Effectiveness of a community leaders' programme to promote healthy lifestyles in Tokyo, Japan

Shinko Yajima, Takehito Takano, Keiko Nakamura and Masafumi Watanabe
Health Promotion/International Health, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan
Address for correspondence: Shinko Yajima Health Promotion/International Health Division of Public Health Graduate School of Tokyo Medical and Dental University Yushima 1-5-45, Bunkyo-ku Tokyo 113-8519 Japan
The aim of this study was to evaluate a community-based health promotion programme in terms of changing: (i) attitudes with respect to a healthy lifestyle; (ii) behaviour with respect to access to health-related information; and (iii) attitudes and health literacy regardless of socio-economic status. In this programme, 20 people are selected every 2 years in each municipality from the lay people of the community, and they are designated as members of a ‘community leaders' committee’ by the Mayor. They, as a group, have opportunities to gain knowledge about and skills in healthy lifestyles, and undertake voluntary activities to serve the community. A programme intervention sample (INT group) was selected from programme participants from 13 municipalities in the greater Tokyo area. A questionnaire survey was carried out with the INT group and a general population group (REF group). The data obtained for female respondents, aged 30–59 years, in the two sample populations (n = 662 and 1361, respectively) were analysed using the 2 test, the Kruskal–Wallis test and multivariate log-linear methods. Another questionnaire was given to female programme participants (n = 200) to identify any changes since the start of their participation. The results showed that the people in the INT group were pursuing healthier lifestyles than those in the REF group; current non-smokers who performed physical exercise and who ate meals regularly paid more attention to a healthy lifestyle and were more interested in the relationship between food and health. From the INT and REF groups, 22 and 4% of people, respectively, frequently obtained information from health professionals, and 29.8 and 10.8%, respectively, were satisfied with their access to health-related information. Results of multivariate log-linear analysis showed that significantly more people in the INT group were doing exercise, eating meals regularly, paying attention to nutritional balance and to food additives, were interested in health, and were satisfied with access to health information, after excluding the effects of age and socio-economic factors (p < 0.05). The results also showed positive changes after the implementation of the programme. These findings indicated that the people in the INT group were significantly more likely to pursue a healthier lifestyle and to have greater health literacy than those in the REF group, regardless of socio-economic status. In conclusion, this community participation approach, employing a committee style, was effective in improving health-related behaviour and in promoting health literacy while overcoming socio-economic variation.
Key words: health literacy; health promotion; intervention analysis; leaders' committee

Health Workforce, Medical - Department of Human Services, Victoria

Medica

General
Ministerial Review of Victorian Public Health Medical Staff
Ministerial Review of Victorian Public Health Medical Staff - Report of the Review Panel (2007) (PDF file 906KB)
Initial response to the Ministerial Review of Victorian Public Health Medical Staff (2008) (PDF file 64KB)
Medical Workforce Report
This report has been developed to augment the Australian Institute of Health and Welfare's national Medical Labour Force reports by providing more detailed and specific information about the medical workforce in Victoria. This report incorporates data from surveys from 2000 to 2004 to enable analysis of change over time.
The Medical Workforce of Victoria 2000–2004 (2006) (PDF file 3,085KB)
Strengthening Medical Specialist Training Program - 2008
The 2008 Strengthening Medical Specialist Training program has been developed to increase medical specialist training positions in Victorian public hospitals.
The program aims to:
Identify shortages or oversupply in specialist training positions
Map current service delivery against training capacity through the Specialist Training Annual Growth (STAG) model
Provide flexible funding options to support growth identified through WEIS, to address demonstrated workforce shortage and maldistribution and to undertake research.
This program incorporates the existing Advance Specialists Training Posts in Regional Australia (ASTPRA). Together with the Commonwealth, the Victorian Government is funding positions at major rural centres for doctors who are training to be medical specialists.
2008 Strengthening Medical Specialist Training program information sheet (pdf, 88k)
For more information please contact medical.specialists@dhs.vic.gov.au
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Planning for growth in the Victorian medical workforce
In 2006, the Commonwealth government announced an additional 220 undergraduate medical places for Victoria.
The Commonwealth government also, in 2007, removed the 25 per cent cap on the number of domestic undergraduate full fee paying students that can enter medical studies.
As a result of these changes, the number of medical intern positions required by domestic graduates of Victorian medical schools is predicted to jump from 348 in 2008 to as many as 690 in 2012. Demand for postgraduate year two (PGY2) and specialist training places will also increase in the future.
In response, the 2008–09 State Budget includes funding of $55.15 million over four years to support the increased numbers of students. This includes additional capital investment in teaching infrastructure ($20.02 million over two years) as well as further early graduate places to train up to 211 additional doctors per year by 2012 to meet future workforce challenges ($35.13 million over four years).
