Women's Health and Education Center (WHEC)

WHEC Update - February 2007

A Newsletter of worldwide activity of Women's Health and Education Center (WHEC)
February 2007; Vol. 2, No. 2

Confession, they say, is good for the soul. WomensHealthSection.com has been a delight, a challenge, a stimulus, a source of laughter and sometimes irritation and simply pain in the neck. Assembled in 5 separate sections and 8 sub-sections is a selection of more than 200 systematic reviews of the literature, about 1,800 URLs, linked to 12,000 to 15,000 web-networks in any given month reflecting the breadth and depth of the specialty. This delightful collection reminds us that there is more to medicine than strict science. I am certain that is why readers find this publication interesting and entertaining. The goal of WomensHealthSection.com is to promote excellence in the clinical practice of obstetrics and gynecology and closely related fields. We continue to have the highest circulation worldwide among all obstetrics and gynecology journals - about 4 million readers a year in 154 countries. Each month we send you WHEC Update (Policy-Briefs) to highlight the efforts of the United Nations in tackling various issues at the National and International levels. We hope this provides a comprehensive account of the many challenges before the international community, as well as the joint ongoing efforts to find solutions. Helping others gives success true meaning.

These basic facts about the United Nations and its system reflect the multitude of ways in which the United Nations touches the lives of people everywhere. It chronicles the work of the Organization in such areas as health, peace, development, human rights, humanitarian assistance, disarmament and international law. Globalization is transforming the world. While it brings great benefits to some countries and individuals - faster growth, higher living standards, new opportunities - a backlash has risen because these benefits are distributed so unequally and because the global market is not yet underpinned by values and rules that address key social concerns such as the protection of human rights, labor standards and the environment. Poverty and inequality are fertile ground for conflict. We hope to help promote understanding about the United Nations and its presence in people's lives.

United Nations in a united world

Your Questions, Our Reply:

What do people expect from their doctors?

Quality in medical care: it might be said that what patients ought to want and are entitled to expect is a professional service of the highest quality. Quality has been defined as "fitness to the purpose". Clearly patients expect medicine to be something more than the mere application of medical science to the human condition. The simplest way to find out what people might want or expect from their doctors is to ask them. Surprisingly few people seem to worry about the technical competence of doctors. What they worry about is doctor's ability to understand the patient as a person and provide the right guidance. Financial, legal and administrative techniques seem powerless to ensure that this demand is met. The message seems to be that people want personally relevant healthcare delivered by a doctor who knows them well and which addresses their particular problems. By inference, people do not want healthcare which is pursuing some medically defined agenda, or is delivered by an impersonal team.

Market-driven healthcare: A growing proportion of the peoples of the world are now demanding personal medical care on a scale that few countries can afford. What the patient needs is a doctor whom he or she trusts, with the skill to assist in making strategic life decisions. No one wants to be cared for by a committee. Litigation is also a growing phenomenon in many parts of the world. Medical malpractice legislation has been used to control medicine in the United States for some time. As a means of ensuring quality, it has failed. "Defensive medicine" involves much needless investigation and it can become enormously expensive. Yet another solution is to establish a vast bureaucracy of external assessors who scrutinize records and statistics of practice activity. Their methods are biased in favor of checklists and measurable quantities. The subjective and qualitative aspects of care - valued so highly by patients - are inaccessible to such an approach.

My suggestion; the quality assurance is best left to the profession itself. The quality of care must be reviewed, but not in a piecemeal fashion. It should be looked at using methods which question total patient management and the values and attitudes on which it is based. This form of peer-review should become an integral part of the professional task, with sufficient working time allotted to it. It requires skills which should form a central part of the physician's education and training.

The market knows best.

