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Volume 2, Number 51
23 December 2002
FAMILY PLANNING / REPRODUCTIVE HEALTH LAW AND POLICY
Fifth
Asian and Pacific Population Conference Adopts Plan of Action on
Population and Poverty (press release)
The Fifth Asian and Pacific Population Conference concluded with
the adoption by consensus of a Plan of Action on Population and
Poverty addressing population issues as a key contribution to reducing
poverty in the region and meeting the United Nations Millennium
Development Goal of halving the number of people living on less
than US$1 a day by the year 2015.
US Loses Vote at Population Conference (news article)
The United States lost a vote at an international conference Tuesday
as Asia-Pacific countries rejected the Bush administration's stand
against abortion and condom use among adolescents.
Reproductive
Health, Including Family Planning 
(report)
This paper reviews progress in the Asia-Pacific region since 1994
in the area of reproductive health, including policies and programs.
It covers the issue of designing comprehensive good quality reproductive
health services and specific components of reproductive health care.
With regard to the implementation of such services, it considers
human resources development for integrated reproductive health care,
logistics and commodities, training and supervision, management
information systems, access to care and services, quality of care,
new approaches in planning for reproductive health, and options
for financing such services. It concludes with recommendations to
advance the agenda set at the International Conference on Population
and Development in 1994 and the Fourth Asian and Pacific Population
Conference in 1992.
Partnerships
and Resources: Towards Cairo +10: Achievements, Unfinished Business
and New Challenges
(report)
The International Conference on Population and Development (ICPD)
represented a watershed in international thinking and policy-making
in the areas of population and family planning. This paper reviews
progress achieved since ICPD in the areas of reproductive health,
gender equality, adolescent health services, population growth and
fertility rates, HIV/AIDS, funding issues and millennium development
goals as well as recent global conference on development issues.
Special focus is given to the issue of partnership and concludes
with a set of recommendations for improving partnership.
Report
of the Implementation of Commission Resolution 54/4 on Mobilization
of Human and Financial Resources for Further Implementation of Actions
to Achieve the Population and Development Goals of the ESCAP Region
(report)
This paper briefly describes the significant activities undertaken
by the secretariat of the Economic and Social Commission for Asia
and the Pacific in implementing a resolution for the mobilization
of human and financial resources for further implementation of actions
to achieve the population and development goals of the ESCAP region.
Partnerships
and Resources: Resource Mobilization in the ESCAP Region
(report)
The Programme of Action of the International Conference on Population
and Development (ICPD) specified the financial resources, both domestic
and donor funded, necessary to implement a wide-ranging population
and reproductive health package over a 20-year period. Approximately
two thirds of the projected costs in developing countries were expected
to come from domestic sources and one third from the international
donor community. It was estimated that approximately $11 billion
would be needed to cover the costs of population activities in the
ESCAP region in the year 2000. This paper describes the funding
provided by major donors in the Asia-Pacific region plus a profile
of domestic resource flows in a number of countries in the region.
FAMILY PLANNING / REPRODUCTIVE HEALTH RESEARCH
Low
Dose Mifepristone and Two Regimens of Levonorgestrel for Emergency
Contraception: A WHO Multicentre Randomised Trial (PubMed abstract)
This study was a randomised, double-blind trial in 15 family-planning
clinics in 10 countries. The authors randomly assigned 4136 healthy
women with regular menstrual cycles, who requested emergency contraception
within 120 h of one unprotected coitus, to one of three regimens:
10 mg single-dose mifepristone; 1.5 mg single-dose levonorgestrel;
or two doses of 0.75 mg levonorgestrel given 12 h apart. The three
regimens studied are very efficacious for emergency contraception
and prevent a high proportion of pregnancies if taken within 5 days
of unprotected coitus. Mifepristone and levonorgestrel do not differ
in efficacy.
Fertility
Levels and Trends, and Their Implications for Policies and Programmes
(report)
Annex 1
| Annex 2
Related news article: Asia
Makes Progress in Promoting Family Planning: UN Report
Family planning has been steadily gaining greater acceptance in
the Asia-Pacific region as most countries in the region have promoted
reproductive health care and women's rights, a UN report said at
the Fifth Asian and Pacific Population Conference in Bangkok.
