|SCN News, Number 17 - Nutrition and HIV/AIDS (ACC/SCN, 1998, 72 p.)|
Diet, Nutrition and Chronic Disease: An Asian
edited by P. Shetty and C. Gopalan
Review by S. Smitasiri and S.
Institute of Nutrition, Thailand
This book is the proceedings of the Asian Nutrition Forums symposium that was organised in New Delhi, India in 1997 to discuss the emergence of nutrition-related chronic disease in Asia. It consists of reviews of current epidemiological information and recommendations for developing health and nutrition policies from selected Asian scientists who have direct experiences with this issue. Lessons learned from industrialised and affluent countries are valuable for the prevention and management of the problem. The data presented indicate that changes in diet and lifestyle are leading to health problems dominated by overnutrition while undernutrition remains a significant concern. This double burden is a threat to socio-economic progress in a region that has the largest population in the developing world.
Reviews of the current epidemiological information on the emerging problem from India, China, Indonesia, Philippines and Korea are presented. There are increasing prevalence rates of coronary heart disease, hypertension, diabetes mellitus, obesity and cancer accompanied by increased intakes of dietary fat, protein, salt and sugar as well as changing lifestyles. Large population-based epidemiological studies to assess the risk factors of chronic disease in Asia are needed to supplement the information already available.
The current status of diabetes mellitus is assessed in one paper from Thailand and three papers from India. Four sections focus on cardiovascular diseases. One paper from China and four papers from India emphasise the emerging problem and the role of diet. Section 16 profiles cancers in India. It discusses the possible roles of dietary factors and physical activity. A review of osteoporosis in China, Thailand and India is included. Nutritional status as determined by anthropometry, dietary intakes and biochemical parameters, appears to be related to osteoporotic fractures. However, the early onset of peak bone mass and the early age of type II fracture, as well as, the absence of a higher incidence in females suggests a re-examination of existing paradigms.
In sections 21-24 the focus is on obesity and the role of diet and exercise (one paper from Malaysia and three papers from India). Current thinking on dietary guidelines from Indonesia, Thailand, Philippine, China are included along with a section which shares European experiences. An article from India pinpoints a need to change the dietary habits in urban populations. Japanese experience in changing lifestyles, health education and chronic disease prevention are described. Finally, a report of a collaborative effort in the development of Asian food-based dietary guidelines is included.
Policy makers, program managers, practitioners, researchers, academics and students working in the areas of food, nutrition and public health will find this book helpful in describing the current nutritional status of the Asian populations.
The symposium was supported by the World Health Organization. The publication was made possible by support from the World Cancer Research Fund. Published by Smith-Gordon and Company Limited, 13 Shalcomb Street, London SW10 OHZ. Tel: +44 171 351 7042, Fax: +44 171 351 1250. 143 pp. Suttilak Smitasiri and Sakorn Dhanamitta can be contacted at the Division of Communication and Behavior Science, Institute of Nutrition, Mahidol University at Salaya, Phuthamonthon 4 Road, Nakorn Phathom 73170, Thailand. Tel: 662 441 0218, 889-3309, Fax: 662 441 9344-5, E-mail: [email protected]
Iodine in Pregnancy (1998)
edited by John Stanbury, Frans Delange, John Dunn and Chandrakant Pandav
The past decade has witnessed remarkable progress in extending iodine prophylaxis to many areas of the world where iodine deficiency had resulted in a variety of health problems. The reduction in iodine deficiency disorders has been dramatic, even though much remains to be done through iodization of salt, and where that is not immediately realizable, use of slow release iodine oil. The rapid extension of preventive programs, primarily in developing and less industrialized countries has led to an examination of the good and possibly undesirable consequences of iodine on the fetus and newborn.
à Are there health risks associated with iodine supplementation?
à Is excess thyroid hormone damaging to the nervous system and responsible for later cognitive and behavioral change?
à How is the risk of thyrotoxicosis minimized?