About NGO Association with the UN:

Second Committee: Economic and Financial - From strengthening coordination of humanitarian and disaster relief assistance, including special economic aid to individual countries or regions, to correcting global trade imbalances and promoting information technology for development, the Second Committee works hard on these issues. By a draft on the external debt crisis and development, adopted without a vote, the General Assembly stressed that debt-relief could play a key role in liberating resources for poverty eradication, economic growth and sustainable development. A significant proportion of official development assistance (ODA) is aimed at promoting sustainable development in poorer countries, particularly through natural resource conservation, environmental protection and population programs. Many delegations have pointed out that writing off the escalating external debt burden of the world's poorest countries must become a top priority in helping them to restore economic growth, fight the HIV/AIDS pandemic and meet the Millennium Development Goals (MDGs). According to the United Nations Conference on Trade and Development (UNCTAD), Africa's economic growth levels must double to 7% annually over the next decade in order to halve poverty by the year 2015. But continued debt servicing has made it impossible for Africa's heavily indebted poor countries (HIPCs) to increase savings and investments to promote economic growth. Eight years after launching the Heavily Indebted Poor Countries Debt Initiative, these nations are still far from reaching sustainable debt levels.

International financial institutions also drew attention to the intractable debt crisis. However, inexpensive and simple measures, with proper resource allocation and strong institutional structures, are available to reduce the impact of disaster. Focusing on the developmental effects of climate change The UN protocol, a legally binding treaty in effect from 16 January 2005, will have thirty supporting industrialized countries cut their green house gas emissions to nearly 5% below 1990 levels. NGOs have responsibility to try to make good recommendations and the Second Committee has a direct impact in achieving MDGs.

Collaboration with World Health Organization (WHO):

WHO package of essential Health Impact Assessment (HIA) functions: many countries now find themselves in a process of accelerated development. For sustainability's sake, their governments will need to consider the health of their population. WHO offers a comprehensive package consisting of workshops for ministry of health staff, which focuses on essential HIA management training courses, with the objective of developing skills for intersectoral negotiation skills in development planning, and policy seminars to create an enabling environment for HIA. These capacity-building activities already refer to health promotion, and the package is continuously reviewed and upgraded to include further elements and to ensure the involvement health promotion staff in its implementation. HIA capacity-building is perhaps the field where strengthening the links between HIA and health promotion can have the most immediate results and benefits. For details please visit: www.who.int/hia/en/

Collaboration with UN University (UNU):

UNU-WIDER - The World Institute for Development Economics Research (WIDER) was established by the United Nations University (UNU) as its first research and training center and started work in Helsinki, Finland in 1985. The Institute undertakes applied research and policy analysis on structural changes affecting the developing and transitional economies, provides a forum for the advocacy of policies leading to robust, equitable, and environmentally sustainable growth, and promotes capacity strengthening and training in the field of economic and social policy maker. Work is carried out by staff researchers and visiting scholars in Helsinki and through networks of collaborating scholars and institutions around the world.

An effective state is able to mobilize revenue and spend it on infrastructure, services, and public goods that both enhance human capital and the well-being of communities (especially the poor), as well as stimulating investment and employment creation by the private sector. An effective state also manages public finance to ensure that macroeconomic balance is maintained - with policy neither too restrictive to discourage private investment and growth, nor too accommodative to create high inflation and crowd out private investment. Growth, poverty reduction, and social peace are all undermined when public expenditure management and taxation are weak, and when the fiscal debt are not managed successfully. And large-scale aid and debt relief cannot work without a good fiscal system. These are the some of the important issues on the agenda of UNU-WIDER. Fiscal policy is more than just a question of good economics; it is also fundamental to the politics of development. If a measure of peace can be achieved then any political settlement must have a fiscal dimension.

