- Email: [email protected]
World Bank boosts India's population project
THE LANCET
POLICY AND PEOPLE
World Bank boosts India’s population project “With the new approach, the he World Bank has announced its programme focus will shift from largest-ever credit for a reproachieving contraceptive targets to ductive and child health project. It is responding sensitively to the health giving US$ 248·3 million to the govneeds of clients, and providing better ernment of India. The project is the quality, gender-sensitive information, largest support from the Bank or any and services that are more accessible other development agency to follow to the poor”, according to Indra on from the 1994 International Pathmanathan, the World Bank’s task Conference on Population and manager for the project. Development in Cairo. Implementation of The project—to be policy reform “requires completed by 2003—is fundamental attitudinal intended to improve the and behavioural change national family-welfare in more than 280 000 programme, and is managers and workers, described as a major as well as in the policy shift in that community”, notes the programme. Bank. For decades, the The specific targets country’s familyset for the project are planning programme to: reduce unwanted has been enmeshed in pregnancies among the chasing ever-elusive Banking on help 30 million women who targets, by coercion as have “unmet contraceptive needs”; well as with enticements such as reduce the health risks associated radios. Despite devouring a large with pregnancy and childbearing for proportion of the health and familythe 220 million women of reproducwelfare budget, the programme is still tive age; and increase child survival in described as a fiasco. The fertility the 0–4 age group by extending the rate, although down from 6 to 3·4 programme to a further 10 million births per woman, is still short of the children and reducing maternal illdesired replacement-fertility goal of health, which is associated with about 2·1 births per woman. India is set to 30% of deaths in children under become the world’s most populous 5 years of age. nation by 2040. The latest policy shift is towards a “participatory planning approach”. Sanjay Kumar Images of India
T
New Irish government faces health tasks into a settlement rather than proceed he Irish electorate once again with a court case against the health failed to elect a majority governdepartment. The health minister— ment on June 6. It is generally both before and during accepted that when the the campaign—refused 166 new deputies to the to open the files, saying Dáil take their seats on it could damage future June 26 to vote for the liability cases. Ahern Prime Minister, Fianna said then that liability Fail leader Bertie Ahern had been proven in the will get the job. recent Blood Tribunal Although not in the and he wanted the case new government’s top discussed openly. three priorities, health The new government will still be high on the may also be forced to agenda. Ahern has tackle hospital waiting promised to open times. The case of a 13health-department files Ahern—health tasks ahead month-old girl having on Brigid McCole’s to wait more than a year for cardiac death, one of 1400 women infected surgery hit the front pages when her with hepatitis C from contaminated consultant suggested that perhaps anti-RhD (see Lancet May 17, only Albania was in a worse situation. p1459). She was visited and harassed on her deathbed by national blood service lawyers, trying to force her Karen Birchard PA
T
1754
Israel Health Ministr y to sue tobacco firms
D
eputy Minister of Health (Shas) Rabbi Shlomo Benizri announced last week that his ministry will be filing a NIS 20 (US$5·88) billion lawsuit against Israeli and foreign manufacturers and importers of cigarettes. This is one of the moves taken by new Health Minister Yehoshua Matza to spearhead “active health care and administration”, part of his battle with the Ministry of Finance to release funds to prevent the health system falling apart. The suit calls on the tobacco industry to pay damages for the cost to health providers of treating smokers and their cigarette-related illnesses. This suit resembles the recent multistate action brought in the USA. Following that example, where hundreds of billions of dollars are at stake, Israel will ask the court to force the tobacco companies to pay all legal fees. The decision and announcement came on World No Tobacco Day, May 31, and followed last week’s strong statements by Shas spiritual leader Rabbi Ovadia Yosef, who denounced cigarette manufacturers and distributors. He shocked followers by calling on them to stop smoking and for cigarette-industry employees to stop their work, referring to them as “agents of the Angel of Death”, who were contributing to 5000 annual tobacco-related deaths nationwide. The spokesman for Israel’s cigarette manufacturer, Dubek, refused to comment. Benizri, who was appointed by the Health Minister, won promises from Knesset Speaker Dan Tichon to begin enforcing no-smoking regulations in the Knesset. He assured Benizri that fines would be issued to people in the building who failed to comply, saying that the Knesset must serve as an example for the laws it passes. “This is a serious campaign to eliminate cigarette smoking, not a cosmetic job”, said Benizri. Some of the anti-smoking steps include the banning of sales of cigarettes to those under 18; outlawing cigarette-vending machines; and raising the cost of cigarettes. The money from fines will be used to finance information, enforcement, and to offset some of the treatment costs.