The growth in training positions will be staged over four years to build system capacity and ensure that service viability and the quality of clinical education are maintained. As the first stage of this growth, in 2009 there will be a total of 45 new funded medical intern positions and 16 PGY2 positions available for distribution.
Further information on this matter can be found in the document, Planning for growth in the Victorian medical workforce - June 2008 (PDF file 127KB)
Recruitment initiatives
Recruitment of international health care professionals to Victoria - strategic directions 2007-10
In March 2007, the Victorian Government launched the Health careers for a healthy future campaign. As part of this campaign the Department of Human Services has developed the Recruitment of international health care professionals to Victoria – strategic directions 2007-10 package.
The package includes information about:
incentive packages for international medical graduates (IMGs) and allied health professionals (AHPs)
scholarships to support international nurse graduates to meet Victorian registration requirements
a research project looking at the barriers to recruitment of IMGs to Victoria
the opportunity for hospitals to advertise medical vacancies in the British Medical Journal at no cost
Region of Choice initiative for AHPs
retention of specialist recruitment firm to screen unsolicited curriculum vitae from IMGs and assist with recruitment of senior specialist staff for hospitals
Cultural Diversity Education Program for overseas trained nurses.
Further information for international health care professionals:
Recruitment of international health care professionals to Victoria – strategic directions 2007-10 (September 2007) (pdf, 289k)
Incentive packages for international medical graduates - September 2007 (pdf, 262k)
To apply for an incentive package for international medical graduates, health services should complete the following forms:
> see instructions for completing forms
International medical graduates recruitment–incentive package application form (pdf, 601k)International medical graduates recruitment–incentive package acquittal form (pdf, 552k)
Further information for Allied Health professionals:
Guidelines for allied health professional incentive packages - September 2007 (pdf, 279k)
To apply for an incentive package for Allied Health professionals, health services should complete the following forms:
> see instructions for completing forms
Allied health professional recruitment–incentive package application form (pdf, 624k)Allied health professional recruitment–incentive package acquittal form (pdf, 172k)
For the opportunity to advertise medical vacancies in the British Medical Journal at no cost, hospitals should complete the following form:
British Medical Journal vacancy template (pdf, 585k)
Instructions for completing forms
If you have Adobe Acrobat Reader 7 [or higher], you can download the interactive version of the International Medical Graduate Recruitment - Incentive Package Application and Acquittal Forms directly above, save it to your computer, fill it in and email it to: despina.papastamopoulos@dhs.vic.gov.au
Note: Acrobat Reader versions 6 or below will allow you to save the response form and fill it in on screen but you will need to print and fax or mail in your response to the address above.
> Get the latest version of Acrobat Reader
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Rural Clinical Schools
In February 2001, the Commonwealth Government committed $117.6 million over 4 years to establish Rural Clinical Schools (RCS) attached to university medical faculties. In Victoria, the venture is supported by the Victorian Government, with a contribution of $4.5 million over 3 years to each of the University of Melbourne and Monash University for teaching infrastructure and student accommodation.
University of Melbourne School of Rural Health sites are located at Shepparton, Ballarat and Wangaratta. Monash University School of Rural Health sites are located at Traralgon, Bairnsdale, Sale, Warragul, Bendigo and Mildura.
Although the focus is on medical training, the Rural Clinical Schools will create a network of quality to support all health professions in rural Victoria.
Advanced Procedural Skills for GPs
The objective of the Procedural GPs Initiative is to increase the number of procedural GPs by providing more opportunities for GPs to acquire and maintain the relevant skills.
Procedural posts are supernumerary advanced procedural skill posts with Joint Consultative Committee (JCC) Advanced Rural Skills Post (ARSP) accreditation. Funding is available for posts in anaesthetics, surgery, obstetrics and emergency medicine and can be applied for through the GP Regional Training Providers (RTPs). Contact details for the RTPs is included in the application kit.
Advanced GP Procedural Training Posts in Rural Victoria - Guidelines for 2007 (2006) (PDF File 104kb)
Extended Skills for GPs
The Extended Skills for GPs program was launched in 2004 as an initiative to support the acquisition of specialised skills for general practitioners in Victoria. The Extended Skills for GPs program aims to provide a skilled GP workforce that is competent to deliver medical services relevant to the State’s health priorities. The program seeks to increase the retention and recruitment of GPs in areas of workforce shortage.
Funding is available for posts in a wide range of areas and can be applied for through the GP Regional Training Providers (RTPs). Contact details for the RTPs is included in the application kit
Extended Skills for GPs - Guidelines for 2007 (2006) (PDF File 122kb)
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Overseas trained doctors for hospital practice
The Council of Australian Governments agreed on 10 February 2006 to a national assessment process for international medical graduates (IMGs) to ensure appropriate standards in qualifications and training as well as an increase in the efficiency of the assessment process.