à Which is more cost effective, an iodized oil program or an iodized salt program?
This collection of related essays seeks answers to these and other questions. Answers are almost always incomplete but may serve to provoke more illuminating research and guide medical and health practices in combating iodine deficiency. The book concludes with the statement by the World Health Organization on the safe use of iodized oil to prevent iodine deficiency in pregnancy and a summary of the published evidence of the use of iodized oil during pregnancy.
The International Council for the Control of Iodine Deficiency Disorders (ICCIDD) is a non-profit no-governmental organisation dedicated to the sustainable elimination of iodine deficiency disorders (IDD) throughout the world. The ICCIDD was granted an official status as an international NGO at the 47th World Health Assembly held in Geneva in 1994. Published by Manzar Khan, Oxford University Press, YMCA Library Building, Jai Singh Road, New Delhi 110 001. ISBN 0 19 564780 7
Catch Them Young (1998)
by Selna Chaubey (World Bank)
This booklet written in non technical language represents a departure in format for World Bank publications. The book let describes the Tamil Nadu Integrated Nutrition Project as one of the most successful nutrition projects in India. The project contributed significantly to a reduction in malnutrition and infant mortality in the state and has generated widespread participation. The report brings the project to life through storytelling and the description of actual cases of mothers and children.
For the Tamil Nadu project as a whole, severe malnutrition was reduced by 44% from 1992-1997 although for moderate malnutrition, improvement has not been as rapid. Infant mortality, however, fell from 84 per 1,000 live births at the beginning of the project to 54 per 1,000 in 1996, well below the national average. The number of women who received at least one antenatal checkup has increased from 39% in 1992-93 to 90% in 1997. More than half of all eligible women receive at least four checkups.
One factor in the projects success was the way local leaders were used in the program. Priests and practitioners of traditional medicine, mothers-in-law and panchayat members were included because their words are often law in communities. Sensitising such groups was a way of assuring that program messages would reach people and translate into mother and child-care practices in their homes.
While the project coordinators concede that there were some gaps in the program there was general consensus that such programs need to put more responsibility in the hands of the communities. Project workers should play more of an advisory role while communities take charge and manage their own activities.
Source: The World Bank, 1818 H Street, N.W., Washington, DC, 20433 USA. Tel: 202477-1234, Fax: 202-477-6391
Nutritional Neuroscience: a New International Journal on Diet, Nutrition and the Nervous System
Nutrition Neuroscience is a new international, interdisciplinary broad-based journal for reporting research on the role of diet, dietary supplements, and food additives on the neurochemistry, neurobiology, and behaviour of all organisms, including humans. Published by Harwood Academic Publishers of Amsterdam, The Netherlands, the journal is published every two months.
This is the first journal with a central theme of integrating nutrition and the nervous system. It is anticipated that the journal will serve as a common forum for scientific discourse among neuroscientists, nutritionists, psychiatrists, naturopaths, and those interested in preventive medicine.
The editorial advisory board is made up of scientists and clinicians from four continents and fourteen countries with expertise in different fields of nutrition and neuroscience. The Editor-in-Chief is Dr Chandan Prasad of the Louisiana State University Medical Center, USA.
The journal accepts full-length research papers, short communications, review articles, book reviews, clinical case reports, scientific commentary, and news items. The following are examples of some of the specific topics the journal may cover:
à Effect of diet (including trace metals, antioxidants, and phytonutrients), dietary supplements, and food additives on the metabolism and physiology of central and peripheral neurons, neurotransmitters, neurotransmitter receptors, behaviour (learning, memory, anxiety, etc.), and neuroendocrine regulations;
à Demonstration of neuroactive substances (hormones, peptides and neuromodulator substances) in food;
à Use of diet and dietary supplements (protein, carbohydrate, fat, caffeine, tryptophan, etc.) in the management of psychiatric disorders;
à Dietary considerations in the management of neurologic disorders like epilepsy and Parkinsons disease; diet and sleep;
à Diet and mental performance.