Rachelle H B Fishman
Vol 349 • June 14, 1997
POLICY AND PEOPLE
World Bank boosts India’s population project “With the new approach, the he World Bank has announced its programme focus will shift from largest-ever credit for a reproachieving contraceptive targets to ductive and child health project. It is responding sensitively to the health giving US$ 248·3 million to the govneeds of clients, and providing better ernment of India. The project is the quality, gender-sensitive information, largest support from the Bank or any and services that are more accessible other development agency to follow to the poor”, according to Indra on from the 1994 International Pathmanathan, the World Bank’s task Conference on Population and manager for the project. Development in Cairo. Implementation of The project—to be policy reform “requires completed by 2003—is fundamental attitudinal intended to improve the and behavioural change national family-welfare in more than 280 000 programme, and is managers and workers, described as a major as well as in the policy shift in that community”, notes the programme. Bank. For decades, the The specific targets country’s familyset for the project are planning programme to: reduce unwanted has been enmeshed in pregnancies among the chasing ever-elusive Banking on help 30 million women who targets, by coercion as have “unmet contraceptive needs”; well as with enticements such as reduce the health risks associated radios. Despite devouring a large with pregnancy and childbearing for proportion of the health and familythe 220 million women of reproducwelfare budget, the programme is still tive age; and increase child survival in described as a fiasco. The fertility the 0–4 age group by extending the rate, although down from 6 to 3·4 programme to a further 10 million births per woman, is still short of the children and reducing maternal illdesired replacement-fertility goal of health, which is associated with about 2·1 births per woman. India is set to 30% of deaths in children under become the world’s most populous 5 years of age. nation by 2040. The latest policy shift is towards a “participatory planning approach”. Sanjay Kumar Images of India
T
New Irish government faces health tasks into a settlement rather than proceed he Irish electorate once again with a court case against the health failed to elect a majority governdepartment. The health minister— ment on June 6. It is generally both before and during accepted that when the the campaign—refused 166 new deputies to the to open the files, saying Dáil take their seats on it could damage future June 26 to vote for the liability cases. Ahern Prime Minister, Fianna said then that liability Fail leader Bertie Ahern had been proven in the will get the job. recent Blood Tribunal Although not in the and he wanted the case new government’s top discussed openly. three priorities, health The new government will still be high on the may also be forced to agenda. Ahern has tackle hospital waiting promised to open times. The case of a 13health-department files Ahern—health tasks ahead month-old girl having on Brigid McCole’s to wait more than a year for cardiac death, one of 1400 women infected surgery hit the front pages when her with hepatitis C from contaminated consultant suggested that perhaps anti-RhD (see Lancet May 17, only Albania was in a worse situation. p1459). She was visited and harassed on her deathbed by national blood service lawyers, trying to force her Karen Birchard PA
T
1754
Israel Health Ministr y to sue tobacco firms
D
eputy Minister of Health (Shas) Rabbi Shlomo Benizri announced last week that his ministry will be filing a NIS 20 (US$5·88) billion lawsuit against Israeli and foreign manufacturers and importers of cigarettes. This is one of the moves taken by new Health Minister Yehoshua Matza to spearhead “active health care and administration”, part of his battle with the Ministry of Finance to release funds to prevent the health system falling apart. The suit calls on the tobacco industry to pay damages for the cost to health providers of treating smokers and their cigarette-related illnesses. This suit resembles the recent multistate action brought in the USA. Following that example, where hundreds of billions of dollars are at stake, Israel will ask the court to force the tobacco companies to pay all legal fees. The decision and announcement came on World No Tobacco Day, May 31, and followed last week’s strong statements by Shas spiritual leader Rabbi Ovadia Yosef, who denounced cigarette manufacturers and distributors. He shocked followers by calling on them to stop smoking and for cigarette-industry employees to stop their work, referring to them as “agents of the Angel of Death”, who were contributing to 5000 annual tobacco-related deaths nationwide. The spokesman for Israel’s cigarette manufacturer, Dubek, refused to comment. Benizri, who was appointed by the Health Minister, won promises from Knesset Speaker Dan Tichon to begin enforcing no-smoking regulations in the Knesset. He assured Benizri that fines would be issued to people in the building who failed to comply, saying that the Knesset must serve as an example for the laws it passes. “This is a serious campaign to eliminate cigarette smoking, not a cosmetic job”, said Benizri. Some of the anti-smoking steps include the banning of sales of cigarettes to those under 18; outlawing cigarette-vending machines; and raising the cost of cigarettes. The money from fines will be used to finance information, enforcement, and to offset some of the treatment costs.
Rachelle H B Fishman
Vol 349 • June 14, 1997