development. That, in turn, requires enabling policies to be in place.
Many sectors are already impacted by sanitation-triggered illnesses of their workers, including agriculture, fish-farming, energy production, large-scale industrial processes, small-scale industry, transport and recreation.
Health, safety and comfort standards for sanitation as well as aesthetic considerations also heavily influence the choice of tourist destinations.
Report on progress
Between 1990 and 2004, an estimated 1.2 billion people gained access to improved sanitation, an increase of 10 percent. To meet the Millennium Development Goals' sanitation target, however, over 1.6 billion more will need to be reached by 2015, with developing countries facing the biggest challenge. Globally, this translates into 626,000 people per day being given access to an improved sanitary facility.
While many regions are on track to meet the MDG sanitation target, we will miss this global target by a wide margin.
The East Asia/Pacific region recorded the largest improvements, with sanitation coverage increasing from 30 per cent in 1990 to 51 percent in 2004, putting it on track to reach its target of 65 percent. The Middle East/North Africa and Latin America / Caribbean are also generally on track to meet their MDG sanitation targets.
The areas with the least access are West and Central Africa (36 per cent coverage), South Asia (37 per cent) and Eastern and Southern Africa (38 per cent). In terms of absolute numbers, the greatest improvements have been in South Asia, which more than doubled its coverage from 17 per cent in 1990 to 37 percent in 2004. Yet the increase is still not sufficient for the region to meet its MDG sanitation target of 58 per cent by 2015.
Urban-Rural Discrepancies
Access to improved sanitation was more than twice as high in urban areas than in rural areas in 2004 (80 per cent in urban areas versus 39 per cent in rural areas). Of the 2.6 billion people currently without access to improved sanitation, 2 billion (77 per cent) live in rural areas. The urban-rural disparity is largest in South Asia, where only 27 per cent of the rural population is served, compared to 63 per cent in urban areas. Only in industrialized countries is urban and rural coverage comparable
According to UN experts, key steps needed to accelerate progress on this issue include:
Secure political commitment to universal sanitation
Sanitation is a political and institutional orphan, an under-funded sector with no voice at the policy or service delivery 'high table'. Establishing one national coordinating body, formulating a single, country-wide sanitation plan, and putting into place a transparent monitoring framework could spur and drive progress.
Market sanitation and hygiene and focus on long-term behaviour change
Health-oriented information campaigns have been less successful at driving demand than using commercial techniques and appealing to consumer preferences for convenience, comfort, safety, cleanliness and prestige. Building community consensus that open defecation and other environmental hazards are actually serious health problems -- that can be solved by toilets -- has proved successful in a number of countries. Supporting health departments and community health workers to focus on long-term behaviour changes and educating children through school-based programs are both necessary for sustaining demand and helping new behaviours stick.
Significant professional business development support for small-scale sanitation providers is required, as is greater training of sanitary engineers, to meet the demands of the massive scaling up of efforts required for universal coverage. It needs to be made easy for lower income families to build and maintain toilets, washrooms and wastewater disposal systems whose benefits they understand, and whose domestic convenience they actively seek.
Source: http://www.sciencedaily.com/releases/2008/03/080320095022.htm
ScienceDaily (Mar. 21, 2008) — World Water Day, to be marked March 20, focuses this International Sanitation Year on the 2.6 billion people with inadequate access to toilets. Some argue that meeting the sanitation MDG is also a prerequisite to the goals of reducing global poverty.
Achieving the sanitation goal -- to simply halve the number of people without access to a toilet by 2015 -- would cost $38 billion, less than 1% of annual world military spending. That investment, however, would yield $347 billion worth of benefits -- much of it related to higher productivity and improved health. Experts estimate that $9 in productivity, health and other benefits are returned for every dollar invested installing toilets for people in countries that today are off-track in meeting the UN Millennium Development Goal (MDG) for sanitation.
According to UN figures, meeting the sanitation MDG target would add 3.2 billion annual working days worldwide. Universal coverage would add more than four times as many working days.