For enquiries about subscription, please email [email protected]. The subscription rate for personal use is US$95 per year. For instructions to authors and other information about the journal, please contact Dr Prasad (Editor-in-Chief), Department of Medicine, Box T4M5, Louisiana State University Medical Center, 1542 Tulane Ave., New Orleans, LA 70112, USA. Tel: 1 504 568 6446 Fax: 1 504 568 4159 Email: [email protected]
The Editor-in-Chief will make every effort towards an expedient review of submitted manuscripts. Additional information about the journal can be found on the web at: http://www.gbhap.com/Nutritional_Neuroscience/
Human Development Report (1998)
This years report Human Development Report examines consumption from the perspective of human development. It concludes that despite a dramatic surge in consumption in many countries more than a billion people lack the opportunity to consume in ways that would allow them to meet their basic needs. Of the 4.4 billion people in developing countries, nearly three-fifths lack basic sanitation. Almost a third have no access to clean water. A quarter do not have adequate housing. A fifth have no access to modern health services. A fifth of children do not attend school to grade 5. About a fifth do not have access to sufficient dietary energy and protein. Others are consuming in ways that cannot be long sustained environmentally or socially. Poor people and poor countries need to accelerate the growth of their consumption but they need not follow the path trodden by the rich and high growth economies. Production techniques can be made more environmentally friendly. Patterns of consumption that harm society and reinforce inequalities can be changed. A determined effort must be made to eradicate poverty.
However, the Report doesnt conclude that more or less consumption is needed but rather a different pattern of consumption is required. Many of the approaches and technologies needed to make consumption more sustainable are already in use or are on the drawing board but they need to be applied far more broadly. Stronger international support is needed to moderate the inequity among and within countries. In industrialised countries, 7-17% of the population is poor and levels of deprivation have little to do with average per capita income.
This Report is an important contribution to the international debate on consumption and human development. It should serve as a stimulus to the many non-governmental and community movements that have long led the way on issues of consumption, poverty, environment and human development. These groups should form alliances that define a more human vision of consumption for the 21st century.
The Principal Coordinator of the Human Development Report is Dr. Richard Jolly, the SCNs Chair. Copies of the report can be obtained from the United Nations Development Programme, 1 UN Plaza, New York, New York 10017, USA.
Web site: http://www.undp.org/undp/hdro ISBN 0-19-512459-6
Monitoring Vitamin A Programs
edited by Jeny Cervinskas and Robin Houston
This manual responds to the need for guidelines in the design and implementation of low-cost monitoring systems for vitamin A interventions. It is designed for program managers who are seeking easy-to-follow steps for establishing such systems. Experience has revealed new ways to improve the effectiveness of interventions through better communications on dietary practices, expanded channels of supplement delivery, and new opportunities for fortification of staple foods. Such improvements must be supported by well-designed dietary information systems, quality control and enforcement.
Although the impact of vitamin A interventions can be measured periodically in a population using clinical and biochemical indicators, there is also a need for process monitoring on an ongoing basis. This will ensure the effectiveness of the interventions in delivering required quantities of the micronutrient on a continuous and sustained basis. Increasingly, interventions require the participation of several sectors and careful monitoring at various stages is a critical requirement.
Such monitoring systems can also provide a measure of progress toward the goal of ensuring adequate vitamin A status for the population. The guidelines are based on field experience in a variety of countries. However, they must be adapted to suit specific situations and locally determined needs.
In addition to the seven chapters addressing the various aspects of vitamin A monitoring, the manual contains a list of technical support for program monitoring and a supplement schedule for the prevention and treatment of vitamin A deficiency.
Food fortification experiences in Canada
The MI in collaboration with Health Canada is producing a publication in which the long and successful history of fortifying foods with necessary micronutrients in Canada has been documented.
The upcoming publication Food Fortification in Canada outlines Canadian experiences with national food fortification programs as a means of sharing knowledge and as a successful example for other countries planning to undertake similar activities to prevent and control micronutrient deficiencies.
