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Argentina tries social security reforms
POLICY AND PEOPLE
Indian human-rights body supports anti-discrimination law for HIV patients he National Human Rights Commission (NHRC) has agreed to support the demand for new legislation to prevent discrimination against HIV-infected people employed by private-sector companies, at a meeting in New Delhi, India, on Nov 24–25. The Indian constitution already prohibits discrimination on the grounds of religion, caste, or creed against people working in the public sector. This ruling was reinforced by a judgement of the Mumbai High Court
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in 1997 that stated that employees in state-owned companies can not be denied employment because they are HIV positive, if they are qualified to work and pose no risk to colleagues. But there is no such guarantee against discrimination in the private sector. The NHRC conference on human rights and HIV/AIDS discussed such discriminatory behaviour by employers and recommended anti-discrimination legislation to cover the private sector as well.
Nepal formulates ethical guidelines for medical research The National Health Research Council (NHRC) in Nepal has produced national ethical guidelines for health research. Nepal has also become the first country in South Asia to set up a forum for ethical review committees of clinical trials and to promote ethics education programmes. NHRC prepared a final draft of the guidelines after a consultation meeting on Nov 13–16 in Kathmandu. The NHRC has set up a national ethics committee, and the country’s six medical schools and two universities have been asked to set up institution level ethics committees. All research proposals including clinical trials by foreign pharmaceutical companies, will have to approved by the national committee or any other ethical committee approved by NHRC. “Nepal can serve as a role model for all small countries in the region”, says Vasantha Muthuswamy, deputy director general of the Indian Council of Medical Research (ICMR), who delivered the keynote speech at the Kathmandu meeting. “Developing guidelines is the easier part, but an essential initial step. The real task is their effective implementation”. Dinesh C Sharma
Participants also recommended that the state should guarantee a safe working environment for all workers and should provide medical insurance for HIV-positive employees. NHRC will forward their recommendations to the government. In an address to the conference the Health Minister, C P Thakur, assured participants that the recommendations will be a useful guide for government action. “In addition to an umbrella law on anti-discrimination, we need to amend a number of other laws like the Indian Penal Code, Suppression of Immoral Traffic Act, that impede HIV/AIDS intervention programmes”, said Anand Grover of Lawyers Collective, a Mumbai-based non-governmental organisation. The NHRC has also set up a core advisory group on public health and human rights. “We will act both as a . . . channel of ideas to the NHRC and as a referral panel on specific health-related cases”, says K Srinath Reddy, a cardiologist and chairperson of the ten-member group of health experts. Dinesh C Sharma
Argentina tries social security reforms rgentina’s President Fernando De la Rua has ordered deregulation of the republic’s health insurance regime, as fraud investigators continue their inquiries into missing insurance funds controlled by trade unions. The shortfalls have left doctors unpaid, while hospitals and clinics teeter on the brink of insolvency (see Lancet 2000; 356: 492). De la Rua side-stepped opposition from the Argentine Congress by invoking his powers to legislate in situations of urgency. As of Jan 1, the country’s 12 million employees will have the right to subscribe to the health insurance/social security scheme of their choice rather than being tied to occupational schemes. The decree signed on Nov 29 requires that rules for implementing the new system must be settled by Dec 22. Employees who currently face a mandatory 3% deduction of salary in favour of a tied occupational scheme, will be able to switch to their choice of 260 schemes. The legislation envisages provision of full health cover in return
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for a payment of $20 per month. De la Rua’s decree is seen as a major challenge to the comprehensive approach to health cover/social security through partnership between the state and trade unions, which was initiated 50 years ago by President Juan Peron. The current Peronist party might have been expected to mount stiff opposition to any such proposals had they been presented to the Congress as a legislative draft. But De la Rua found himself under pressure to act. Apart from other considerations, the International Monetary Fund has made social security reform a condition of continued relief of Argentina’s international debt. The new system is likely to prompt intense discussions. Managers of 800 privately owned hospitals and clinics have already voiced concerns. Other details remain to be clarified, such as how the reform will affect the 15 million Argentines who currently have no health cover, other than emergency treatment at the country’s cash-starved public hospitals. Graciela Iglesias Rogers
Protests at Indian approval of non-iodised salt
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he World Medical Association (WMA), the International Council of Nurses, and the International Pharmaceutical Federation made a joint appeal on Nov 27 to the Indian government to reimpose its ban on non-iodised salt. “Iodine deficiency is the single most preventable cause of mental retardation and iodised salt is the cheapest and most effective way to combat this scourge”, says Delon Human, WMA’s chief executive. The Indian government withdrew its order making iodisation of salt compulsory in September, following complaints from small salt producers that they could not afford to run iodisation plants and that their livelihoods were threatened. Local Indian health groups have protested against the decision, as have UN agencies such UNICEF which argue that the costs are minimal—about US$0·04 per person annually—and that the benefits are huge. Clare Kapp
THE LANCET • Vol 356 • December 9, 2000
For personal use only. Not to be reproduced without permission of The Lancet.