Some 2.6 billion people -- over a third of humanity -- lack access to adequate sanitation. Each of those devotes a conservatively estimated 30 minutes a day queuing for public toilets and / or seeking seclusion. The cumulative time involved equals about two working days per month.
A more drastic consequence, however, is the number of workdays lost to diarrhoeal disease -- either by ill workers or when she or he is caring for a sick child or relative.
In addition, many women avoid workdays during menstruation when workplaces have no toilets.
Health Impacts
Diarrhoeal disease is a leading cause of death and illness, killing 1.8 million people each year. Poor hygiene and lack of access to sanitation together contribute to 88 per cent of all deaths from diarrhoeal disease, with children paying the highest price: 5,000 deaths a day. Hundreds of millions of other children suffer reduced physical growth and impaired cognitive functions due to intestinal worms.
Improved access to sanitation would also lead to very high avoided health sector costs, according to UN research.
On a typical day in sub-Saharan Africa, for example, half the hospital beds are occupied by people afflicted with faecal-borne disease. Treating preventable infectious diarrhoea consumes 12 percent of the region's total health budget.
Globally, $552 million in direct treatment costs would be avoided by meeting the MDG sanitation target.
Around the world, an estimated 200 million tons of human waste and untold millions of tons of wastewater are discharged uncontained and untreated, into watercourses every year. As a result, humans are regularly exposed to bacteria, viruses and parasites -- spread through direct or indirect contact with these watercourses. Such exposure is the leading cause for diarrhoeal disease (including dysentery and cholera), parasitic infections, worm infestations and trachoma.
Sanitation and Children
Healthy children learn more than children suffering from worm infections, which sap nutrients and calories and lead to listlessness and trouble concentrating. Up to two thirds of all schoolchildren in some African countries are infected with parasitic worms.
Schools without private and separate sanitation facilities for boys and girls have higher incidence of diarrheal disease but also lower attendance and a higher dropout rate, especially for girls whose parents may remove them from the education system when they start menstruating. This fuels the discrepancy in primary school completion rates: one in four girls do not complete primary school, compared to one in seven boys.
More girls in school means higher rates of female literacy -- for every 10 percent increase in female literacy, a country's economy can grow by 0.3 percent.
UN experts estimate the reduction in diarrhea engendered by meeting the sanitation target would add an estimated 272 million days of school attendance.
Ensuring economic benefits
Many UN studies have shown that public- and private-sector investment into sanitation can lead to economic benefits for communities. In particular, small entrepreneurs can benefit from infrastructure development. That, in turn, requires enabling policies to be in place.
Many sectors are already impacted by sanitation-triggered illnesses of their workers, including agriculture, fish-farming, energy production, large-scale industrial processes, small-scale industry, transport and recreation.
Health, safety and comfort standards for sanitation as well as aesthetic considerations also heavily influence the choice of tourist destinations.
Report on progress
Between 1990 and 2004, an estimated 1.2 billion people gained access to improved sanitation, an increase of 10 percent. To meet the Millennium Development Goals' sanitation target, however, over 1.6 billion more will need to be reached by 2015, with developing countries facing the biggest challenge. Globally, this translates into 626,000 people per day being given access to an improved sanitary facility.
While many regions are on track to meet the MDG sanitation target, we will miss this global target by a wide margin.
The East Asia/Pacific region recorded the largest improvements, with sanitation coverage increasing from 30 per cent in 1990 to 51 percent in 2004, putting it on track to reach its target of 65 percent. The Middle East/North Africa and Latin America / Caribbean are also generally on track to meet their MDG sanitation targets.
The areas with the least access are West and Central Africa (36 per cent coverage), South Asia (37 per cent) and Eastern and Southern Africa (38 per cent). In terms of absolute numbers, the greatest improvements have been in South Asia, which more than doubled its coverage from 17 per cent in 1990 to 37 percent in 2004. Yet the increase is still not sufficient for the region to meet its MDG sanitation target of 58 per cent by 2015.