Related MI publication: Iron Fortification of Flour. The MI, in collaboration with USAIDOMNI is drafting a comprehensive 3-volume manual covering all programmatic, technical and analytical aspects of flour fortification, quality control and monitoring. The manual is now in final draft and will be printed shortly.
New* Progress in Controlling Vitamin A Deficiency.
New* Food Fortification to End Micronutrient Malnutrition: State-of-the-Art. Proceedings from a Satellite meeting to the IUNS, August 2, 1997, Montreal, Canada.
New* Expert Consultation on Anemia Determinants and Interventions: Proceedings from September 1997 MI hosted meeting, Ottawa, Canada. (See SCN News 15, p 53)
New* Major Issues in the Control of Iron Deficiency.
New* Economic Consequences of Iron Deficiency.
Requests for pricing and ordering information should be sent by email to: [email protected] Tel: 613-236-6163, Fax (613) 236-9579 The mailing address is Micronutrient Initiative. PO Box 8500, Ottawa, ON, Canada K1G 3H9. Web site: http://www.idrc.ca/mi
Management and Training for Nutrition Programmes - Flexible Modules for Training (1998)
This nutrition training course has been established by the WHO Regional Office for the Eastern Mediterranean and the Nutrition Institute in Cairo, Egypt, in response to the need for more trained nutritionists in the Eastern Mediterranean Region. Nutrition has become a serious health concern in this Region, where socioeconomic conditions vary widely, emergency situations (drought, war and earthquakes) are common, and consequently the problems of undernutrition, overnutrition, and micronutrient deficiencies often occur side by side. The course aims to provide training for programme managers and nutrition personnel at country level within the Eastern Mediterranean Region, and emphasises the use of active learner participation and the application of practical skills.
The course is organised into six skills-oriented independent modules:
1. Essentials of nutrition and development
2. Nutrition in the community
3. Communication, extension and training
4. Management of nutrition programmes and projects
5. Supportive disciplines (biostatsistics, epidemiology and computing)
6. Participant individual project
These have been published as a set of booklets, which will assist those responsible for nutrition in countries of the Region to conduct training at country level. Each module booklet, which can be used independently, contains the rationale, objectives and content of the module, followed by the facilitators guide and the participants guide. An introductory manual provides suggestions for training methodologies, and for organising and coordinating the course.
WHO-EM/NUT/196.0/E/L 1998. The course set of an introduction manual plus six modules, is available for limited distribution from Dr A. Verster, Regional Advisor, Nutrition, Food Security and Safety, WHO Regional Office for the Eastern Mediterranean, P.O. Box 1517 Alexandria - 21511, Egypt. Tel: +203 483 0090/7/8/9 Fax: +203 483 8916 Email: [email protected]
Diabetes and Exercise 5th International Conference
Almost everyone in the Caribbean is able to identify at least one person - whether a family member, neighbour or friend - who has diabetes mellitus. Most of these cases are the result of insulin resistance (Type 2 diabetes). The role of exercise in treating these cases is becoming more widely recognised not only as an adjunct to diet but as a therapy itself.
The conference included presentations on the practical aspects of diabetes and exercise paying particular attention to minimising the risks of exercise in type 1 (insulin dependent) diabetes. In type 1 diabetes, exercise by itself will not have a significant effect on overall glycaemic control but is encouraged primarily for its role in preventing cardiovascular disease. Since hypoglycaemia may occur during or after exercise, guidelines on carbohydrate replacement were also given. In Type 2 diabetes (non-insulin dependent), exercise is an important component of the management along with diet and drug therapy because of its role in improving insulin resistance. Exercise in the treatment of children, pregnant women and the elderly with diabetes was also discussed. Programmes for exercise should be tailored to specific age groups, social settings and disability levels. A wide variety of activities, including dancing and fun activities, should be explored.
