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Prompting partnerships for African health
POLICY AND PEOPLE
Prompting partnerships for African health sector, national governments, and wenty-one countries in Africa multilateral agencies. For example, make use of the training facilities AMREF clearly needs an exit policy; offered by the African Medical and its limited budget does not allow its Research Foundation (AMREF). A projects to continue indefinitely. small laboratory has room for only six In a general air of optimism, old student fieldworkers; the library for tensions and realities did surface. Ok community healthworkers occupies a Pannenborg, who mere 30 m2. But runs the World not for much Bank’s health, longer. On March nutrition, and 30, Kenya’s population operHealth Minister, ations in Africa, Jackson Kalweo, emphasised the formally launched bank’s macroecothe building of nomic perspeca US$2-million tive. The World new training cenBank is a finantre on a site near cial institution, Nairobi’s Wilson Artist’s impression of the new centre susceptible to Airport. financial reasoning—eg, investment On April 1, AMREF (97% of in the education of girls in Pakistan whose staff are African) celebrated its would yield a 28% annual return over 40th anniversary with a conference in 50 years. The British government’s London on African health, combinvision of the World Bank was very ing this with further appeals for different, protested George Foulkes, donations towards the commitment UK Under Secretary of State for of the UK AMREF office to raise International Development. It is an £150 000 (US$249 000) for the new instrument for development, and the centre. £300 million lately approved for AMREF is a non-governmental the International Development organisation—a term now apparently Association arm of the bank reflected being replaced by “civil society that philosophy. organisation”—and the talk at the Marlborough House conference was all of “partnership”, with the private David Sharp
T
pituitary-hormone recipients has already commenced. However, contrary to one Senate recommendation, those wanting to sue will not be eligible for legal aid. The money will be deposited into a trust in two instalments of $1·5 million; the first available now, and the second in 1999–2000. The amount ring-fenced for the fund is equivalent to the cost of potential litigation. Sue Bryne, coordinator of the national CJD Support Network, said: “This is better than anything we have had before, but some people would have preferred to see the litigation go ahead so that the issues could be aired in public. Although the government has apologised, we have had no expression of regret from those responsible.” Federal Health Minister Michael Wooldridge said that the government had set up the fund to try to deal with the issue in a sensitive way. Amanda Tattam
Sanjay Kumar
AMREF
ustralian recipients of human pituitary hormones who have a psychiatric disorder through knowing that they have an increased chance of developing Creutzfeldt-Jakob disease (CJD) are now being offered oneoff compensation payments. Last month, the federal government agreed with the majority of the findings of a Senate Committee inquiry on CJD and has set up an A$3-million (US$2-million) fund to provide compensation. The Australian Human Pituitary Hormone Program (AHPHP; 1965–85) involved treating infertile women with human pituitary gonadotropin and children of short stature with human growth hormone. Five Australian recipients of these hormones have died of CJD. About 2500 official and unofficial AHPHP participants who can prove they have a “recognised psychiatric condition” can apply for funds, regardless of whether or not they have sued the government. Legal action by
1114
A
t the first-ever assembly of the Global Environment Facility (GEF) last week in New Delhi, India (April 1–3), GEF came under intense review and serious criticism. GEF is entrusted with implementing the Earth Summit charter to protect the global environment through the funding of projects in four specific areas: climate change; preservation of biodiversity; ozonelayer protection; and prevention of degradation of international waters. “In recent years, developed countries, with only a few exceptions, have been reducing their overseas development assistance”, said Jin Liqun, Assistant Minister of Finance of the People’s Republic of China. “They have failed to honour their commitment made in Rio”, he added. The US$2·75 billion replenishment for GEF, to be used for grants and concessional loans over the next 4 years, has invited widespread criticism from developing countries and non-governmental organisations. John Mate of Greenpeace Canada said the amount was “peanuts” to save the health and wellbeing of the planet’s inhabitants, and symptomatic of western government’s lack of serious commitment to global environmental concerns. Two of GEF’s key implementing agencies, the World Bank and the United Nations Development Programme, bore the brunt of the blame for failing to sufficiently incorporate major global environmental concerns into their operations. Even allowing for funding limitations, GEF’s functioning has left much to be desired—a fact that is formally acknowledged in its latest reports. How far has GEF succeeded in its objectives? The answer remains elusive because crucial monitoring and evaluation efforts remain inadequate. Several developing countries also expressed serious concern over the lack of clear definitions in the crucial area of project assignments. This failure, which thwarts one of GEF’s actual objectives, leaves huge scope for such assignments being arbitrary and dominated by industrialised nations. These countries demanded a more transparent and participatory approach to assignments that respected the equality of nations.