Urban-Rural Discrepancies
Access to improved sanitation was more than twice as high in urban areas than in rural areas in 2004 (80 per cent in urban areas versus 39 per cent in rural areas). Of the 2.6 billion people currently without access to improved sanitation, 2 billion (77 per cent) live in rural areas. The urban-rural disparity is largest in South Asia, where only 27 per cent of the rural population is served, compared to 63 per cent in urban areas. Only in industrialized countries is urban and rural coverage comparable
According to UN experts, key steps needed to accelerate progress on this issue include:
Secure political commitment to universal sanitation
Sanitation is a political and institutional orphan, an under-funded sector with no voice at the policy or service delivery 'high table'. Establishing one national coordinating body, formulating a single, country-wide sanitation plan, and putting into place a transparent monitoring framework could spur and drive progress.
Market sanitation and hygiene and focus on long-term behaviour change
Health-oriented information campaigns have been less successful at driving demand than using commercial techniques and appealing to consumer preferences for convenience, comfort, safety, cleanliness and prestige. Building community consensus that open defecation and other environmental hazards are actually serious health problems -- that can be solved by toilets -- has proved successful in a number of countries. Supporting health departments and community health workers to focus on long-term behaviour changes and educating children through school-based programs are both necessary for sustaining demand and helping new behaviours stick.
Significant professional business development support for small-scale sanitation providers is required, as is greater training of sanitary engineers, to meet the demands of the massive scaling up of efforts required for universal coverage. It needs to be made easy for lower income families to build and maintain toilets, washrooms and wastewater disposal systems whose benefits they understand, and whose domestic convenience they actively seek.
Source: http://www.sciencedaily.com/releases/2008/03/080320095022.htm
Sunday, March 9, 2008
BIOTECHNOLOGY AND FOOD INSECURITY
Low productivity in agriculture is a major cause of poverty, food insecurity, and poor nutrition in low-income developing countries. Agricultural biotechnology offers great potential as an instrument for achieving food security and poverty reduction.. It uses advanced plant-breeding techniques to introduce beneficial traits to the crops grown for food and fibre.
The need for food security and economic value of agricultural products highlights their significance for all countries of the world, no matter at what stage of development they may be. It has been estimated that around 70 per cent of poor and food-insecure people reside in rural areas and depend directly or indirectly on agriculture for their livelihoods. Whether in rural or urban areas, poor people spend as much as 50–70 per cent of their incomes on food.
In spite of the past advances in food production 800 million people, mostly in developing countries go to bed hungry everyday. Micronutrient deficiencies affect three billion people. Malnutrition hinders the development of human potential and the nation’s social and economic development.
To face these situations of food scarcity and insecurity to farmers, considerable attention has been focused on the use of biotechnology to improve the quantity and quality of food supply. This interest is fueled, in part, by a growing world population that is expected to double by the year 2025, coupled with the realisation that there are limited options for increasing the amount of land under cultivation for the production of food crops without imposing undesirable environmental costs.
Productivity gains are also essential to assure that food supplies remain adequate as world population increases by 25 per cent to 7.5 billion in 2020. And it is estimated that over 97 per cent of the projected growth will take place in the developing countries.
Applications of agricultural biotechnology to developing countries could address some of these very issues if research focuses on how to reduce the need for inputs and increase efficiency of input use. This could lead to the development of crops that utilise water more efficiently, fix nitrogen from the air, extract phosphate from the soil more effectively, and resist pests without the use of synthetic pesticides.
Successful efforts in this direction would reduce dependence on access to inputs, making the technology more readily available to poor farmers. It is possible that the introduction of agricultural biotechnology in the developing countries like Pakistan can contribute to increased productivity, lower unit costs and prices for food, preservation of forests and fragile land, poverty reduction, and improved nutrition. This depends on whether the research is relevant to poor people, on the economic and social policy environment, and on the nature of the intellectual property rights arrangements governing the technology.