A national implementation committee has been overseeing the development of the process, with implementation occurring in a staged manner from July 2007. An update on progress is provided below.
Progress report – Nationally Consistent Assessment Process for IMGs (PDF file 16KB)
In the 2007 State Budget, the Victorian government allocated $1.64 million in 2007–08 ($7.82 million over four years) to implement the national assessment process for IMGs. This includes more stringent pre-employment checks, participation in orientation programs and workplace based assessments of clinical performance. A copy of the IMG funding strategy can be found here: IMG Funding Strategy 2007–08 (PDF file 77KB)
Information for IMGs about immigration and visa requirements, medical registration, the Victorian health system, living in Victoria and finding a job can be found at IMGs in Victoria
Other initiatives
Rural Workforce Agency Victoria
Rural Workforce Agency Victoria (RWAV) was established in 1998 to overcome the shortage of rural doctors and improve access to medical services for rural Victorians. Initiatives include:
Continuing Professional Development for GPs Subsidy Program
The Department provides over $200,000 per annum to subsidise rural GPs' access to procedural, non-procedural and other health related training. The capped subsidies address direct training costs as well as travel, accommodation and child-care.
Rural Medical Family Network (RMFN)
The RMFN aims to attract, recruit and retain general practitioners to rural general practice through the promotion of rural lifestyles and through the provision of support, mentoring and networking opportunities for doctor's families. Funding provided by the Department assists in the development of information brochures for families who are relocating and spouse programs at major event and "meet and greet" programs.
Overseas Trained Doctor Rural Recruitment Scheme
Operated by RWAV on behalf of the Victorian Government the Victorian Overseas Trained Doctor Rural Recruitment Scheme is a program to attract, assess, place and support overseas trained general practitioners in rural and regional Victoria. Enquiries can be directed to the Rural Workforce Agency Victoria on Ph +61 3 9349 4899.
Back to top
Prevocational General Practice Placements Program (PGPPP)
This program is designed to provide junior doctors with a 10-13 week placement in a rural general/community practice. Further information can be found on the Commonwealth Department of Health website
Doctor Connect Website
The DoctorConnect website is an Australian Government initiative. This website has been developed by the Australian Government Department of Health and Ageing for doctors trained outside of Australia and Australian medical employers.

Health Workforce, Medical - Department of Human Services, Victoria

Medica

General
Ministerial Review of Victorian Public Health Medical Staff
Ministerial Review of Victorian Public Health Medical Staff - Report of the Review Panel (2007) (PDF file 906KB)
Initial response to the Ministerial Review of Victorian Public Health Medical Staff (2008) (PDF file 64KB)
Medical Workforce Report
This report has been developed to augment the Australian Institute of Health and Welfare's national Medical Labour Force reports by providing more detailed and specific information about the medical workforce in Victoria. This report incorporates data from surveys from 2000 to 2004 to enable analysis of change over time.
The Medical Workforce of Victoria 2000–2004 (2006) (PDF file 3,085KB)
Strengthening Medical Specialist Training Program - 2008
The 2008 Strengthening Medical Specialist Training program has been developed to increase medical specialist training positions in Victorian public hospitals.
The program aims to:
Identify shortages or oversupply in specialist training positions
Map current service delivery against training capacity through the Specialist Training Annual Growth (STAG) model
Provide flexible funding options to support growth identified through WEIS, to address demonstrated workforce shortage and maldistribution and to undertake research.
This program incorporates the existing Advance Specialists Training Posts in Regional Australia (ASTPRA). Together with the Commonwealth, the Victorian Government is funding positions at major rural centres for doctors who are training to be medical specialists.
2008 Strengthening Medical Specialist Training program information sheet (pdf, 88k)
For more information please contact medical.specialists@dhs.vic.gov.au
Back to top
Planning for growth in the Victorian medical workforce
In 2006, the Commonwealth government announced an additional 220 undergraduate medical places for Victoria.
The Commonwealth government also, in 2007, removed the 25 per cent cap on the number of domestic undergraduate full fee paying students that can enter medical studies.
As a result of these changes, the number of medical intern positions required by domestic graduates of Victorian medical schools is predicted to jump from 348 in 2008 to as many as 690 in 2012. Demand for postgraduate year two (PGY2) and specialist training places will also increase in the future.
In response, the 2008–09 State Budget includes funding of $55.15 million over four years to support the increased numbers of students. This includes additional capital investment in teaching infrastructure ($20.02 million over two years) as well as further early graduate places to train up to 211 additional doctors per year by 2012 to meet future workforce challenges ($35.13 million over four years).
The growth in training positions will be staged over four years to build system capacity and ensure that service viability and the quality of clinical education are maintained. As the first stage of this growth, in 2009 there will be a total of 45 new funded medical intern positions and 16 PGY2 positions available for distribution.