Australia announces CJD compensation package
A
Global facility fails to protect environment
THE LANCET • Vol 351 • April 11, 1998
Prompting partnerships for African health sector, national governments, and wenty-one countries in Africa multilateral agencies. For example, make use of the training facilities AMREF clearly needs an exit policy; offered by the African Medical and its limited budget does not allow its Research Foundation (AMREF). A projects to continue indefinitely. small laboratory has room for only six In a general air of optimism, old student fieldworkers; the library for tensions and realities did surface. Ok community healthworkers occupies a Pannenborg, who mere 30 m2. But runs the World not for much Bank’s health, longer. On March nutrition, and 30, Kenya’s population operHealth Minister, ations in Africa, Jackson Kalweo, emphasised the formally launched bank’s macroecothe building of nomic perspeca US$2-million tive. The World new training cenBank is a finantre on a site near cial institution, Nairobi’s Wilson Artist’s impression of the new centre susceptible to Airport. financial reasoning—eg, investment On April 1, AMREF (97% of in the education of girls in Pakistan whose staff are African) celebrated its would yield a 28% annual return over 40th anniversary with a conference in 50 years. The British government’s London on African health, combinvision of the World Bank was very ing this with further appeals for different, protested George Foulkes, donations towards the commitment UK Under Secretary of State for of the UK AMREF office to raise International Development. It is an £150 000 (US$249 000) for the new instrument for development, and the centre. £300 million lately approved for AMREF is a non-governmental the International Development organisation—a term now apparently Association arm of the bank reflected being replaced by “civil society that philosophy. organisation”—and the talk at the Marlborough House conference was all of “partnership”, with the private David Sharp
T
pituitary-hormone recipients has already commenced. However, contrary to one Senate recommendation, those wanting to sue will not be eligible for legal aid. The money will be deposited into a trust in two instalments of $1·5 million; the first available now, and the second in 1999–2000. The amount ring-fenced for the fund is equivalent to the cost of potential litigation. Sue Bryne, coordinator of the national CJD Support Network, said: “This is better than anything we have had before, but some people would have preferred to see the litigation go ahead so that the issues could be aired in public. Although the government has apologised, we have had no expression of regret from those responsible.” Federal Health Minister Michael Wooldridge said that the government had set up the fund to try to deal with the issue in a sensitive way. Amanda Tattam
Sanjay Kumar
AMREF
ustralian recipients of human pituitary hormones who have a psychiatric disorder through knowing that they have an increased chance of developing Creutzfeldt-Jakob disease (CJD) are now being offered oneoff compensation payments. Last month, the federal government agreed with the majority of the findings of a Senate Committee inquiry on CJD and has set up an A$3-million (US$2-million) fund to provide compensation. The Australian Human Pituitary Hormone Program (AHPHP; 1965–85) involved treating infertile women with human pituitary gonadotropin and children of short stature with human growth hormone. Five Australian recipients of these hormones have died of CJD. About 2500 official and unofficial AHPHP participants who can prove they have a “recognised psychiatric condition” can apply for funds, regardless of whether or not they have sued the government. Legal action by
1114
A
t the first-ever assembly of the Global Environment Facility (GEF) last week in New Delhi, India (April 1–3), GEF came under intense review and serious criticism. GEF is entrusted with implementing the Earth Summit charter to protect the global environment through the funding of projects in four specific areas: climate change; preservation of biodiversity; ozonelayer protection; and prevention of degradation of international waters. “In recent years, developed countries, with only a few exceptions, have been reducing their overseas development assistance”, said Jin Liqun, Assistant Minister of Finance of the People’s Republic of China. “They have failed to honour their commitment made in Rio”, he added. The US$2·75 billion replenishment for GEF, to be used for grants and concessional loans over the next 4 years, has invited widespread criticism from developing countries and non-governmental organisations. John Mate of Greenpeace Canada said the amount was “peanuts” to save the health and wellbeing of the planet’s inhabitants, and symptomatic of western government’s lack of serious commitment to global environmental concerns. Two of GEF’s key implementing agencies, the World Bank and the United Nations Development Programme, bore the brunt of the blame for failing to sufficiently incorporate major global environmental concerns into their operations. Even allowing for funding limitations, GEF’s functioning has left much to be desired—a fact that is formally acknowledged in its latest reports. How far has GEF succeeded in its objectives? The answer remains elusive because crucial monitoring and evaluation efforts remain inadequate. Several developing countries also expressed serious concern over the lack of clear definitions in the crucial area of project assignments. This failure, which thwarts one of GEF’s actual objectives, leaves huge scope for such assignments being arbitrary and dominated by industrialised nations. These countries demanded a more transparent and participatory approach to assignments that respected the equality of nations.
Australia announces CJD compensation package
A
Global facility fails to protect environment
THE LANCET • Vol 351 • April 11, 1998