In these days, the emphasis is being put up on using crops that have been evolved by biotechnological ways. So, genetically modified organisms have been produced and used commercially. Globally over 70 different commercially important species of plants have been modified to incorporate mainly seven transgenic traits i.e. herbicide tolerance, insect resistance, viral disease tolerance, fungal disease tolerance, product quality improvements, male sterility traits, others i.e. production of metabolites/chemicals, improvement of nutritional traits, incorporation of marker genes, stress resistance properties etc.
The important crops that have been modified genetically include maize, soybean, cotton, tomato, potato, alphalpha, petunia, rapeseed and mustard, rice, wheat, beet, barley, chickpea, cabbage and tobacco. But at present, four plant species (soybean, maize, cotton and rapeseed) dominate with two traits (herbicide tolerance and insect resistance).
Modern biotechnology is not a silver bullet for achieving food security, but used in conjunction with traditional knowledge and conventional agricultural research methods; it may be a powerful tool in the fight against poverty that should be made available to poor farmers and consumers. It has the potential to help enhance agricultural productivity in developing countries in a way that further reduces poverty, improves food security and nutrition, and promotes sustainable use of natural resources. Solutions to the problems facing small farmers in developing countries will benefit both farmers and consumers.
Biotechnology may offer cost-effective solutions to micronutrient malnutrition, such as vitamin A- and iron-rich crops. By raising productivity in food production, agricultural biotechnology could help further reduce the need to cultivate new lands and help conserve biodiversity and protect fragile ecosystems. Policies must expand and guide research and technology development to solve problems of importance to poor people. Research should focus on crops relevant to small farmers and poor consumers in Pakistan, such as cotton, rice, maize, wheat, and millet, along with livestock.
Expanded enlightened adaptive research on agricultural biotechnology can contribute to food security in developing countries, provided that it focuses on the needs of poor farmers and consumers in those countries, identified in consultation with poor people themselves. Public sector research, particularly through international agricultural research centres and national agricultural research systems, is essential for assuring that molecular biology-based science can fulfill the needs of poor people. Yet at present, public international agricultural research centres are devoting less than 10 per cent of their research budgets to biotechnology.
Agricultural biotechnology must be viewed as one element in a comprehensive sustainable poverty alleviation strategy focused on broad-based agricultural growth, not a technological quick fix for world hunger. There is considerable potential for biotechnology to contribute to improved yields and reduced risks for poor farmers, as well as more plentiful, affordable, and nutritious food for poor consumers. It is not, as some critics have charged, ‘a solution looking for a problem.’ The problems are genuine and momentous.
The biggest risk of modern biotechnology for developing countries is that technological development will bypass poor people. In such a case, if agricultural biotechnology research is prohibited in the developed countries, opportunities for reducing poverty, food insecurity, child malnutrition, and natural resource degradation will be missed, and the productivity gap between developing and developed country agriculture will widen.
So, it is obvious that the governments and funding agencies should continue and increase their investments in biotechnology as a means of achieving their goals of poverty reduction and food security.
Source:http://www.dawn.com/2008/01/07/ebr5.htm
The need for food security and economic value of agricultural products highlights their significance for all countries of the world, no matter at what stage of development they may be. It has been estimated that around 70 per cent of poor and food-insecure people reside in rural areas and depend directly or indirectly on agriculture for their livelihoods. Whether in rural or urban areas, poor people spend as much as 50–70 per cent of their incomes on food.
In spite of the past advances in food production 800 million people, mostly in developing countries go to bed hungry everyday. Micronutrient deficiencies affect three billion people. Malnutrition hinders the development of human potential and the nation’s social and economic development.
To face these situations of food scarcity and insecurity to farmers, considerable attention has been focused on the use of biotechnology to improve the quantity and quality of food supply. This interest is fueled, in part, by a growing world population that is expected to double by the year 2025, coupled with the realisation that there are limited options for increasing the amount of land under cultivation for the production of food crops without imposing undesirable environmental costs.