Point of View:

Conflict of Interest in Research- why it hurts all of us:

We live in a time of increasing commercialization of all aspects of public life. The influence of multinational corporations is not surprising, given that many of them represent more economic power than half the nations on earth. The effects of all this power are easy to see in western democratic societies, where industry lobbying is all pervasive. In our role as healthcare providers, whether at the coalface of patient care or in research, we have to deal with the consequences. We can't be without them, and our patients and clients can't either. Industry contacts are valuable and can make a huge difference, helping us reach our goals easier and more effectively. I am personally very grateful to a number of corporate sponsors for support of past and present research projects. No doubt there are many opportunities for cooperation that benefit everybody. But of course commercial companies aren't nice to us out of humanitarian kindness. They see us in a role that can degenerate into that of a glorified PR consultant- if we let that happen. And it is happening all the time. Many current papers on drug treatment present data from industry-controlled-trials, with data collection and analysis handled by either the companies themselves or a contractor, 'authored' by people who have received money from the companies selling the drugs assessed in the papers. As regards who has actually written the paper- that's often difficult to ascertain. Ghost-writing of such articles is widespread.

Our patients and clients expect a very different role from us. When we prescribe medication or suggest the acquisition of a certain product, we take responsibility for purchase decisions, whether by the health service, a hospital or an individual. We are supposed to protect the patient or consumer from inappropriate or dangerous products or interventions. In order to be able to preserve our role of advocate and our professional independence, in order to make sure the public won't see us as the culprits in the biomedical scandals of the 21st century, we need to reduce the influence of industry on our professional activities, in particular as regards research and teaching. Cooperation between clinical researchers and industry needs to be strictly regulated, in order to avoid conflicts of interest. Our duty is towards the public who expect us to be unbiased in our research and clinical practice. This can only be achieved if we refuse to be part of a sales machine.

By Dr. Hans Peter Dietz
Associate Professor in Obstetrics and Gynaecology
Western Clinical School, Nepean Campus, University of Sydney
Nepean Hospital, Penrith NSW 2750 Australia

Joint United Nations Program on HIV/AIDS (UNAIDS):

Declaration of Commitment on HIV/AIDS "Global Crisis - Global Action: series continues

  1. Recalling and reaffirming our previous commitments on HIV/AIDS made through: The United Nations Millennium Declaration of 8 September 2000;The Political Declaration and Further Actions and Initiatives to Implement the Commitments made at the World Summit for Social Development of 1 July 2000; The Political Declaration and Further Action and Initiatives to Implement the Beijing Declaration and Platform for Action of 10 June 2000; Key Actions for the Further Implementation of the Programme of Action of the International Conference on Population and Development of 2 July 1999; The regional call for action to fight HIV/AIDS in Asia and the Pacific of 25 April 2001; The Abuja Declaration and Framework for Action for the Fight Against HIV/ AIDS, Tuberculosis and other Related Infectious Diseases in Africa, 27 April 2001; The Declaration of the Ibero-America Summit of Heads of State of November 2000 in Panama; The Caribbean Partnership Against HIV/AIDS, 14 February, 2001; The European Union Programme for Action: Accelerated Action on HIV/ AIDS, Malaria and Tuberculosis in the Context of Poverty Reduction of 14 May 2001; The Baltic Sea Declaration on HIV/AIDS Prevention of 4 May 2000; The Central Asian Declaration on HIV/AIDS of 18 May 2001
  2. Convinced of the need to have an urgent, coordinated and sustained response to the HIV/AIDS epidemic, which will build on the experience and lessons learned over the past 20 years;
  3. Noting with grave concern that Africa, in particular sub-Saharan Africa, is currently the worst affected region where HIV/AIDS is considered as a state of emergency, which threatens development, social cohesion, political stability, food security and life expectancy and imposes a devastating economic burden and that the dramatic situation on the continent needs urgent and exceptional national, regional and international action;
  4. Welcoming the commitments of African Heads of State or Government, at the Abuja Special Summit in April 2001, particularly their pledge to set a target of allocating at least 15 per cent of their annual national budgets for the improvement of the health sector to help address the HIV/AIDS epidemic; and recognizing that action to reach this target, by those countries whose resources are limited, will need to be complemented by increased international assistance;
  5. Recognizing also that other regions are seriously affected and confront similar threats, particularly the Caribbean region, with the second highest rate of HIV infection after sub-Saharan Africa, the Asia-Pacific region where 7.5 million people are already living with HIV/AIDS, the Latin America region with 1.5 million people living with HIV/AIDS, and the Central and Eastern European region with very rapidly rising infection rates; and that the potential exists for a rapid escalation of the epidemic and its impact throughout the world if no specific measures are taken;
    To be continued...