Further information on this matter can be found in the document, Planning for growth in the Victorian medical workforce - June 2008 (PDF file 127KB)
Recruitment initiatives
Recruitment of international health care professionals to Victoria - strategic directions 2007-10
In March 2007, the Victorian Government launched the Health careers for a healthy future campaign. As part of this campaign the Department of Human Services has developed the Recruitment of international health care professionals to Victoria – strategic directions 2007-10 package.
The package includes information about:
incentive packages for international medical graduates (IMGs) and allied health professionals (AHPs)
scholarships to support international nurse graduates to meet Victorian registration requirements
a research project looking at the barriers to recruitment of IMGs to Victoria
the opportunity for hospitals to advertise medical vacancies in the British Medical Journal at no cost
Region of Choice initiative for AHPs
retention of specialist recruitment firm to screen unsolicited curriculum vitae from IMGs and assist with recruitment of senior specialist staff for hospitals
Cultural Diversity Education Program for overseas trained nurses.
Further information for international health care professionals:
Recruitment of international health care professionals to Victoria – strategic directions 2007-10 (September 2007) (pdf, 289k)
Incentive packages for international medical graduates - September 2007 (pdf, 262k)
To apply for an incentive package for international medical graduates, health services should complete the following forms:
> see instructions for completing forms
International medical graduates recruitment–incentive package application form (pdf, 601k)International medical graduates recruitment–incentive package acquittal form (pdf, 552k)
Further information for Allied Health professionals:
Guidelines for allied health professional incentive packages - September 2007 (pdf, 279k)
To apply for an incentive package for Allied Health professionals, health services should complete the following forms:
> see instructions for completing forms
Allied health professional recruitment–incentive package application form (pdf, 624k)Allied health professional recruitment–incentive package acquittal form (pdf, 172k)
For the opportunity to advertise medical vacancies in the British Medical Journal at no cost, hospitals should complete the following form:
British Medical Journal vacancy template (pdf, 585k)
Instructions for completing forms
If you have Adobe Acrobat Reader 7 [or higher], you can download the interactive version of the International Medical Graduate Recruitment - Incentive Package Application and Acquittal Forms directly above, save it to your computer, fill it in and email it to: despina.papastamopoulos@dhs.vic.gov.au
Note: Acrobat Reader versions 6 or below will allow you to save the response form and fill it in on screen but you will need to print and fax or mail in your response to the address above.
> Get the latest version of Acrobat Reader
Back to top
Rural Clinical Schools
In February 2001, the Commonwealth Government committed $117.6 million over 4 years to establish Rural Clinical Schools (RCS) attached to university medical faculties. In Victoria, the venture is supported by the Victorian Government, with a contribution of $4.5 million over 3 years to each of the University of Melbourne and Monash University for teaching infrastructure and student accommodation.
University of Melbourne School of Rural Health sites are located at Shepparton, Ballarat and Wangaratta. Monash University School of Rural Health sites are located at Traralgon, Bairnsdale, Sale, Warragul, Bendigo and Mildura.
Although the focus is on medical training, the Rural Clinical Schools will create a network of quality to support all health professions in rural Victoria.
Advanced Procedural Skills for GPs
The objective of the Procedural GPs Initiative is to increase the number of procedural GPs by providing more opportunities for GPs to acquire and maintain the relevant skills.
Procedural posts are supernumerary advanced procedural skill posts with Joint Consultative Committee (JCC) Advanced Rural Skills Post (ARSP) accreditation. Funding is available for posts in anaesthetics, surgery, obstetrics and emergency medicine and can be applied for through the GP Regional Training Providers (RTPs). Contact details for the RTPs is included in the application kit.
Advanced GP Procedural Training Posts in Rural Victoria - Guidelines for 2007 (2006) (PDF File 104kb)
Extended Skills for GPs
The Extended Skills for GPs program was launched in 2004 as an initiative to support the acquisition of specialised skills for general practitioners in Victoria. The Extended Skills for GPs program aims to provide a skilled GP workforce that is competent to deliver medical services relevant to the State’s health priorities. The program seeks to increase the retention and recruitment of GPs in areas of workforce shortage.
Funding is available for posts in a wide range of areas and can be applied for through the GP Regional Training Providers (RTPs). Contact details for the RTPs is included in the application kit
Extended Skills for GPs - Guidelines for 2007 (2006) (PDF File 122kb)
Back to top
Overseas trained doctors for hospital practice
The Council of Australian Governments agreed on 10 February 2006 to a national assessment process for international medical graduates (IMGs) to ensure appropriate standards in qualifications and training as well as an increase in the efficiency of the assessment process.
A national implementation committee has been overseeing the development of the process, with implementation occurring in a staged manner from July 2007. An update on progress is provided below.