Productivity gains are also essential to assure that food supplies remain adequate as world population increases by 25 per cent to 7.5 billion in 2020. And it is estimated that over 97 per cent of the projected growth will take place in the developing countries.
Applications of agricultural biotechnology to developing countries could address some of these very issues if research focuses on how to reduce the need for inputs and increase efficiency of input use. This could lead to the development of crops that utilise water more efficiently, fix nitrogen from the air, extract phosphate from the soil more effectively, and resist pests without the use of synthetic pesticides.
Successful efforts in this direction would reduce dependence on access to inputs, making the technology more readily available to poor farmers. It is possible that the introduction of agricultural biotechnology in the developing countries like Pakistan can contribute to increased productivity, lower unit costs and prices for food, preservation of forests and fragile land, poverty reduction, and improved nutrition. This depends on whether the research is relevant to poor people, on the economic and social policy environment, and on the nature of the intellectual property rights arrangements governing the technology.
In these days, the emphasis is being put up on using crops that have been evolved by biotechnological ways. So, genetically modified organisms have been produced and used commercially. Globally over 70 different commercially important species of plants have been modified to incorporate mainly seven transgenic traits i.e. herbicide tolerance, insect resistance, viral disease tolerance, fungal disease tolerance, product quality improvements, male sterility traits, others i.e. production of metabolites/chemicals, improvement of nutritional traits, incorporation of marker genes, stress resistance properties etc.
The important crops that have been modified genetically include maize, soybean, cotton, tomato, potato, alphalpha, petunia, rapeseed and mustard, rice, wheat, beet, barley, chickpea, cabbage and tobacco. But at present, four plant species (soybean, maize, cotton and rapeseed) dominate with two traits (herbicide tolerance and insect resistance).
Modern biotechnology is not a silver bullet for achieving food security, but used in conjunction with traditional knowledge and conventional agricultural research methods; it may be a powerful tool in the fight against poverty that should be made available to poor farmers and consumers. It has the potential to help enhance agricultural productivity in developing countries in a way that further reduces poverty, improves food security and nutrition, and promotes sustainable use of natural resources. Solutions to the problems facing small farmers in developing countries will benefit both farmers and consumers.
Biotechnology may offer cost-effective solutions to micronutrient malnutrition, such as vitamin A- and iron-rich crops. By raising productivity in food production, agricultural biotechnology could help further reduce the need to cultivate new lands and help conserve biodiversity and protect fragile ecosystems. Policies must expand and guide research and technology development to solve problems of importance to poor people. Research should focus on crops relevant to small farmers and poor consumers in Pakistan, such as cotton, rice, maize, wheat, and millet, along with livestock.
Expanded enlightened adaptive research on agricultural biotechnology can contribute to food security in developing countries, provided that it focuses on the needs of poor farmers and consumers in those countries, identified in consultation with poor people themselves. Public sector research, particularly through international agricultural research centres and national agricultural research systems, is essential for assuring that molecular biology-based science can fulfill the needs of poor people. Yet at present, public international agricultural research centres are devoting less than 10 per cent of their research budgets to biotechnology.
Agricultural biotechnology must be viewed as one element in a comprehensive sustainable poverty alleviation strategy focused on broad-based agricultural growth, not a technological quick fix for world hunger. There is considerable potential for biotechnology to contribute to improved yields and reduced risks for poor farmers, as well as more plentiful, affordable, and nutritious food for poor consumers. It is not, as some critics have charged, ‘a solution looking for a problem.’ The problems are genuine and momentous.
The biggest risk of modern biotechnology for developing countries is that technological development will bypass poor people. In such a case, if agricultural biotechnology research is prohibited in the developed countries, opportunities for reducing poverty, food insecurity, child malnutrition, and natural resource degradation will be missed, and the productivity gap between developing and developed country agriculture will widen.
So, it is obvious that the governments and funding agencies should continue and increase their investments in biotechnology as a means of achieving their goals of poverty reduction and food security.
Source:http://www.dawn.com/2008/01/07/ebr5.htm
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