The main papers of the conference are summarised in CAJANUS - The Caribbean Food and Nutrition Institute Quarterly. Volume 31, No 2, 1998. Cajanus is available from the Caribbean Food and Nutrition Institute, P.O. Box 140, Kingston 7, Jamaica. Annual subscription: Free to subscribers in CFNI member countries; US$6.00 for other developing countries, and US$12.00 for developed countries.
Rapid Assessment Procedures (RAP): Ethnographic Methods
to Investigate Womens Health
by Joel Gittelsohn, Pertti J. Pelto, Margaret E. Bentley, Karabi Ghattacharyya, and Joan Jensen
This manual contains guidelines and procedures for carrying out an ethnographic study of womens health. It provides tools for the generation and analysis of data to facilitate programme development, implementation, evaluation, and improvement by governmental and nongovernmental institutions concerned with womens health. The main body of the manual focuses on a series of data collection exercises that will permit an organization to collect data on local perceptions and practices regarding womens health in the study area. It differs from other ethnographic manuals in its focus on the health problems of women rather than a specific disease or cluster of diseases. It provides detailed suggestions for the appropriate training of data collectors, and it provides for the optional use of specialized computer software packages.
This manual is available from the International Nutrition Foundation, Boston, Mass., USA, 1998. (ISBN 1-892468-01-8) 196 pages, paperback. US$15.00 plus $3.00 shipping and handling. (Developing country individuals and institutions US$10.00 plus $5.00 shipping and handling).
Control of Cardiovascular Diseases in Developing
edited by Christopher Howson, K. Srinath Reddy, Thomas Ryan and Judith Bale, Institute of Medicine
Cardiovascular diseases (CVDs), the major forms of which are ischemic heart disease, hypertension and stroke, are increasing in epidemic proportions in developing countries. Of the 52 million deaths reported worldwide in 1990, 15 million are attributable to CVD. It is estimated that CVD is now the developing worlds leading cause of death. This report addresses the research needed to improve understanding of the scope of this challenge, the various risk factors involved, and ways of preventing and treating these diseases that will be both feasible and affordable for the developing world.
The explanation for the global epidemic of CVD targets the following:
à the declining mortality and fertility rates leading to an increase in middle and older age groups that are likely to develop CVD;
à economic development that allows adoption of a Western lifestyle, which may include a diet high in fat and salt; increased tobacco use; and less physical activity.
Recommendations on opportunities and priorities for research and development to reduce the CVD burden in developing countries as well as the institutional arrangements needed to achieve these goals include the following:
à determine the magnitude of the CVD burden in developing countries,
à develop targeted, effective primary prevention strategies,
à reduce tobacco use,
à detect and treat high blood pressure,
à initiate pilot studies to evaluate effective, low-cost drugs,
à develop and assess procedures for affordable clinical care for CVD.
The report concludes that it is necessary to build capacity to conduct research at the regional and local level. An organizational mechanism that will facilitate CVD prevention and control around the world is required. Only then are there likely to be significant decreases in premature death from this disease.
Copies of this report are available for sale from the National Academy Press, Box 285, 2101 Constitution Avenue, N.W., Washington, DC 20055. Tel: 800-624-6242 or 202-334-3313 (in the Washington metropolitan area), or visit the NAPs on-line bookstore at www.nap.edu The full text of the report is available on-line at: www.nap.edu/readingroom
Canadian Journal of Development
Revue Canadienne Ddes du Dloppement
A special issue of the Canadian Journal of Developmental Studies is titled The Quest for Food Security in the Twenty-First Century. It contains a total of 14 articles, 10 written in English and 4 in French. International targets for poverty reduction, agricultural biodiversity, and gender issues as they relate to food security are among topics discussed.
For more information or to order please contact: Canadian Journal of Development Studies, University of Ottawa, 538 King Edward Avenue, Box 450, Station A, Ottawa, ON. K1N 6N5 Tel: 613 562 5800 Extension 1561, Fax: 613 562 5100 Email: [email protected] Website: http://www.uottawa.ca/publications/cjds
The Price of the Special Issue is Can$30 in Canada; $US30 in other countries (add $5 for airmail).