Progress report – Nationally Consistent Assessment Process for IMGs (PDF file 16KB)
In the 2007 State Budget, the Victorian government allocated $1.64 million in 2007–08 ($7.82 million over four years) to implement the national assessment process for IMGs. This includes more stringent pre-employment checks, participation in orientation programs and workplace based assessments of clinical performance. A copy of the IMG funding strategy can be found here: IMG Funding Strategy 2007–08 (PDF file 77KB)
Information for IMGs about immigration and visa requirements, medical registration, the Victorian health system, living in Victoria and finding a job can be found at IMGs in Victoria
Other initiatives
Rural Workforce Agency Victoria
Rural Workforce Agency Victoria (RWAV) was established in 1998 to overcome the shortage of rural doctors and improve access to medical services for rural Victorians. Initiatives include:
Continuing Professional Development for GPs Subsidy Program
The Department provides over $200,000 per annum to subsidise rural GPs' access to procedural, non-procedural and other health related training. The capped subsidies address direct training costs as well as travel, accommodation and child-care.
Rural Medical Family Network (RMFN)
The RMFN aims to attract, recruit and retain general practitioners to rural general practice through the promotion of rural lifestyles and through the provision of support, mentoring and networking opportunities for doctor's families. Funding provided by the Department assists in the development of information brochures for families who are relocating and spouse programs at major event and "meet and greet" programs.
Overseas Trained Doctor Rural Recruitment Scheme
Operated by RWAV on behalf of the Victorian Government the Victorian Overseas Trained Doctor Rural Recruitment Scheme is a program to attract, assess, place and support overseas trained general practitioners in rural and regional Victoria. Enquiries can be directed to the Rural Workforce Agency Victoria on Ph +61 3 9349 4899.
Back to top
Prevocational General Practice Placements Program (PGPPP)
This program is designed to provide junior doctors with a 10-13 week placement in a rural general/community practice. Further information can be found on the Commonwealth Department of Health website
Doctor Connect Website
The DoctorConnect website is an Australian Government initiative. This website has been developed by the Australian Government Department of Health and Ageing for doctors trained outside of Australia and Australian medical employers.

tobacco control resource centre > tcrc related links > information

This links section contains links to sites that contain information about a number of issues relating to tobacco and its use. This includes studies/research into tobacco and its health effects as well as statistics, scientific journals and wide ranging databases.


Databases
http://www.ncbi.nlm.nih.gov/PubMed/ The National Library of Medicine offers the abstracts of a huge number of articles concerning the health effects of tobacco. Useful for those in the health profession and perhaps biologists due to the scientific depth of the reports.
http://blpc.bl.uk/ "This free service allows you to browse the material held in the major Reference and Document Supply collections of the British Library. In most cases it is possible to request copies of document supply material from the Library's Document Supply Centre (BLDSC). The records are vast.
http://www.treatobacco.net/ This is a source of evidence-based data and practical support for the treatment of tobacco dependence, aimed at physicians, nurses, pharmacists, dentists, psychologists, researchers, policy makers, regulators and anyone interested in the personal and public health issues connected with tobacco use around the world. Essentially a database, it is split into five main sections,Efficacy, Safety, Demographics and Health Effects, Health Economics, Policy. Well laid out and truly extensive, this site is an important resource for those involved with tobacco. Available in English, Spanish, French, Portuguese, German and Russian.
http://www.update-software.com/ A page providing access to a number of health related databases including abstracts of Cochrane Reviews, a regularly updated collection of evidence-based medicine databases, the Cochrane reviews in Spanish and other Spanish databases, the WHO reproductive health library, evidence based medicine guidelines and the cancer library. A wide range of topics are covered.
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Foundations/Institutes
http://www.iarc.fr/ The International Agency for Research on Cancer's (IARC) mission is to coordinate and conduct research on the causes of human cancer, the mechanisms of carcinogenesis, and to develop scientific strategies for cancer control. Databases containing various information on different cancers are available and recent press releases are online and often concern tobacco.
http://www.uicc.org/programmes/tobacco/The International Union against cancer offers a regularly updated site with the latest news on tobacco from the UK, Europe, France and Spain a range of anti-tobacco adverts and campaigns, a range of tobacco control fact sheets in English and others in Spanish, online access to the International Journal of cancer and many other resources including an extensive links section with links to many Journals.
http://www.crc.org.uk/ Cancer research UK is a volunteer run cancer research organization and charity. The site is well laid out and offers a wealth of information on cancer and its causes. Recent reports outlining various links between smoking and cancer are available as well as much more.
