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Serbian trichinosis row
The criticism that very poor countries have no resources to reallocate and manage properly does not hold, he argues. In his personal career, most of which has been spent in health-sector development in low-income countries, he has found that "there is never nothing" except in war-torn areas. He adds, though, that the poorest countries have a very strong claim on international resources,. which the bank should help them to articulate. Some of the poorest countries might not have the intellectual capacity to assimilate the multiplicity of advice received from the various donors. Here Feachem would favour all the donors sitting down with the government, in its own country-"not in Geneva, not in
Washington"-with
:
acquired
government’s health departments nowadays acknowledge "social variations"
The UK
the
nation’s
health-a
delicate
euphemism for the well-known association of illness with poverty. This month, two reports appear suggesting ways to bridge the gap in health between the rich and the poor. The King’s Fund report is the subject of this week’s editorial (page 1061). The other, produced by the Public Health Alliance (ISBN offers no political solutions but suggests, : instead, how people can help to improve the lot of the quarter of the UK’s population who live in poverty. : The report emphasises that this is no easy task, "Faced with the current scale of . poverty and the difficulties involved in . tackling it and its effects, there is a danger of disillusion, despair, apathy and alienation among poor people, workers and service providers". : The authors, from the Greater Glasgow Health Board Department of Public more
1-87-351413-1),
Health, began by sending
out
over
are
not
lost,
through such programmes or through the pace of unwise political reforms or economic measures. But progress will be made only by identifying particular services to be ring-fenced and protected.
!
:
Feachem acknowledges that in some quarters there are "unhappy voices" about fears that the World Bank might be displacing WHO as the leading thinker on global health policy, but he declares that collaboration between the two organisations is stronger than it has even been in his 30-year career, and at the WHO executive board meeting in January this year he urged the members to increase the partnership. The bank, he says, is working towards "a robust, more relaxed, less anxious, collegial professional relationship" with WHO, whereby it would take "five minutes, not five months", to agree on who takes the lead on what projects before getting on with the work. Already two technical follow-ups to WDR 93 have been WHO led-a book on DALYs just produced and a 10-volume publication on the global burden of disease due out
:
:
early next year.: the UK. Voluntary and local government initiatives range from providing day-care facilities for elderly Asians to a campaign to prevent suicide amongst isolated farmers. The difficulties of setting up and running such organisations is described, and the report includes a database disc on poverty and health projects. Although "social variations" in health are plainly the responsibility of a government which encourages inequalities in wealth and opportunity in order to sustain a marketplace economy, the authors avoid tangling with political issues; they are, however, uncompromising in their insistence that "... health is a fundamental right of every human being, not an optional extra that some people may choose to buy into". Their definitions of unhelpful health and welfare services include "only providing help when families are in crisis" and "forcing families to define financial problems as emotional problems or personal inadequacy before help is given".
8000 ques-
tionnaires to people and organisations : working with the poor and then visiting John Bignall
1104
decades,
whether
projects throughout
UK poverty of health
leagues apprecitate them. So how does he
programmes for correcting economic imbalances have had negative impacts on health services, he says. High on his list of priority tasks will be to ensure that health gains, sometimes
agency playing honest broker. He would not approve of the external agencies meeting outside the country "to cook the books" before pre-
in
on
adjustment
one
senting a government with one answer, for he believes strongly in there being a marketplace of ideas. WDR 93 also introduced the controversial "disability-adjusted life-years" (DALYs) a unit of measurement of the global burden of disease that is based on a series of assumptions and that was used to compare costs of health interventions. Recounting how, in 1992, during the preparation of WDR 93, his colleagues were amazed that there was no global mortality map, let alone a measure of the impact of illness, Feachem describes the attempt "to impose discipline on data" as a major achievement, but he will welcome improved versions-as well as adaptations for local use.
Feachem believes that chief executives a marketplace for and senior managers should be able to specifics rather than on generalities is a point that Feachem complete their job in 5-10 years and often harks back to. For example, there is : should not stay on too long, no matter now keen awareness that structural how good they are or how much their colLike the concept of
ideas, this focus
expect his efforts to change the pattern of the bank’s lending in 5-10 years? With bank lending on health rising inexorably, and with the long pipeline for projects, his contributions would not affect the quantity of lending, hence he is focussing on the quality of the lending. On the bank’s intellectual contributions, one of Feachem’s aims will be to support and work closely with others in areas where the bank does not have an obvious leadership role; these others include the WHO Tropical Diseases Research Programme and new structures that might emerge from the deliberations of he WHO Ad Hoc Committee on Health Research and Development that is completing it work this summer. And how would he like to be remembered at LSHTM (with which he has been associated since 1976)? The slow, measured response was: "For doing what I think I did-which was, together with an exceptional group of colleagues, to enhance greatly the academic, managerial, and financial status of the school and guarantee its success and influence into the next century". He was referring to the "much-needed root-and-branch reforms that left no aspect of the school’s activities untouched".