Top Two Articles Accessed in January 2007:

  1. Infertility: Evaluation and Management
    Supported by an educational grant from the Women's Health and Education Center (WHEC). Special thanks to Dr. Bradley J. Van Voorhis,
    Professor of Obstetrics and Gynecology and Reproductive health, University of Iowa (USA) for his contributions and insights to the symposium
  2. Syphilis in Pregnancy: Prevention of Congenital Syphilis
    Women's Health and Education Center's Contribution

News, Invitations and Letters:

WEDNESDAY, 21 FEBRUARY 2007 at 10:00 AM; Update on the work of the General Assembly - A Briefing for NGOs A Briefing by the Office of the President of the General Assembly on:

  • Thematic Debates of the General Assembly on Gender Equality and on the Dialogue of Civilizations
  • Security Council Reform
  • Environmental Governance
  • Financing for Development
  • System-wide Coherence
  • The Capital Master Plan

Conference Room 3, United Nations, New York; for more information, please contact Ms. Shamina de Gonzaga, Special Adviser on NGO relations in the Office of the President of the General Assembly

Summary - Forum on General Assembly and Non-Governmental Organization (NGO) Relations: An interactive forum on General Assembly and non-governmental organization relations was held on 21st November 2006 at the Millennium UN Plaza Hotel, under the auspices of the Office of the President of the General Assembly and the United Nations Foundation. The aim of the forum was to stimulate greater understanding between Member States and non-governmental organization (NGOs) regarding the challenges and opportunities for further partnership. The forum brought together representatives of 50 Member States, 150 NGOs and 7 United Nations offices who shared their views, concerns and recommendations. The following key messages emerged from the forum:

  1. Partnership between the United Nations and NGOs is vital to the success of the UN in achieving its goals.
  2. NGOs bring vision and information to UN meetings and contribute to UN efforts operationally, financially, and in terms of public awareness and support.
  3. NGO participation in UN meetings and processes is complementary, not contradictory, to the UN's intergovernmental structure whereby Member States are the sole decision-makers.
  4. The systemic implementation of best practices of NGO participation in the UN would benefit all stakeholders.

First Person Diplomacy: Too Important to Be Left to Men? By Akmaral Arystanbkova. Of the delegates from 50 countries who signed the Charter of the United Nations in San Francisco on 26 June 1945, four were women: Virginia Gildersleeve (United States), Bertha Lutz (Brazil), Wu Yi-fang (China) and Minerva Bernardino (Dominican Republic). I happened to meet Ms. Bernardino, a woman of quite venerable age, at UN Headquarters in New York when she was given an award from the Franklin and Eleanor Roosevelt Institute by then United States First Lady Hillary Rodham Clinton. Ms. Bernardino had been her country's Permanent Representative to the United Nations for many years. "I used to be a fighter for women's rights", she said in her address. "I still am." She had been an active participant in the movement for women's right to vote in Latin America, and continued to fight for equal rights within the newly founded world Organization, considering that it was essential that international texts stress not only human rights but also equality between men and women. Details: http://www.un.org/Pubs/chronicle/2002/issue3/0302p62_first_person.html

Special Thanks:

WHEC thanks Kaylene Selleck, Editorial Assistant, at the Bulletin of the World Health Organization for her priceless work, support and friendship. Thanks for making editing look so easy. We all wish you the best.

Beyond the numbers...

The reply of the Spartan father who said to his son, when complaining that his sword was too short. "Add a step to it" is applicable to everything in life.

Women's Health & Education Center
Dedicated to Women's and Children's Well-being and Health Care Worldwide