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US National Institutes of Health under fire
POLICY AND PEOPLE
Achievements on population issues counted since Cairo o mark World Population Day on July 11, the International Planned Parenthood Federation (IPPF; London, UK) held a seminar in London to review achievements made since the 1994 International Conference on Population and Development (ICPD) in Cairo, Egypt. The seminar is part of a programme of Cairo+5 events that will culminate in a Special Session of the United Nations General Assembly in June, 1999, to review and assess the implementation of the ICPD Programme of Action. The ICPD marked a shift away from demographic targets to an integrated development approach to population issues. The 20-year Programme of Action aims to give all couples and individuals the right to decide freely and responsibly the number, spacing, and timing of their children, and to have the information and means to do so. Women’s education and equality are at the heart of the Programme, which also calls for universal access to quality and affordable reproductive health services and to primary education, and for mea-
T
donor contributions have not changed since 1995 and, in some countries, have even declined (see http://www.unfpa.org and http://www.rockfound.org). IPPF warns that the shortfall in promised assistance from developed nations will mean that by 2000, inadequate provision of contraception will result in as many as 220 million unintended pregnancies, 50–90 million abortions, 60–110 million unwanted births, and the deaths of up to 8·9 million infants and children. The Cairo+5 events aim to work towards the full implementation of the Cairo commitments and to raise awareness of such key issues as adolescents’ rights to sexual and reproductive health care. Before June, 1999, the UNFPA will sponsor a series of Cairo+5 review-related activities involving programme and donor countries, non-governmental organisations, and the private sector. IPPF has also set up a Cairo+5 website with links to the UNFPA site (http://www.ippf.org/cairo). Janna Palmer
US National Institutes of Health under fire
CDC gets new director
AP
Jeffrey Koplan has been appointed as director of the US Centers for Disease Control and Prevention (CDC), announced the Health and Human Services secretary on July 10. Koplan succeeds David Satcher, who vacated the post in February
Koplan: “disease detective”
after his appointment as US Surgeon General. An epidemiologist, Koplan has previously served as Assistant Surgeon General and director of CDC’s National Center for Chronic Disease Prevention and Health Promotion. He will take up the position on Oct 5. 䡺
210
sures to reduce infant, child, and maternal mortality. IPPF’s Cairo+5 position paper, presented last week, reports on many achievements worldwide since the ICPD. There has been a 33·6% increase in the provision of family planning services, and family planning associations reached some 9·4 million people in 1997. The main obstacle to the implementation of the Programme of Action is funding. Governments agreed at Cairo to increase spending on population and related programmes to US$17 billion annually by 2000. Two-thirds of this amount would come from developing countries, the remainder from donor governments. The report Coming up short: struggling to implement the Cairo Programme of Action, by the UN Population Fund (UNFPA) and High Stakes, a report on population and development launched last week by the Rockefeller Foundation (New York, USA) show that this funding commitment is not being met. Developing countries pay three quarters of the cost of family planning and reproductive health services, but
he US National Institutes of Health (NIH) must include more participation from the public in its decision-making process, because NIH’s interaction with the public is “generally weak” compared with its interaction with research communities. This is the main conclusion of an Institute of Medicine (IoM) report released on July 8. The report urges NIH to establish an Office of Public Liaison in the NIH director’s office to document “public outreach, input, and response mechanisms”. In addition, the report says, the agency should create similar offices in all of its research institutes, and establish a Director’s Council of Public Representatives to be chaired by the NIH director. Developed by an advisory committee headed by Leon Rosenberg (Princeton University, NJ, USA), the report was requested by Senators Bill Frist (Republican, Tennessee) and Dan Coates (Republican, Indiana). The IoM committee was given the job of evaluating the criteria that NIH use to make funding allocations for research, as well as the mechanisms for public input and the impact of Congressional mandates on fund-
T
ing decisions. In the report, the committee concludes that it “generally supports the criteria that NIH uses for priority setting”. However, at an IoM press conference on July 8, Rosenberg said the group believes that “NIH has fallen short in its ability to explain to the public how these criteria are implemented”. The committee also urges NIH to “strengthen its analysis and use of health data, such as burdens and costs of diseases, and of data on the impact of research on the health of the public”. The group recommends that the priority-setting process should be done in a more unified manner by the NIH director, so that each institute submits annual strategic plans to the director (see http://www.nap.edu/readingroom/ books/nih/). In a statement released in response to the report, NIH director Harold Varmus agrees that “there is room for additional public input into these processes”, and says that NIH will review the report “in detail” with its staff and advisory groups to decide on implementation plans. Lisa Putman