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Health
http://www.surgeongeneral.gov/tobacco/ The website of the US surgeon general provides a number of interesting and informative reports in both English and Spanish. These cover advice for smokers and advice for health professionals working with tobacco users. Up to date US press releases are also available on this simple to use and important site.
http://www.iarc.fr/ The International Agency for Research on Cancer's (IARC) mission is to coordinate and conduct research on the causes of human cancer, the mechanisms of carcinogenesis, and to develop scientific strategies for cancer control. Databases containing various information on different cancers are available and recent press releases are online and often concern tobacco.
http://www.uicc.org/programmes/tobacco/ The International Union against cancer offers a regularly updated site with the latest news on tobacco from the UK, Europe, France and Spain a range of anti-tobacco adverts and campaigns, a range of tobacco control fact sheets in English and others in Spanish, online access to the International Journal of cancer and many other resources including an extensive links section with links to many Journals.
http://www.srnt.org/ "The Society for Research on Nicotine and Tobacco aims to stimulate a generation of new knowledge concerning nicotine in all its manifestations -from molecular to societal. The site offers some information in German and French as well as English. Addresses of various organisations are listed and information regarding research into tobacco is given however, the material is fairly sparse and most of the site has not been updated recently.
http://www.who.ch/ The Homepage of the World Health Organization. Providing summaries of the latest health related news that occasionally relates to tobacco. With links to the other areas of the site, a site map and an A to Z this page would act as a good starting point for those just beginning a wide, health related, search for research purposes.
http://www.who.int/whr/1999/en/pdf/Chapter5.pdf The World Health Report 1999, Chapter 5, Combating the Tobacco Epidemic. This Chapter looks at the Health and Economic costs of Tobacco as well as obstacles that must be overcome by tobacco control programmes. Details are given on a number of components of tobacco control. Although a few years old and therefore slightly out of date, the content is both useful and interesting and would act as a good base for for those interested in understanding or researching tobacco issues.
http://www.healthcentre.org.uk/ This site provides information aimed at medical professionals as well as the general public. A wide range of information is offered, not all tobacco related, and a daily updated section gives health relevant articles from a number of broadsheets.
http://www.nrtc.org.uk/ The National Respiratory Training Centre is an impartial education and research establishment for health professionals which aims to improve the care of patients who suffer from respiratory or allergic disease. Educational programmes are run nationally and internationally and are accredited by the Open University.
http://www.acsh@acsh.org/ The website of the American Council of Science and Health.ACSH is a consumer education consortium concerned with issues related to food, nutrition, chemicals, pharmaceuticals, lifestyle, the environment and health. This inevitably covers a number of tobacco related issues and a number of press releases, editorials, magazine articles and publications are available online.
http://www.cdc.gov/nccdphp/osh/index.htm Centres for disease control and prevention, is based in the USA and provides information on a wide range of health issues. A large number of tobacco related issues are covered and a tobacco information and prevention source is provided. A comprehensive site that should prove very useful to anyone interested in tobacco control.
http://www.lungusa.org/diseases/espanol/hhm17.html The American Lung association has a useful site that provides information in Spanish that gives reasons to smokers to quit.
http://www.lungcancer.org/ This lung cancer awareness campaign is dedicated to improving care for those with lung cancer by disseminating up-to-date and accurate information that encourages early diagnosis; shares developments in screening and treatment; and offers support to lung cancer patients and their loved ones. Containing special advice for patients, caregivers and healthcare professionals, this site could prove helpful to anyone affected or involved with issues in lung cancer.
http://www.tobaccopedia.org/ Part of the International Union against Cancer page, this 'tobacco encyclopedia' provides a useful resource on a number of tobacco issues from the social to the scientific. Many of the articles serve as references rather than in depth discussions but this is a good base for anyone researching tobacco, the tobacco industry, economics and many other areas Information Foundations/Institutes Health
http://www.rcplondon.ac.uk/pubs/books/nicotine/index.htm "Nicotine Addiction in Britain, A report of the Tobacco Advisory Group of the Royal College of Physicians from February 2000. Very interesting and wide ranging.
http://www.pbs.org/wnet/closetohome/science/html/animations.html This page explains some of the effects of drugs on the brain, including nicotine, with a number or pictures and animations available to demonstrate these effects.
http://www.pbs.org/wgbh/nova/cigarette/ A very well designed site , presenting links to four parts of the site offering information on tobacco including a very nicely illustrated description of what nicotine does in your body. Informative but not comprehensive.
http://www.repace.com/ Repace Associates are Secondhand smoke consultants. They offer a fact sheet and a report on secondhand smoke. They also offer a number of services regarding second hand smoke.
http://www.ncth.ca/NCTHweb.nsf The National Clearinghouse on Tobacco and Health is a Program of the Canadian Council for Tobacco Control. The site is kept well updated and has sections relating to Cessation, Denormalization, environmental tobacco smoke, Legislation, Prevention, Taxation and the Tobacco Industry. Other more general information is given and a number of good resources are offered. The site describes the fundamentals of all the topics covered and then goes more in depth describing case studies and research methods. An extremely useful site, based mainly on Canadian statistics. Available in English an French. Activism maybe Information Tobacco Control organisations.
http://www.smokefree.co.uk/ This site lists hotels, guest-houses, B&B's and restaurants in Britain that operate a no smoking policy. A brilliant resource that is easy to use.