Behavioural
Change Communication and Advocacy and Information and Communication
Technology as Tools for Population and Development and Poverty Reduction:
Behavioural Change Communication and Advocacy
(report)
Changes in values played an important role in the transition to
lower birth rates. The change in attitudes and acceptance of family
planning proceeded rapidly in populations that were socially integrated,
and had shared values and good internal communications. A prime
factor in fostering change and development can be the planned and
systematic use of communication to help individuals, communities
and societies to accept change. For decades, population information,
education, and communication (IEC) and advocacy strategies have
been information-source-oriented and driven more by an enchantment
with media, segmented audiences, materials development, and the
goal of awareness creation rather than development messages. Behavior
change takes place more easily and rapidly when groups, even small
ones, become involved in analyzing information, discussing its relevance
to their particular situation, internalizing it, and making decisions
to take action.
Behavioural
Change Communication and Advocacy and Information and Communication
Technology as Tools for Population and Development and Poverty Reduction:
Information and Communication Technology
(report)
Despite the fact that information and communication technology (ICT)
can be used as a tool for implementing poverty reduction and population
programs, ICT usage among ESCAP countries is relatively limited.
The barriers to ICT adoption are lack of financial and human resources,
lack of affordability, lack of awareness of the benefits of ICT,
lack of ability to use ICT proficiently and lack of contents suitable
for local residents. As a means to accelerate the construction of
the necessary ICT infrastructure, policies such as provision of
tax exemptions, removal or modification of regulations, open competition
and expansion of markets are recommended. To build the capacity
of human resources for using ICT, it is suggested that projects
be initiated for improving literacy and fostering communication
and an information-seeking attitude. To handle affordability issues,
special programs are recommended to subsidize the cost of purchasing
telecommunication devices and the use of services. Awareness of
the benefits of ICT, ability to use ICT and the development of contents
suitable for local residents are also needed to ensure the expansion
of ICT usage.
Current
Contraceptive Research (research article)
This article discusses the need for a wide range of contraceptive
methods to address the changing and differing needs of individuals,
and details ongoing research into potential new contraceptive options.
These methods include chemical and mechanical barrier methods, female
hormonal methods and male contraception.
FAMILY PLANNING / REPRODUCTIVE HEALTH NEWS
US:
Democrats Blast New Condom Advisory (news article)
A government fact sheet that long promoted condoms as ''highly effective''
in preventing HIV and other sexually transmitted diseases now offers
a more neutral summary of the pros and cons of condom use.
HIV / AIDS RESEARCH
Impact
of AIDS on Older People in Africa: Zimbabwe Case Study 
(report)
Related news article: African
Elders Bear Hardships of Care for Orphans, AIDS Sufferers
This new WHO report investigates the burden of AIDS on older people
in Zimbabwe and concludes that, the increase in home based and orphan
care due to AIDS places enormous burden older relatives, mostly
older women, who have to provide this care within a context of decreased
economic means, stigma, witchcraft accusations and other challenges
they faced in their old age. It calls for practical and sustainable
approaches that will improve the capacity of older people to enable
them continue providing this important role.
Acceptability
of Male Circumcision as a Tool for Preventing HIV Infection in a
Highly Infected Community in South Africa (Pubmed abstract)
Related news article: Misconceptions
about Circumcision in South Africa (news article)
Nearly one third of circumcised South African men have dangerous
misconceptions about the protective effect of circumcision.
Molecular
Epidemiology of HIV Type 1 in Ecuador, Peru, Bolivia, Uruguay, and
Argentina (PubMed abstract)
Surveillance for HIV infection among people at increased risk was
conducted in five countries in South America. Seroprevalence studies
were conducted in more than 36,000 people in Ecuador, Peru, Boliva,
Uruguay, and Argentina, along with genetic analysis of the HIV-1
strains. In all countries, the prevalence of HIV-1 among men who
have sex with men (MSM) was high (3-30%), whereas the prevalence
among female commercial sex workers (FCSMs) was low (0.3-6%). By
envelope heteroduplex mobility assay, subtype B predominated in
MSM communities and in FCSWs in Ecuador, Bolivia, and Peru. Using
MHA-bf, more than 80% of samples from Ecuador, Peru, and Bolivia
were classified as pure subtype B, whereas in Uruguay and Argentina
this proportion was only 30 to 40%. BF recombinants were the most
prevalent form of HIV-1 in Uruguay and Argentina. Subtype B is the
most common subtype in countries lacking injecting drug use (IDU)
epidemics, whereas BF recombinants are more common in countries
where extensive IDU epidemics have been documented, suggesting the
ontogeny of recombinant strains in particular risk groups in South
America.
