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PubMed1993

Reduced resources applied to antimalarial drug development.

This statement was made in 1984 (Ref. I): 'The Agency for International Development (AID) announced a major breakthrough in the development of a vaccine against the most deadly form of malaria in human beings. The vaccine should be ready for use around the world, especially in developing countries, within five years.' Since then, the spending on development of drugs against malaria has been on the decline. Brian Schuster and Wilbur Milhous wonder. did we declare victory too soon? Wouldn't the prudent approach have been to look at vaccines and drugs as complementary techniques rather than alternative approaches?

Journal Article↗
PubMedDate not supplied

Innovative intersectoral approach reduces blood leads levels of children and workers in Romania.

With the support of the U.S. Agency for International Development (USAID), an intersectoral approach involving the community, governmental and nongovernmental agencies, and the management of the local copper smelting plant succeeded in reducing the blood lead levels of plant workers and of young children living in the vicinity of a copper smelter, Zlatna, Romania. Specifics of the collaborative effort, which attracted enthusiastic responses from all participants, are provided.

Air Pollutants↗
PubMed1988

Public Law 100-202, Joint Resolution making further continuing appropriations for the fiscal year 1988, and for other purposes, 22 December 1987.

This US Act provides the following with respect to universal access to child immunization: "The Congress calls upon the President to direct the Agency for International Development, working through the Centers for Disease Control and other appropriate Federal agencies, to work in a global effort to provide enhanced support towards achieving the goal of universal access to childhood immunization by 1990 by 1) assisting in the delivery, distribution, and use of vaccines, including a) the building of locally sustainable systems and technical capacities in developing countries to reach, by the appropriate age, not less than 80% of their annually projected target population with the full schedule of required immunizations and b) the development of a sufficient network of indigenous professionals and institutions with responsibility for developing, monitoring, and assessing immunization program and continually adapting strategies to reach the goal of preventing immunizable diseases and 2) performing, supporting, and encouraging research and development activities, in both the public and the private sector, that will be targeted at developing new vaccines and at modifying and improving existing vaccines to make them more appropriate for use in developing countries. In support of this global effort, the President should appeal to the people of the US and the US private sector to support public and private efforts to provide the resources necessary to achieve universal access to childhood immunization by 1990." The Act also does the following with respect to various forms of bilateral assistance: 1) prohibits the use of funds for an organization or program that supports coercive abortion or involuntary sterilization; 2) prohibits the use of funds for the performance of abortion as a method of family planning (FP); 3) provides that in awarding grants for natural FP under section 104 of the Foreign Assistance Act no applicant shall be discriminated against because of such applicant's religious or conscientious commitment to offer only natural FP. In addition, the Act stipulates that with respect to appropriations for the Department of Health and Human Services no funds will be used to perform abortions except where the life of the mother would be endangered if the fetus were carried to term.

Abortion, Induced↗
PubMed1997

Population control II: The population establishment today.

Although population assistance represents a relatively small share of official development assistance, it influences many other aspects of development planning. The organizations that comprise the population establishment have a common purpose--the reduction of population growth in the Third World--but they are not homogeneous and sometimes have conflicting goals and strategies. National governments, multilateral agencies, nongovernmental organizations, foundations, academic centers, and pressure groups all contribute to creating and sustaining what has become a virtual population control industry. Through scholarships, travel grants, awards, and favorable publicity, Third World elites have been encouraged to join the population establishment. The World Bank, the U.S. Agency for International Development, and the U.N. Fund for Population Activities have pursued explicit strategies for pressuring Third World governments to design and implement population policies, most recently in Africa.

Coercion↗
PubMed1995

Administration of 25,000 IU vitamin A doses at routine immunisation in young infants.

OBJECTIVE: To investigate whether monthly administration of vitamin A at routine immunisation produces any side-effects, and to examine the effect of this supplementation on the vitamin A nutrition status of infants. DESIGN: A double-blind randomised placebo-controlled clinical trial. SETTING: Immunisation clinic of a large diarrhoea treatment centre. SUBJECTS: Infants aged 6-17 weeks who will receive their first diphtheria-pertussis-tetanus/oral polio vaccine (DPT/OPV) dose. METHODS: Infants were randomly assigned to receive either 25,000 IU vitamin A or placebo. Three such doses were given with each immunisation dose at monthly intervals. Infants were examined by a physician before and during 24 h after the doses and any signs of toxicity were recorded. Venous blood was drawn at entry and 1 month after the 3rd dose for retinol assay. RESULTS: One hundred and one infants received vitamin A and 98 received placebo. Decreased feeding, irritability, diarrhoea, and vomiting were comparable between the two groups. In the vitamin A group five infants developed bulging fontanelle; three of them developed it once (after 1st, 2nd and 3rd dose respectively), one developed it twice (after both the 2nd and 3rd dose), and the other infant after all three doses. In the placebo group a single child developed bulging fontanelle after the 3rd dose. In all the cases the bulging disappeared within 48 h of onset except in one infant, in whom it subsided at 60 h. The total bulging episodes in the vitamin A and placebo groups were 8 and 1 respectively (RR = 7.7; P < 0.04). However, none of these infants had irritability. At entry fasting retinol level was < 10 micrograms/dl in 35% infants and in 87% infants it was < 20 micrograms/dl. After the third dose fasting retinol level was marginally better in the vitamin A group (mean +/- s.d.: 21.9 +/- 8.2 vs 19.2 +/- 7.8; P = 0.05). However, 47% infants receiving supplementation still had serum retinol level <20 micrograms/dl. CONCLUSION: The results suggest that administration of 25,000 IU of vitamin A in young infants along with routine immunisations, though associated with increased incidence of transient bulging fontanelle without any associated adverse signs or symptoms, may still be inadequate to prevent deficiency in this population. SPONSORSHIP: This study was funded by the United States Agency for International Development (USAID) under grant no. DPE-5986-A-1009-00 with the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). The ICDDR,B is supported by countries and agencies which share its concern for the health problems of developing countries.