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Online Journals
http://www.jama.com/ The Journal of the American Medical Association. A regularly updated site covering a huge range of topics. There is online access to many tobacco related articles which cover a number of important areas in tobacco control including risks, social aspects, surveys and statistics of tobacco and much more. These are available for download as HTML or PDF documents and offer an abstract for each article.
http://www.bmj.org/ The British Medical Journal website has an extensive range of health related information including many articles on tobacco. It is possible to search all of the issues of the journal from 1994 onwards on this easy to use site. Of particular use is the 5 August 2000 issue (Volume 321, Issue 7257) which is dedicated to tobacco.
http://www.thelancet.com/ The famous medico-scienific magazine has a large number of articles relating to many areas of tobacco from the advertising strategies of the tobacco industry to the medical conditions caused by smoking. Free registration is necessary to access summaries of the articles but users must subscribe if they wish to read the full text version of the reports.
http://www.nature.com/ The scientific magazine occasionally publishes articles on tobacco and health. The abstracts from the many articles are available only after free registration and the article must be paid for if it is to be viewed in full.
http://www.tobaccocontrol.com/ "Tobacco Control is a quarterly scientific journal that aims to consider all aspects of tobacco prevention and control. Online all articles from 1992 to present day are available but are only free if older than 12 months. The abstracts of all articles can be viewed. The site offers a large number of extensive articles, studies and reports and would prove very useful to anyone interested in almost any area concerning tobacco, especially the more social aspects. This would be particularly helpful to anyone researching tobacco use.
http://www.neurology.org/ The online version of the official journal of the American Academy of Neurology has some articles that would be useful for those interested in health issues surrounding tobacco. A search of all the journals dated from 1965 onwards is possible.
http://www.nejm.org/ The New England Journal of Medicine has online access to many articles dated from 1975 onwards. Users are able to access all articles published no less than six months ago after taking out free subscription but cannot access the more recent articles unless they are purchased.
http://www.newscientist.com/ New Scientist magazine offers summaries of recent studies that are easy to read and understand. The articles cover many areas from the social to the scientific. An online archive containing a huge number of articles is available to subscribers. A 7 day free trial is offered.
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Original Studies/History
http://users.wclynx.com/theshaws/index.html An interesting site looking at the history of tobacco advertising and usage.
Reader's Digest Chronologies/summaries/articles:
http://www.pmdocs.com/getallimg.asp?if=avpidx&DOCID=1000210970/0973 Reader's Digest - Smoking and Health index 1924-1953. A list of references of past reports.
http://legacy.library.ucsf.edu/cgi/getdoc?tid=sle75d00&fmt=pdf&ref=results THE EMERGING PATTERN OF ANTI-SMOKING CAMPAIGN. A CHRONOLOGY. A total of 12 Reader's Digest articles from July 1957 to November 1966 are included in this chronology.
http://www.pmdocs.com/getallimg.asp?if=avpidx&DOCID=2024940869/0874 CIPOLLONE V. LIGGETT GROUP: READER'S DIGEST ARTICLES 1940-1980. Detailed summaries of a number of RD stories, assembled for the Cipollone lawsuit.
http://tobaccodocuments.org/bliley_pm/24788.html#images Cigarette Smoking And Health Risks: Four Centuries of Information and Public Awareness. Date 11 Dec 1989.
Articles:
http://legacy.library.ucsf.edu/cgi/getdoc?tid=fzl55d00&fmt=pdf&ref=results RIIS RM (sic) Roger William;THE READERS DIGEST January 1950, p. 1-11 HOW HARMFUL ARE CIGARETTES?
http://legacy.library.ucsf.edu/cgi/getdoc?tid=gsx68d00&fmt=pdf&ref=results CAN THE POISONS IN CIGARETTES BE AVOIDED? Reader's digest article.
http://legacy.library.ucsf.edu/cgi/getdoc?tid=jap01f00&fmt=pdf&ref=results Miller-L;Monahan-J;The Reader's Digest [July 1954, p. 1-6] The Facts Behind the Cigarette Controversy.
http://tobaccodocuments.org/atc/60303353.html#images Miller-LM Monahan-J [July 1957, p. 43-49] Wanted And Available Filter-TipsThat Really Filter
http://legacy.library.ucsf.edu/cgi/getdoc?tid=jnn55d00&fmt=pdf&ref=results MILLER LM;MONAHAN J;READERS DIGEST [January 1958, p. 25-29] NICOTINE-THE SMOKER'S ENIGMA.