Complementary Feeding of Young Children in Developing
Countries: a review of current scientific knowledge
This document provides the background information that is necessary for the development of scientifically sound feeding recommendations and appropriate intervention programmes to optimise childrens dietary intake and enhance their nutritional status. The review is intended primarily for health professionals and others concerned with the nutrition, health, and well-being of children in developing countries. Although much of the information may also be relevant for young children in industrialised countries, the document focuses on the particular needs of children in low-income settings, and the recommendations have been formulated with consideration of the economic and environmental constraints that are common in developing countries.
The rationale for the current review is based on the availability of new scientific evidence in a number of areas of child feeding. Longitudinal growth studies suggest that the major period of growth-stunting is from early infancy to about 2 years of age. This corresponds to the time of the introduction of complementary foods. New data are also available on the required energy density and micronutrient needs of young children. These studies suggest that a new look at the use of complementary feeding is appropriate. The document is organised into nine major sections. Background information is presented on the maturation of physiological processes relevant to child feeding. The importance of breastfeeding and the age of introduction of complimentary foods are discussed. A broad range of technical information on different aspects of complementary feeding is examined including the energy, protein and micronutrients required from complimentary foods at different ages and appropriate feeding frequency. The importance of sensory characteristics of these foods as determinants of intake is also included. Global information on child-feeding practices and current programmatic interventions to promote child feeding are also discussed. The report concludes with a summary of appropriate child-feeding practices and a discussion of future research needs. Over 500 scientific references are included with this review.
For further information please contact Randa Saadeh, WHO/NHD, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland. Tel: 41 227913315 Fax: 41 22 791 4156 Email: [email protected]
The Right to Food in Theory and Practice
What is the right to food? How important is it? What are its implications for every human being? Who is responsible for implementing it so that everyone, everywhere has enough to eat? These questions are of fundamental importance, not only to the worlds more than 800 million underfed people, but also to national governments, international bodies, non-governmental organisations (NGO) and others concerned with economic development and the improvement of living standards worldwide.
This special publication, released to commemorate the fiftieth anniversary of the Universal Declaration of Human Rights, examines the rights related to food from both the human rights and the operational points of view. The booklet provides insight into the meaning of the right to adequate food and provides an overview of NGOs actions in various parts of the world. The World Food Programme discusses the right to food in emergencies with special emphasis on the plight of internally displaced persons. Various articles about womens right to food, hunger mapping, follow-up action to the World Food Summit, the special Programme for Food Security, and the importance of national legislation in implementing the rights related to food are also discussed.
Available Food and Agricultural Organization of the United Nations, Viale delle Terme di Caracalla, 00100 Rome, Italy ISBN 92-5-104177-6 48 pp. Also available on line at: www.fao.org/legal
World Alliance for Nutrition and Human Rights - WANAHR
edited by Michael Latham and Carolyn Campbell
This bulletin (No. 7, September 1998) contains six papers on the use of food as a weapon of war and for political purposes. Some papers are more general and examine the use of food as a weapon from an historical and ethical perspective while others are case studies discussing specific countries. The first article by Marc Cohen evaluates the ethical, religious and legal framework of food rights. The use of food as a weapon in many different countries and situations as diverse as India and Chile, East Timor and Cambodia, and Somalia and Iraq are discussed.
Austen Davis of Medecins sans Frontieres examines the food atrocities of the Sudan. He describes a situation where the entrenched government of a country wages a food war against a vast region of its own country. The situation in Sudan is perhaps unprecedented because the civil war has been going on for four decades. Apparently all sides see food abuse as a very potent weapon and this makes the work of NGOs and UN agencies extremely difficult.