Double-Blind Method↗
PubMed1976

Research and development of unconventional systems for immunization.

The problems raised by the ever expanding world population justify the work of USAID (U.S. Agency for International Development). Continual efforts must be made to develop and efficiently operate methods of control of the microbial and parasitic infections which menace our sources of protein. This programme includes immunization, technical methods in bacterial and viral genetics to obtain attenuated strains, and improvements in production, preservation and distribution of preparations. An example of an unconventional but promising system of application is the pilot study recently begun in the Missouri-Mississippi River region.

Animals↗
PubMed1997

International family planning funds will be expedited.

With a 53-46 vote on February 25, the Senate approved a resolution to speed up the release of funding to the US Agency for International Development (USAID) for its overseas family planning programs. The resolution, which had been passed by the House on February 13 (see RFN VI/2), will make money budgeted for fiscal year 1997 available on March 1, 4 months earlier than originally scheduled. Under the omnibus budget bill approved at the end of September 1996, funding was to have been withheld until July 1--a full 9 months into the fiscal year--unless President Clinton made a finding that the delay was harming the functioning of the US family planning program. Based on a report from USAID, which found that the delay would cause at least 17 programs around the world to suspend their services and result in significant and permanent damage to US population-control efforts, President Clinton issued the finding in support of moving up the release of funds. The Senate did not consider a House-passed provision that would have barred family planning programs that receive US money from providing abortions, even if they paid for the procedures through other sources of funding.

Americas↗
PubMedDate not supplied

The control of measles in tropical Africa: a review of past and present efforts.

Measles in tropical Africa is endemic and cyclical, with a high incidence that usually peaks during the dry seasons. Measles may be a contributing factor in 10% of all deaths among African children. Several problems have hindered measles immunization programs in Africa; these include difficulties in maintaining the cold chain, poor epidemiologic surveillance, and the logistical problems involved in reaching a population that is 80% rural. The United States Agency for International Development and the World Health Organization both have programs that are helping to increase immunization coverage and to solve the problems just mentioned. Many countries have begun to train their own personnel to administer immunization programs. However, because of limited staff and equipment, a high birth rate, and an uncertain social situation, no firm predictions can be made concerning the permanent control of measles in tropical Africa.

Africa↗
PubMed1995

Update: dracunculiasis eradication--Ghana and Nigeria, 1994.

The plan for the global eradication of dracunculiasis (i.e., Guinea worm disease) was developed in October 1980 (1). Since 1987-1988, Global 2000, Inc., the United Nations Children's Fund (UNICEF), and the U.S. Agency for International Development have assisted the Guinea Worm Eradication Programs in Ghana and Nigeria, countries in west Africa. In 1989, Ghana and Nigeria ranked first and second in the number of reported cases of dracunculiasis with 179,556 and 640,008 cases, respectively (2). This report summarizes data for the two countries during 1994 and describes efforts toward eradication of dracunculiasis.

Dracunculiasis↗
PubMed1999

The results framework--an innovative tool for program planning and evaluation.

This article constitutes a case study of the development and implementation of the "results framework," an innovative planning and evaluation tool that is rapidly becoming a standard requirement for United States Agency for International Development (USAID) projects. The framework is used in a USAID-funded regional initiative for HIV/AIDS prevention in Central America. This new program evaluation and monitoring tool provides many advantages over traditional evaluation approaches that use outside consultants to provide midterm and end-of-project evaluations. The results-framework process, which spans the life of the project, provides an opportunity for program staff, donors, partners, and evaluators to work as a team to collect and use rich, longitudinal data for project planning, implementation, and evaluation purposes.

Central America↗
PubMedDate not supplied

Does A.I.D. still spell relief?