HIV/AIDS
and Poverty: The Impact of HIV/AIDS in the ESCAP Region
(report)
In the Asian and Pacific region, the demographic impact of HIV/AIDS
varies greatly across countries, affecting mortality levels, life
expectancy, fertility and population structures; the economic impacts
are felt more strongly at the community and household levels than
at the macro-level. Interventions to alleviate the socioeconomic
impacts of HIV/AIDS should be conducted to carefully target the
population groups potentially most vulnerable.
HIV / AIDS NEWS
WTO
Talks on Cheap Drugs Collapse (news article)
A deal to ensure better access to cheap medicines for poor countries
collapsed late Friday, with developing country diplomats blaming
the United States for holding out at the World Trade Organization
(WTO). Washington was the only government that openly refused to
accept a draft WTO agreement to allow some developing countries
to ignore patents and order cheap copies when importing drugs to
treat diseases such as HIV/AIDS and malaria.
South
Africa: Activists Gear Up for AIDS Drug Court Battle (news article)
South Africa's minister of health and a provincial health minister
are being taken to court by AIDS lobby group the Treatment Action
Campaign, for failing to provide nevirapine to pregnant women in
one of the country's nine provinces.
Thailand
Overwhelmed by Runaway AIDS: Cuts in Prevention Programs Followed
Nation's Initial Success (news article)
For years, Thailand's AIDS prevention program was acclaimed as a
model for Asia, a beacon of light in a region that had no tradition
of tackling a major health crisis head-on. But even that wasn't
enough. Today, AIDS is the leading cause of death in Thailand, overtaking
traffic accidents, heart disease, and cancer.
MATERNAL AND CHILD HEALTH RESEARCH
Ndola
Demonstration Project: A Midterm Analysis of Lessons Learned
(report)
This report reveals findings from an intervention study in Zambia
to investigate how integrating services for prevention of mother-to-child
transmission of HIV into low-resource maternal-child health settings
influences mothers' ability to make and implement informed decisions
about HIV. The research demonstrated it is feasible to increase
women's knowledge of the risks of mother-to-child transmission without
eroding good breastfeeding practices.
The
Effect of Rapid HIV-1 Testing on Uptake of Perinatal HIV-1 Interventions:
A Randomized Clinical Trial (PubMed abstract)
The purpose of the study was to examine whether HIV-1 testing using
a rapid assay increases the proportion of pregnant women obtaining
HIV-1 results and the uptake of perinatal HIV-1 interventions. Pregnant
women attending public health clinics in Nairobi were offered voluntary
counselling and testing for HIV-1. Consenting women were randomly
assigned to receive either rapid or conventional HIV-1 testing.
Results showed that Rapid HIV-1 testing significantly increased
the proportion of women receiving HIV-1 results, which is important
for sexual and perinatal HIV-1 prevention. The challenge remains
to improve the uptake of perinatal HIV-1 interventions among HIV-1-seropositive
women.
Altered
Arousal Response in Infants Exposed to Cigarette Smoke (research
abstract)
Related news article: Smoke
Exposure Shown to Weaken Arousal in Infants
Babies exposed to tobacco smoke have a weaker arousal response than
other infants, which could partly explain why children whose parents
smoke have a higher risk of cot death.
Empty
Arms: The Effect of the Arms Trade on Mothers and Children (research
article)
Trading in arms, both legal and illegal, is highly detrimental to
the health of mothers and children in the countries where armed
conflict occurs. The authors report on the devastating effects of
legal and illegal weapons exported into poor countries in conflict
in Africa and Asia.
MATERNAL AND CHILD HEALTH NEWS
New
Combo Vaccine Will Mean Fewer Shots for Babies (news article)
The US Food and Drug Administration has approved a five-in-one combination
vaccine, Pediarix, which could result in 24 million fewer injections
a year for US infants.
Maternal
Mortality (news article)
The World Health Organization has identified 23 nations in which
the maternal death rate is greater than 1,000 per 100,000 births.
Rwanda has a staggering 2,300 deaths per 100,000 births. It is no
exaggeration to say that the issue of maternal mortality and morbidity,
fast in its conspiracy of silence, is the most neglected tragedy
of our times.
Got
Milk? Scientists Discover Key Lactation Gene (news article)
Researchers have discovered that a gene called xanthine oxidoreductase,
or XOR for short, is required for lactation in female mice. This
previously unidentified role for XOR in lactation reveals a possible
genetic basis for the lactation difficulties experienced by nearly
5% of women.
