Dear Readers

According to estimates by the World Health Organization (WHO), more than half of the medical apparatus in Third World health facilities is not in working order. This means lower-quality medical care and a waste of valuable resources. The onus is on those responsible in health ministries, manufacturers of medical apparatus and development aid organizations, m equal measure, to take steps to remedy the situation.

About 70% of the hospital equipment in the developing world comes from the industrialized countries. Much of it is second-hand apparatus, supplied with the best of intentions, but ill-suited to the real needs of health facilities. Sadly, the result of these uncoordinated consignments is that the equipment only lasts for a third of its potential service life.

Our Focus articles discuss possible solutions, which start with both donors and recipients. Important factors include, for example, standardization of quality criteria, equipment lists and supplies of spare parts. Also, success is clearly in evidence where maintenance measures have become an integral part of the overall management of health systems. Planned maintenance is a key factor in ensuring continued operation of health facilities.

The authors also look at the problems of energy supply and waste disposal. They report on experience gathered by GTZ's Division of Health, Population and Nutrition and its partner organizations, and by FAKT, the Stuttgart-based Association for Appropriate Technology, which is a member of the NGO-GTZ AT-Forum.

Peter Bosse-Brekenfeld