The U.S. Agency for International Development has helped foreign governments lower infant mortality rates and extend life expectancy through a combination of disease prevention and medical treatment. But problems at home include allegations of fraud and abuse at the agency's highest levels. A.I.D.'s efforts abroad are complicated by the government's restrictive anti-abortion policy.

Abortion, Legal↗
PubMed1991

The Quality Assurance Project: introducing quality improvement to primary health care in less developed countries.

Persistently excessive morbidity and mortality rates in less developed countries (LDCs) served by primary health care systems suggest that the quality of services is inadequate. The PRICOR project, sponsored by the United States Agency for International Development, has designed and implemented methods for quality assessment and problem solving in LDC health systems. After developing comprehensive lists of essential activities and tasks, similar to practice parameters, for seven child survival interventions, PRICOR supported comprehensive quality assessment studies in twelve LDC countries. The studies, yielding over 6000 observations of health worker-client encounters, indicated highly prevalent, serious program deficiencies in areas including diagnosis, treatment, patient education and supervision. To facilitate corrective action, PRICOR assisted managers in conducting operations research to resolve priority problems revealed by the assessments. The recently initiated Quality Assurance Project is building on PRICOR techniques in designing and implementing sustainable continuous quality improvement programs for LDC health systems.

Acute Disease↗
PubMed2006

Sex in Geneva, sex in Lilongwe, and sex in Balaka.

This paper compares three interpretations of women and the transmission of HIV in rural Malawi. One is disseminated world-wide by institutions with a global reach such as the World Health Organization in Geneva and United States Agency for International Development (USAID); the second is provided by urban Malawians situated in the capital of Lilongwe, the seat of government and the site of the many international and national non-governmental agencies; the third is articulated by rural women and men in Balaka District, Malawi. We focus on women's motivations for extramarital sex, using qualitative interview data. We find that whereas in Geneva and Lilongwe women from rural Malawi are said to engage in sexual relationships outside of marriage because they need money for survival, in Balaka they are said to be motivated not only by money for survival but also for attractive consumer goods as well as by passion and by revenge for a husband's infidelity. We also find that data collection procedures influence explanations for women's affairs, as does the respondent's gender. An implication of this study is that AIDS-prevention policies based on the view from Geneva and Lilongwe need modification for Balaka, and by implication for rural Africa more generally.

Adolescent↗
PubMed1984

DeLucca named project director in Guatemala.

Mike Delucca, a social marketing specialist since 1978, has been named director of a new contraceptive social marketing effort in Guatemala. The project is sponsored by Importadora de Productos Farmaceuticos (IPROFA), S.A., a group of private-sector community leaders who came together specifically to set up the project. IPROFA plan to being marketing 1 brand of oral contraceptive, condom, and foaming tablet in early 1985. Efforts will first be targeted at economically and socially disadvantaged fertile couples between the ages of 18-44 in large urban areas. By the end of 1985 marketing will begin in rural and small urban areas. DeLucca is on assignment IPROFA from Juarez and Associates, a marketing and research firm in Los Angeles. He was formerly with Development Associates of Arlington, Virginia, and served as project director for the social marketing project in El Salvador. He joined the Guatemala project in May 1984, overseeing prelaunch activities that included development of the marketing plan. After the product launch he will coordinate sales and follow-up marketing studies. The project is the result of a cooperative agreement between IPROFA and US Agency for International Development (USAID) signed in April 1982.

Administrative Personnel↗
PubMed1990

The commitment to breastfeeding.

The Agency for International Development (A.I.D.) is increasing its efforts to promote breastfeeding, as part of its child survival initiatives in child spacing, diarrheal disease control, and nutrition. Research suggests that promotion can increase breastfeeding rates. The Agency, for the first time, has set aside funds specifically for breastfeeding promotion and is working to identify places in its programs where such promotion can take place.

Breast Feeding↗
PubMed2003

Community-level access and control in the management of Lake Victoria's fisheries.

The fisheries of Lake Victoria have reached a critical stage in their development: catches are declining, and there is increasing evidence of hardship amongst the fishing communities. In an effort to countermand the reduction in the flow of economic benefits the lake's riparian states are collaborating with international agencies to develop a fisheries management strategy that would be based on a partnership between stakeholders. One possible area for such collaboration is via the devolution of certain access controls to fishing communities. This paper describes findings from recent research and argues that notions of access are linked to community perceptions of the resource, control over it and their own individual and collective manoeuvrings designed to retain and improve livelihoods.

Africa↗
PubMedDate not supplied

The development of a family nurse practitioner programme in Botswana.

The Family Nurse Practitioner Programme, offered through the National Health Institute in Botswana, Africa, is the result of a collaborative effort between the Ministry of Health of the Government of Botswana and the United States Agency for International Development. This one-year post-basic nursing programme evolved from a national commitment to expand and upgrade primary health care services. The curriculum, based on service needs and reflecting national development priorities, has been designed to increase the relevance of nursing education to the social and health needs of the people.

Botswana↗