The next two papers deal with the impact sanctions have on the food and nutrition of a population. In Cuba, where U.S. sanctions have been in place for many years, the Cuban government implements policies that do a great deal to protect the health and nutrition of its people especially children. Sanctions against Iraq, on the other hand, have led to considerable hardship and an increase in child mortality for that population. However, lifting the embargo on the sale of oil could largely solve the disastrous humanitarian situation in Iraq.
The final papers are UN documents that discuss economic sanctions and human rights. The first is a report submitted to the Seventeenth session of the UN Committee on Economic, Social and Cultural Rights and discusses the relationship between economic sanctions and respect for economic, social and cultural rights. The second report, UN Document E/CN, 4,1998/67 written by Max Van der Stoel, is a strong condemnation of human rights in Iraq. The editors of the WANAHR Bulletin conclude that it is never appropriate to infringe on the rights of a civil society just because their leaders have violated internationally accepted rules of behaviour related to peace and security.
Produced by the WANAHR Secretariat, c/o Norwegian Institute of Human Rights, Universitetsgt 22-24, N-0162 Oslo, Norway Tel: +47 22 84 20 01 Fax: +47 22 84 20 02 Email: [email protected] Contributions to the WANAHR Bulletin are welcome. The Bulletin especially calls for contributions or communications from NGOs in the Third World wishing to become allies in the WANAHR network.
Development and Human Rights: The Role of the World Bank
With this publication, the World Bank Group joins the international community in celebrating the Fiftieth Anniversary of the Universal Declaration of Human Rights. The principles enshrined in the historic 1948 Declaration, and refined in later international agreements, continue to provide a touchstone for governments and citizens around the world. They also serve as a challenge for the World Bank and other members of the UN family to advance through their work the ideals represented in the UN Charter.
The World Bank believes that the attainment of human rights is a central and irreducible goal of development. By placing the dignity of every human being-especially the poorest - at the very foundation of its approach to development, the Bank helps people to build lives of purpose and hope.
Through its support of primary education, health care and nutrition, sanitation, housing, and the environment, the Bank has helped hundreds of people achieve crucial economic and social rights. In areas of civil and political rights, the Banks contributions are necessarily less direct, but perhaps equally significant. By helping fight corruption, improve transparency and openness in governance, strengthen judicial systems, and modernize financial sectors, the Bank helps to build environments in which people are better able to pursue a broader range of human rights.
In addition to commemorating this years anniversary, the short booklet is intended to provide a vehicle for continued dialogue with external groups dedicated to the advancement of human rights.
The World Bank, 1818 H street, N. W., Washington, D.C. 20433, ISBN 0-8213-4340-8 30pp Tel: 202-477-1234, Fax: 202-477-6391 Email: [email protected]
Reducing the Odds - Preventing Perinatal Transmission of
HIV in the United States
edited by Michael Stoto, Donna Almario and Marie McCormick (Institute of Medicine)
The basis of this report is the finding in 1994 that administration of the antiretroviral drug zidovudine (known as ZDV and previously as AZT) during pregnancy and childbirth could reduce by about two-thirds the chance that the child of an HIV-positive mother would be infected with HIV.1 These findings led government agencies and professional organisations in the United States to propose and implement recommendations calling for counselling and testing of all pregnant women for HIV, mostly on a voluntary basis. This report addresses ways to increase prenatal testing, improve therapy for HIV-infected women and children and generally reduce perinatal HIV infections. The report also considers the ethical and public health issues associated with screening policies as prevention tools, and their implications for prevention and treatment opportunities for women and infants.
1. Conner EM et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N Engl J Med 331:1173-1180, 1994.
This book will be available for sale from the National Academy Press, 2101 Constitution Avenue, N.W., Lock Box 285, Washington, D.C. 20055. Tel: 800-624-6242 or 202-334-3313 (in the Washington metropolitan area), or from the NAP on-line bookstore at: www.nap.edu The summary of this book is available on-line at: www.nap.edu/readingroom
Guidance on Regulatory Assessment of HACCP: Report of a Joint FAO/WHO Consultation on the Role of Government Agencies in Assessing HACCP (1998)
For many years public health and food inspection authorities worldwide have supported the use of the HACCP system.