THE LANCET • Vol 352 • July 18, 1998
Achievements on population issues counted since Cairo o mark World Population Day on July 11, the International Planned Parenthood Federation (IPPF; London, UK) held a seminar in London to review achievements made since the 1994 International Conference on Population and Development (ICPD) in Cairo, Egypt. The seminar is part of a programme of Cairo+5 events that will culminate in a Special Session of the United Nations General Assembly in June, 1999, to review and assess the implementation of the ICPD Programme of Action. The ICPD marked a shift away from demographic targets to an integrated development approach to population issues. The 20-year Programme of Action aims to give all couples and individuals the right to decide freely and responsibly the number, spacing, and timing of their children, and to have the information and means to do so. Women’s education and equality are at the heart of the Programme, which also calls for universal access to quality and affordable reproductive health services and to primary education, and for mea-
T
donor contributions have not changed since 1995 and, in some countries, have even declined (see http://www.unfpa.org and http://www.rockfound.org). IPPF warns that the shortfall in promised assistance from developed nations will mean that by 2000, inadequate provision of contraception will result in as many as 220 million unintended pregnancies, 50–90 million abortions, 60–110 million unwanted births, and the deaths of up to 8·9 million infants and children. The Cairo+5 events aim to work towards the full implementation of the Cairo commitments and to raise awareness of such key issues as adolescents’ rights to sexual and reproductive health care. Before June, 1999, the UNFPA will sponsor a series of Cairo+5 review-related activities involving programme and donor countries, non-governmental organisations, and the private sector. IPPF has also set up a Cairo+5 website with links to the UNFPA site (http://www.ippf.org/cairo). Janna Palmer
US National Institutes of Health under fire
CDC gets new director
AP
Jeffrey Koplan has been appointed as director of the US Centers for Disease Control and Prevention (CDC), announced the Health and Human Services secretary on July 10. Koplan succeeds David Satcher, who vacated the post in February
Koplan: “disease detective”
after his appointment as US Surgeon General. An epidemiologist, Koplan has previously served as Assistant Surgeon General and director of CDC’s National Center for Chronic Disease Prevention and Health Promotion. He will take up the position on Oct 5. 䡺
210
sures to reduce infant, child, and maternal mortality. IPPF’s Cairo+5 position paper, presented last week, reports on many achievements worldwide since the ICPD. There has been a 33·6% increase in the provision of family planning services, and family planning associations reached some 9·4 million people in 1997. The main obstacle to the implementation of the Programme of Action is funding. Governments agreed at Cairo to increase spending on population and related programmes to US$17 billion annually by 2000. Two-thirds of this amount would come from developing countries, the remainder from donor governments. The report Coming up short: struggling to implement the Cairo Programme of Action, by the UN Population Fund (UNFPA) and High Stakes, a report on population and development launched last week by the Rockefeller Foundation (New York, USA) show that this funding commitment is not being met. Developing countries pay three quarters of the cost of family planning and reproductive health services, but
he US National Institutes of Health (NIH) must include more participation from the public in its decision-making process, because NIH’s interaction with the public is “generally weak” compared with its interaction with research communities. This is the main conclusion of an Institute of Medicine (IoM) report released on July 8. The report urges NIH to establish an Office of Public Liaison in the NIH director’s office to document “public outreach, input, and response mechanisms”. In addition, the report says, the agency should create similar offices in all of its research institutes, and establish a Director’s Council of Public Representatives to be chaired by the NIH director. Developed by an advisory committee headed by Leon Rosenberg (Princeton University, NJ, USA), the report was requested by Senators Bill Frist (Republican, Tennessee) and Dan Coates (Republican, Indiana). The IoM committee was given the job of evaluating the criteria that NIH use to make funding allocations for research, as well as the mechanisms for public input and the impact of Congressional mandates on fund-
T
ing decisions. In the report, the committee concludes that it “generally supports the criteria that NIH uses for priority setting”. However, at an IoM press conference on July 8, Rosenberg said the group believes that “NIH has fallen short in its ability to explain to the public how these criteria are implemented”. The committee also urges NIH to “strengthen its analysis and use of health data, such as burdens and costs of diseases, and of data on the impact of research on the health of the public”. The group recommends that the priority-setting process should be done in a more unified manner by the NIH director, so that each institute submits annual strategic plans to the director (see http://www.nap.edu/readingroom/ books/nih/). In a statement released in response to the report, NIH director Harold Varmus agrees that “there is room for additional public input into these processes”, and says that NIH will review the report “in detail” with its staff and advisory groups to decide on implementation plans. Lisa Putman
THE LANCET • Vol 352 • July 18, 1998