MEN'S HEALTH RESEARCH
The
Relationship Between Condom Use, Sexually Transmitted Diseases,
and Location of Commercial Sex Transaction Among Male Hong Kong
Clients (PubMed abstract)
The purpose of this study was to investigate the consistency of
condom use and theprevalence of self-reported sexually transmitted
diseases (STD) among male Hong Kong commercial sex clients with
respect to the geographical location of these transactions. Researchers
found that respondents patronizing female sex workers (FSW) in 'mainland
China only' or in 'mainland China and other places' were more likely
to be inconsistent condom users (28 and 34%) than those patronizing
FSW in 'Hong Kong only' (9.1%). Clients who had commercial sex both
in mainland China and Hong Kong were more likely to use condoms
in Hong Kong than in mainland China (paired OR 4.67, < 0.05).
The researchers concluded that the geographical location of commercial
sexual activity is related to the consistency of condom use, irrespective
of the clients engaged in such activity. Prevention programmes need
to be aware of how risk behaviour is dependent on local contexts.
Long-term
Survival of Human Spermatogonial Stem Cells in Mouse Testes
(PubMed abstract)
Related news article: Study
Points to Sperm-saving Strategy
Trying to grow human sperm in mice may sound like a crazy idea,
but it could lead to a better way of helping some men maintain their
own sperm-producing capacity. For the first time, scientists have
succeeded in getting human stem cells that are the precursors of
sperm to survive in mice.
MEN'S HEALTH NEWS
Specific
Protein Essential to Making Healthy Sperm (news article)
When it comes to a protein involved in making sperm, it is possible
to have too much of a good thing. Scientists have found that extra
amounts of the protein can interfere with an essential step in sperm
development in mice.
Combat
Can Kill Marriages, Study Finds (news article)
New research suggests that three of the biggest U.S. wars of the
past century may have taken a heavy personal toll on the marriages
of those soldiers who fought on the front lines. Men who served
in combat in World War II, the Korean War and the Vietnam War were
62% more likely to get divorced than other men of their generation,
according to the largest and most comprehensive study of its kind.
POPULATION RESEARCH
Population
and Poverty in Asia and the Pacific
(report)
A paper presented at the Fifth Asian and Pacific Population Conference
in Bangkok last week, it sets out some specific linkages between
population trends and poverty, in the areas of migration, population
aging, and HIV/AIDS, by comparing demographic and economic trends
in East Asia (where mortality and fertility are low, and economic
growth has been rapid) with South and Central Asia (where the opposite
is true).
Population
Ageing : Policy Responses to Population Aging in Asia and the Pacific
(report)
Annex
1
This paper reviews the aging situation in the Asia-Pacific region
from the perspective of the demographic transition, the feminization
of aging and its socioeconomic implications. It highlights a number
of "best practices" in terms of community participation,
income security, health care, and family support and co-residence,
and concludes with a set of recommendations formulated with a view
to the challenges ahead.
Population
Ageing : Policy Responses to Population Aging in Asia and the Pacific
(report)
Annex 1
This paper and reviews the aging situation in the Asia-Pacific region
from the perspective of the demographic transition, the feminization
of aging and its socioeconomic implications. It highlights a number
of "best practices" in terms of community participation,
income security, health care, and family support and co-residence,
and concludes with a set of recommendations formulated with a view
to the challenges ahead.
POPULATION NEWS
Population
Boom Strains the Struggling Philippines (news article)
The Philippines, already struggling to feed, house and employ its
80 million people, is in a baby boom that is set to double the population
in the next 30 years, according to the government's Commission on
Population.
China
to Control Population Size Within 1.4bn by 2010 (news article)
At the 5th Asia-Pacific Population Conference convened in Bangkok
of Thailand on December 16, the State Family Planning Commission
of China delivered a report, saying China will endeavor to control
its population size under 1.4 billion (Hong Kong, Macao SAR and
Taiwan excluded) by the end of 2010.
WOMEN'S HEALTH RESEARCH
A
Gene-Expression Signature as a Predictor of Survival in Breast Cancer
(Research article)
Related news article: Genetic
'Signature' Predicts Breast Cancer Outcome
Women who carry a particular genetic "signature" in their
breast cancer cells are more than five times as likely as those
without that genetic pattern to see their cancer spread to other
parts of their bodies after the tumor is removed, researchers report.
Although this method to predict cancer prognosis is more accurate
than currently used techniques, this and similar techniques "can
never be totally accurate." Current methods to predict the
path of a tumor include a woman's age, the size of her tumor, and
whether the disease has spread to her lymph nodes, often a sign
that the cancer will soon infiltrate other body regions. Adding
this genetic technique to classical methods will undoubtedly improve
the accuracy with which doctors can predict how a patient's cancer
will progress, which would enable patients to "make informed
decisions" about which treatments they should add onto surgery.