HACCP - Hazard Analysis and Critical Control Point - is a system which identifies, evaluates, and controls hazards which are significant to food safety.
In many countries HACCP is mandatory. Thus it is essential that government agencies be provided with guidance on their roles and responsibilities regarding HACCP assessment.
This consultation held in Geneva June 2-6, 1998 focused on providing government agencies with guidance on regulatory assessment. The specific areas of interest were:
à the role and responsibilities of government agencies with regard to the assessment of HACCP. Governments may need to facilitate training programmes for industry and government personnel, provide the necessary expertise and training materials and formulate an overall program to access HACPP;
à the essential activities which need to be carried out when assessing HACCP. These include the development of a plan, the effectiveness of control measures, the hazard analysis and verification procedures.
The competencies of assessors and potential problems in regulatory assessment as well as legal considerations and cost/investment concerns were also considered. Future consultations should consider the need for development of internationally accepted criteria for certification of HACCP assessors. The difficulty of translating technical documents into other languages necessitates the development of equivalencies for the essential terms in the area of HACPP and food safety.
Issued by the World Health Organization in collaboration with the Food and Agricultural Organization of the United Nations. For further information and to obtain copies of the document, please contact the Food Safety Unit, Programme of Food Safety and Food Aid, WHO, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland. Tel: 41 22 791 2555 Fax: 41 22 791 4807 Email [email protected] WHO Food Safety documents are also increasingly on the web at http://www.who.ch/ftf/
The International Code of Marketing of Breast-Milk
An International Measure to Protect and Promote Breast-Feeding (1998)
by Sami Shubber
This books consists of an analysis, interpretation and explanation of the International Code of Marketing of Breast-Milk Substitutes. It begins with a survey of the historical development of the International Code, and covers various consultations and drafts leading to the adoption of the Code by the World Health Assembly in 1981. The book then deals with the aim of the International Code, its material scope, definitions, information and education, advertising and promotion of products covered by the Code, the health care system, health workers, company employees, labelling, quality of the products covered by the Code and its implementation and monitoring.
The author offers, throughout the book, his own interpretation of the various provisions of the International Code, in the light of his experience as a Senior Legal Officer of the World Health Organization, responsible for legal matters relating to the Code at the time of its adoption. He also gives examples of actions taken relating to the International Code at the national and international levels. The question of whether or not there is an obligation to implement the International Code is specifically dealt with in the book, taking into account the legal nature of the resolutions of the World Health Assembly. In this context, a comparison with the legal effect of resolutions of the General Assembly of the United Nations has been made. Finally, the author offers his own conclusions on the whole of the International Code.
Published by Kluwer Law International, Order Department, PO Box 322, 3300 AH Dordrecht, The Netherlands, Fax +31-78-6546474, phone +31-78-6546454, EMail: [email protected] or 675 Massachusetts Avenue, Cambridge, MA 02139, USA, Fax: +1-617-3548598, phone +1-617-3540140, Toll free in USA & Canada 1-800-577-8118, EMail: [email protected]
GEMS/Food International Dietary Survey: Infant Exposure
to Certain Organochlorine Contaminants from Breast Milk - A Risk Assessment
by D. Schutz, G.G. Moy and F.K. Krstein
This paper reviews reports of contaminants occurring in human milk at levels which may be of significance for health. The paper discusses possible adverse effects from these contaminants for the nursing infant, and examines the risk management measures which have been suggested or undertaken by governments.
SCN NEWS JULY, 1999
NUTRITION AND HEALTHY AGEING
Please send us materials, books, notice of events, letters to the editor, etc. that you would like us to consider for this issue.
ACC/SCN Secretariat, c/o World Health Organization, 20
Fax: 41-22-797 8891 Email: [email protected]
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