Vivien Choo
Serbian trichinosis
outbreak of trichinosis in eastern Serbia gave rise to heated confrontation in the parliament this week, when opposition MPs called for a vote of no confidence in health minister Leposava Milicevic. According to Veselin Pavicevic, an MP from the (opposition) Serbian Renewal Movement, the Ministry of Health had failed to take even the most elementary measures to localise the source of the infection and carry out checks on pork. Furthermore, Pavicevic claimed, the public had been "misinformed" about the extent of the disease: morbidity had been grossly under-reported. In reality, Pavicevic said, several hundred people were already infected, with several thousand still at risk. The situation is particularly acute because many doctors and health workers have been infected. Pavicevic and his fellow opposition MPs called for an urgent meeting of the parliamentary committee on public health, and an inquiry into the outbreak. An
:
:
row
Vera Rich
Washington"-with
:
acquired
government’s health departments nowadays acknowledge "social variations"
The UK
the
nation’s
health-a
delicate
euphemism for the well-known association of illness with poverty. This month, two reports appear suggesting ways to bridge the gap in health between the rich and the poor. The King’s Fund report is the subject of this week’s editorial (page 1061). The other, produced by the Public Health Alliance (ISBN offers no political solutions but suggests, : instead, how people can help to improve the lot of the quarter of the UK’s population who live in poverty. : The report emphasises that this is no easy task, "Faced with the current scale of . poverty and the difficulties involved in . tackling it and its effects, there is a danger of disillusion, despair, apathy and alienation among poor people, workers and service providers". : The authors, from the Greater Glasgow Health Board Department of Public more
1-87-351413-1),
Health, began by sending
out
over
are
not
lost,
through such programmes or through the pace of unwise political reforms or economic measures. But progress will be made only by identifying particular services to be ring-fenced and protected.
!
:
Feachem acknowledges that in some quarters there are "unhappy voices" about fears that the World Bank might be displacing WHO as the leading thinker on global health policy, but he declares that collaboration between the two organisations is stronger than it has even been in his 30-year career, and at the WHO executive board meeting in January this year he urged the members to increase the partnership. The bank, he says, is working towards "a robust, more relaxed, less anxious, collegial professional relationship" with WHO, whereby it would take "five minutes, not five months", to agree on who takes the lead on what projects before getting on with the work. Already two technical follow-ups to WDR 93 have been WHO led-a book on DALYs just produced and a 10-volume publication on the global burden of disease due out
:
:
early next year.: the UK. Voluntary and local government initiatives range from providing day-care facilities for elderly Asians to a campaign to prevent suicide amongst isolated farmers. The difficulties of setting up and running such organisations is described, and the report includes a database disc on poverty and health projects. Although "social variations" in health are plainly the responsibility of a government which encourages inequalities in wealth and opportunity in order to sustain a marketplace economy, the authors avoid tangling with political issues; they are, however, uncompromising in their insistence that "... health is a fundamental right of every human being, not an optional extra that some people may choose to buy into". Their definitions of unhelpful health and welfare services include "only providing help when families are in crisis" and "forcing families to define financial problems as emotional problems or personal inadequacy before help is given".
8000 ques-
tionnaires to people and organisations : working with the poor and then visiting John Bignall
1104
decades,
whether
projects throughout
UK poverty of health
leagues apprecitate them. So how does he
programmes for correcting economic imbalances have had negative impacts on health services, he says. High on his list of priority tasks will be to ensure that health gains, sometimes
agency playing honest broker. He would not approve of the external agencies meeting outside the country "to cook the books" before pre-
in
on
adjustment
one
senting a government with one answer, for he believes strongly in there being a marketplace of ideas. WDR 93 also introduced the controversial "disability-adjusted life-years" (DALYs) a unit of measurement of the global burden of disease that is based on a series of assumptions and that was used to compare costs of health interventions. Recounting how, in 1992, during the preparation of WDR 93, his colleagues were amazed that there was no global mortality map, let alone a measure of the impact of illness, Feachem describes the attempt "to impose discipline on data" as a major achievement, but he will welcome improved versions-as well as adaptations for local use.
Feachem believes that chief executives a marketplace for and senior managers should be able to specifics rather than on generalities is a point that Feachem complete their job in 5-10 years and often harks back to. For example, there is : should not stay on too long, no matter now keen awareness that structural how good they are or how much their colLike the concept of
ideas, this focus
expect his efforts to change the pattern of the bank’s lending in 5-10 years? With bank lending on health rising inexorably, and with the long pipeline for projects, his contributions would not affect the quantity of lending, hence he is focussing on the quality of the lending. On the bank’s intellectual contributions, one of Feachem’s aims will be to support and work closely with others in areas where the bank does not have an obvious leadership role; these others include the WHO Tropical Diseases Research Programme and new structures that might emerge from the deliberations of he WHO Ad Hoc Committee on Health Research and Development that is completing it work this summer. And how would he like to be remembered at LSHTM (with which he has been associated since 1976)? The slow, measured response was: "For doing what I think I did-which was, together with an exceptional group of colleagues, to enhance greatly the academic, managerial, and financial status of the school and guarantee its success and influence into the next century". He was referring to the "much-needed root-and-branch reforms that left no aspect of the school’s activities untouched".
Vivien Choo
Serbian trichinosis
outbreak of trichinosis in eastern Serbia gave rise to heated confrontation in the parliament this week, when opposition MPs called for a vote of no confidence in health minister Leposava Milicevic. According to Veselin Pavicevic, an MP from the (opposition) Serbian Renewal Movement, the Ministry of Health had failed to take even the most elementary measures to localise the source of the infection and carry out checks on pork. Furthermore, Pavicevic claimed, the public had been "misinformed" about the extent of the disease: morbidity had been grossly under-reported. In reality, Pavicevic said, several hundred people were already infected, with several thousand still at risk. The situation is particularly acute because many doctors and health workers have been infected. Pavicevic and his fellow opposition MPs called for an urgent meeting of the parliamentary committee on public health, and an inquiry into the outbreak. An
:
:
row
Vera Rich