Clinical
Considerations in the Management of Individuals at Risk for Hereditary
Breast and Ovarian Cancer
(research article)
The ability to define women as being at hereditary risk for breast
and ovarian cancer facilitates the use of specialized surveillance
and prevention strategies. Genetic testing, which plays a role in
defining risk, requires careful pre- and post-test counseling to
discuss the limitations of testing itself and available management
strategies.
Chemotherapy-Induced
Amenorrhea and Fertility in Women Undergoing Adjuvant Treatment
for Breast Cancer
(research article)
The majority of women diagnosed with early-stage breast cancer have
an excellent long-term prognosis, but many will undergo temporary
or permanent chemotherapy-induced amenorrhea. The authors review
the current studies on the impact of adjuvant chemotherapy on amenorrhea
and fertility in women with breast cancer. As more women over the
age of 35 consider pregnancy, fertility issues are becoming important
areas of investigation for the adjuvant treatment of breast cancer.
Whether chemotherapy-induced amenorrhea has a prognostic effect
remains unclear, and further studies are warranted.
Aromatase
Inhibitors in Breast Cancer: An Update
(research article)
Tamoxifen has been the endocrine treatment of choice for patients
with breast cancer. The development of selective aromatase inhibitors
has offered an alternative management approach for patients in whom
a hormonal approach is indicated. The authors reviewed reports in
which aromatase inhibitors were compared with tamoxifen for the
treatment of metastatic disease, as well as information pertinent
to their use as adjuvant therapy. Aromatase inhibitors for metastatic
disease appear to provide superior efficacy and a better toxicity
profile in first- and second-line treatment of metastatic disease
than tamoxifen.
YOUTH RESEARCH
Sexual
and Reproductive Health of Young People in the Asia-Pacific Region
(report)
Young people (aged 10-24) in Asia are healthier, more urbanized,
and better educated than earlier generations; nevertheless, substantial
proportions experience risky sexual activity, suffer adverse reproductive
health outcomes, and do not receive prompt or appropriate health
care. Their vulnerabilities remain poorly understood and served.
Young people's awareness of sexual and reproductive health remains
superficial and ridden with misperceptions. The way forward includes
enhancing young people's ability to make informed decisions as a
way to reduce unsafe and unwanted sexual activity. Meanwhile, parents,
teachers and the broader adult community must facilitate this decision-making,
through better communication and by creating environments that protect
adolescents from abuse and enable them to access information and
services. Finally, health services must accommodate the particular
needs of youth in acceptable and non-threatening ways.
Sexual
Intercourse and the Age Difference Between Adolescent Females and
Their Romantic Partners (research article)
Related news article: Young
Girls, Older Partners Leads to High STD Risk
Teenage girls who have older partners are more likely than girls
their same age with younger partners to report behaviors that place
them at high risk of sexually transmitted diseases (STDs). Specifically,
it was discovered that teenage girls who said they were dating someone
at least 2 years older were half as likely as girls with partners
closer to their own age to say they had consistently used condoms
during the past 30 days. In addition, girls with older boyfriends
were more than twice as likely to report that their partners had
had other partners during their relationship in the past 6 months.
Indeed, screening the girls for STDs revealed that those with older
partners were almost four times as likely to have chlamydia.
Effects
of Mandatory Parental Notification on Adolescents' Use of Sexual
Health Care Services (letter to the editor)
Letters to the editor of JAMA (and authors' response) address the
controversial issue of parental notification of their children's
use of sexual health care services.
YOUTH NEWS
TV
Teaches Teenagers About Sex (news article)
Like it or not, Hollywood serves as a sex-education counselor for
many teenagers. One survey, conducted in 2000, found that teenagers
between 13 and 15 ranked entertainment media as the leading source
of information about sexuality and sexual health.
Tanzania:
Room Sharing at Colleges Spreads AIDS (news article)
According to a local researcher, shortage of rooms in students'
halls of residence at local institutions of higher learning encourage
sharing of rooms between male and female students, and subsequently
the spread of HIV.
PROFILES / SPECIAL REPORTS
PMCT
Training Curriculum: Prevention of Mother-to-Child Transmission
of HIV
(training manual)
A five-module course for health providers, this training manual
demonstrates an integrated approach to prevention of mother-to-child
transmission in the maternal-child health care setting. The Kenya
PMCT Project developed the curriculum in partnership with Horizons,
UNICEF, and the Regional AIDS Training Network.
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