PubMed Health⌕ Search

PubMed · 12317112

A strategy for reducing numbers? Response.

Abstract

I am not particularly knowledgeable on the subject-matter of this article; but would like to make brief comments from the broad economic point of view. The concept of a demographic 'trap' is not sound. For one thing, this concept completely ignores the possibility of 'trade' in food by implicitly assuming that the capacity of a community to support its population depends on its own output of food through appropriate economic policies. There were many predictions of disastrous famines in India in the early 70s on the basis of considerations such as those advanced by Dr Ding. Amartya Sen has argued, quite plausibly, that famines occur because of maldistribution of food and lack of adequate 'safety nets' rather than a decline in total food output. Sen is referred to at 1 place in the article; but somewhat out of context. The conclusion that if the birth rate does not fall, the death rate should also not be allowed to fall is repugnant. Look at the countries of Latin America; population growth is high, but there is no 'entrapment'. The so called 'trap' can, of course, occur because of failure of economic and social policies and international economic policies. However, there is nothing inevitable about it (at any given rate of population growth). The author's plea for greater information and public education in respect of demographic trends and consequences is valid. There is also an urgent need for a new thrust in family planning programs on wider economic and social grounds. However, this case is quite independent of the 'entrapment' theory.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

B Jalan. 1991. A strategy for reducing numbers? Response.. https://pubmed.ncbi.nlm.nih.gov/12317112/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Reassortment of Highly Pathogenic Avian Influenza as a Driver for Zoonotic Spillover, Asia.

Highly pathogenic avian influenza H5Nx viruses remain a major zoonotic threat, yet global attention has focused largely on clade 2.3.4.4b, potentially overlooking major changes within long-endemic H5N1 lineages in Asia. Recent reports from South and Southeast Asia describe the emergence of reassortant clade 2.3.2.1 viruses alongside renewed human infections after apparent prolonged epidemiologic stability. Collectively, those events suggest a regional pattern rather than isolated anomalies. In this article, we argue that reassortment, rather than point mutation alone, might be an underrecognized driver of zoonotic risk in endemic H5N1 lineages and is reshaping those lineages. We examine why such events might be underrecognized in settings with entrenched poultry influenza, identify limitations of current surveillance systems, and call for integrated, real-time approaches linking genomic detection with phenotypic assessment across animal and human health sectors to enable timely risk assessment and coordinated public health action.

Asia↗

Financing and health system capacity for precision medicine in Asia: a six country landscape analysis.

BACKGROUND: Precision medicine (PM) adoption is accelerating across Asia, but implementation remains uneven due to differences in financing, infrastructure, governance, and health-system readiness. OBJECTIVES: To examine how six Asian countries (Singapore, South Korea, China, Malaysia, Thailand, and Indonesia) adopt, finance, and integrate PM technologies, and identify common implementation patterns and challenges. METHODS: A landscape review of peer-reviewed literature, government publications, and HTA reports (2010-2026) was conducted, supplemented by stakeholder consultations. PM applications were grouped into public health screening (hereditary breast and ovarian cancer [HBOC] and familial hypercholesterolemia [FH] cascade testing), next-generation sequencing (NGS) applications (rare diseases, oncology, pharmacogenomics), and AI-enabled PM. Evidence was synthesized across access, awareness, reimbursement, and implementation. RESULTS: Public health genomic screening demonstrated the highest implementation readiness, followed by precision oncology, while rare disease diagnostics remained infrastructure-dependent and pharmacogenomics and AI-enabled PM platforms were at earlier stages. Four readiness profiles emerged: highly aligned systems; reimbursement-constrained systems with strong governance and infrastructure; systems strengthening governance, public financing and infrastructure; and strategy-led systems expanding implementation through pilot programs and referral centers. CONCLUSIONS: PM implementation across Asia remains heterogeneous. The identified readiness profiles highlight governance, financing, and infrastructure priorities for sustainable and equitable PM diffusion.

Asia↗

Double heterozygous germline pathogenic variants in patients referred to a tertiary cancer genetics clinic in Singapore.

BACKGROUND: The increasing use of multigene panel testing has led to a rise in the identification of double heterozygous (DH) pathogenic variants in cancer patients, although their frequency and clinical relevance remain poorly characterised, particularly in Asian populations. METHODS: We conducted a retrospective review of 5,178 patients referred to a tertiary cancer genetics clinic in Singapore. DH pathogenic variants were defined as the presence of two or more distinct pathogenic or likely pathogenic germline variants identified by multigene panel testing. Clinical, pathological, and family history data were reviewed and analysed using appropriate non-parametric and exact statistical methods. RESULTS: Among 2,802 index patients with available genetic test results, 593 (21.2%) carried at least one pathogenic/likely pathogenic variant. DH pathogenic variants were identified in 21 individuals (0.75%), of which 9 were patients with breast cancer, 10 with non-breast malignancies, and 2 were cancer-free. The frequency of multiple primary cancers was 26.3% in DH variant carriers, 23.3% in single variant carriers, and 16.5% in those with no pathogenic variants. The median ages of first cancer diagnosis were 47, 44, and 48 years. Several DH combinations involved moderate- or low-penetrance genes, and some clinically unsuspected variants were detected only through broad multigene testing. CONCLUSION: DH pathogenic variants represent a rare subgroup that is increasingly detected through multigene panel testing. Their phenotypic expression is variable, and the influence of additional pathogenic variants remains uncertain. Our findings emphasise the need for tailored genetic evaluation and further research to guide evidence-based management for this complex patient population.

Asia↗