Indian human-rights body supports anti-discrimination law for HIV patients he National Human Rights Commission (NHRC) has agreed to support the demand for new legislation to prevent discrimination against HIV-infected people employed by private-sector companies, at a meeting in New Delhi, India, on Nov 24–25. The Indian constitution already prohibits discrimination on the grounds of religion, caste, or creed against people working in the public sector. This ruling was reinforced by a judgement of the Mumbai High Court
T
in 1997 that stated that employees in state-owned companies can not be denied employment because they are HIV positive, if they are qualified to work and pose no risk to colleagues. But there is no such guarantee against discrimination in the private sector. The NHRC conference on human rights and HIV/AIDS discussed such discriminatory behaviour by employers and recommended anti-discrimination legislation to cover the private sector as well.
Nepal formulates ethical guidelines for medical research The National Health Research Council (NHRC) in Nepal has produced national ethical guidelines for health research. Nepal has also become the first country in South Asia to set up a forum for ethical review committees of clinical trials and to promote ethics education programmes. NHRC prepared a final draft of the guidelines after a consultation meeting on Nov 13–16 in Kathmandu. The NHRC has set up a national ethics committee, and the country’s six medical schools and two universities have been asked to set up institution level ethics committees. All research proposals including clinical trials by foreign pharmaceutical companies, will have to approved by the national committee or any other ethical committee approved by NHRC. “Nepal can serve as a role model for all small countries in the region”, says Vasantha Muthuswamy, deputy director general of the Indian Council of Medical Research (ICMR), who delivered the keynote speech at the Kathmandu meeting. “Developing guidelines is the easier part, but an essential initial step. The real task is their effective implementation”. Dinesh C Sharma
Participants also recommended that the state should guarantee a safe working environment for all workers and should provide medical insurance for HIV-positive employees. NHRC will forward their recommendations to the government. In an address to the conference the Health Minister, C P Thakur, assured participants that the recommendations will be a useful guide for government action. “In addition to an umbrella law on anti-discrimination, we need to amend a number of other laws like the Indian Penal Code, Suppression of Immoral Traffic Act, that impede HIV/AIDS intervention programmes”, said Anand Grover of Lawyers Collective, a Mumbai-based non-governmental organisation. The NHRC has also set up a core advisory group on public health and human rights. “We will act both as a . . . channel of ideas to the NHRC and as a referral panel on specific health-related cases”, says K Srinath Reddy, a cardiologist and chairperson of the ten-member group of health experts. Dinesh C Sharma
Argentina tries social security reforms rgentina’s President Fernando De la Rua has ordered deregulation of the republic’s health insurance regime, as fraud investigators continue their inquiries into missing insurance funds controlled by trade unions. The shortfalls have left doctors unpaid, while hospitals and clinics teeter on the brink of insolvency (see Lancet 2000; 356: 492). De la Rua side-stepped opposition from the Argentine Congress by invoking his powers to legislate in situations of urgency. As of Jan 1, the country’s 12 million employees will have the right to subscribe to the health insurance/social security scheme of their choice rather than being tied to occupational schemes. The decree signed on Nov 29 requires that rules for implementing the new system must be settled by Dec 22. Employees who currently face a mandatory 3% deduction of salary in favour of a tied occupational scheme, will be able to switch to their choice of 260 schemes. The legislation envisages provision of full health cover in return
A
1992
for a payment of $20 per month. De la Rua’s decree is seen as a major challenge to the comprehensive approach to health cover/social security through partnership between the state and trade unions, which was initiated 50 years ago by President Juan Peron. The current Peronist party might have been expected to mount stiff opposition to any such proposals had they been presented to the Congress as a legislative draft. But De la Rua found himself under pressure to act. Apart from other considerations, the International Monetary Fund has made social security reform a condition of continued relief of Argentina’s international debt. The new system is likely to prompt intense discussions. Managers of 800 privately owned hospitals and clinics have already voiced concerns. Other details remain to be clarified, such as how the reform will affect the 15 million Argentines who currently have no health cover, other than emergency treatment at the country’s cash-starved public hospitals. Graciela Iglesias Rogers
Protests at Indian approval of non-iodised salt
T
he World Medical Association (WMA), the International Council of Nurses, and the International Pharmaceutical Federation made a joint appeal on Nov 27 to the Indian government to reimpose its ban on non-iodised salt. “Iodine deficiency is the single most preventable cause of mental retardation and iodised salt is the cheapest and most effective way to combat this scourge”, says Delon Human, WMA’s chief executive. The Indian government withdrew its order making iodisation of salt compulsory in September, following complaints from small salt producers that they could not afford to run iodisation plants and that their livelihoods were threatened. Local Indian health groups have protested against the decision, as have UN agencies such UNICEF which argue that the costs are minimal—about US$0·04 per person annually—and that the benefits are huge. Clare Kapp
THE LANCET • Vol 356 • December 9, 2000
For personal use only. Not to be reproduced without permission of The Lancet.