http://legacy.library.ucsf.edu/cgi/getdoc?tid=pdx31a00&fmt=pdf&ref=results Miller-LM;Monahan-J The Cigarette Industry Changes Its Mind.
http://legacy.library.ucsf.edu/cgi/getdoc?tid=jxo95d00&fmt=pdf&ref=results RATCLIFF JD;TODAYS HEALTH;ama;reader's digest [March 1959, p. 107-110] THE GROWING HORROR OF LUNG CANCER.
http://legacy.library.ucsf.edu/cgi/getdoc?tid=udz24f00&fmt=pdf&ref=results Miller-LM;Monahan-J [November 1959, p. 35-43] The Search For "Safer" Cigarettes.
http://tobaccodocuments.org/atc/60296091.html#images Miller-Lm; Monahan-J [July 1961, p. 45-51] Facts We Re Not Told About Filter-Tips, A Reader S Digest Report to Consumers.
http://legacy.library.ucsf.edu/cgi/getdoc?tid=mnn55d00&fmt=pdf&ref=results MILLER LM;READERS DIGEST LUNG CANCER AND CIGARETTES. HERE ARE THE LATEST FINDINGS.
http://legacy.library.ucsf.edu/cgi/getdoc?tid=onn55d00&fmt=pdf&ref=results MILLER LM;MONAHAN J;READERS DIGEST [August 1963, p. 91-98]THE CIGARETTE CONTROVERSY: A STORM IS BREWING.
http://legacy.library.ucsf.edu/cgi/getdoc?tid=npo49d00&fmt=pdf&ref=results ROSS WS;UNK [Oct. '76, p. 114-118] Poison Gases in Your Cigarettes: Carbon Monoxide.
http://legacy.library.ucsf.edu/cgi/getdoc?tid=lsm59d00&fmt=pdf&ref=results ROSS WS;READERS DIGEST;ROSS WS;WORLD SMOKING & HEALTH [July 1982, p. 111-114] A READER'S DIGEST SPECIAL REPORT. WHAT'S BEEN ADDED TO YOUR CIGARETTE?
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Statistics
http://www.mori.co.uk MORI (Market & Opinion Research International) is the largest independently-owned market research company in the United Kingdom. The site contains a large number of polls and publications that cover many different areas, some relating to tobacco and health.
http://www.statistics.gov.uk This is the official UK statistics site. You can view and download a wealth of economic and social data. Very useful and comprehensive site that covers a huge number of areas and studies.
http://ssdc.ucsd.edu/tobacco/ The California Department of Health Services conducts surveys of attitudes, behaviors, and media exposure regarding smoking and tobacco use. A number of surveys and reports are offered and although not all are particularly recent they could still prove useful for research purposes.
http://www.fedstats.gov/ Provides access to US federal statistics generated by over 70 U.S. government agencies for public use. A very valuable resource site for professionals and includes various statistics regarding tobacco use, sale, economics etc.

Topic: Health Related Information

Women's Diagnostic Cyber Message Board: A Question and Answer board for all topics related to women's health. Physicians respond to questions in a timely manner. While Great Kids, Inc. always recommends that women obtain regular medical care from their physicians, information obtained from this Board can provide program staff and women with background information and help them figure out what questions to ask their doctor.
Visit Women's Diagnostic Cyber Message Board online.
National Center for Education in Maternal and Child Health: Provides a weekly email newsletter with research and other important information on maternal and child health. Highly recommended for all programs.
To subscribe to the newsletter send an email to ALERT@LIST.NCEMCH.ORG, with SUBSCRIBE in the subject line. You do not need to enter any text in the body of the message.
America's Children "Key National Indicators of Well-Being, an annual report that looks at over 20 indicators of well-being in the areas of economic security, health, behavior, education and social environment." source: CD Publications.
Copies of the full report are available at http://childstats.gov.ac/


Research Articles
Articles
Website Provides Quick Access to New and Updated State Health Data and Information(8/27/2003)
Research Brief Summarizes What Is Known About the Outcomes of Child Maltreatment(6/14/2002)
The Psychological Maltreatment of Children—Technical Report (April, 2002)
Annual Report On Child Health Released (11/26/2001)
AAP Publishes Policy Statements On Child Health (11/26/2001)
Study Finds Depressive Symptoms Common In Mothers of Toddlers(11/26/2001)
Article Reviews The Prevalence and Effects of Inhalant Abuse Among Adolescents(3/09/2001)
Report Provides Birth Statistics Trends for States and Largest U.S. Cities(2/23/2001)
Study Finds Overweight Concerns Common Among Young Children(2/23/2001)
Parental Involvement and Accessibility of Drugs Affect Adolescent Risk for Substance Abuse, Says Report(2/23/2001)
Smoking During Pregnancy Relates to Asthma and Wheezing in Children, Indicates Study(2/23/2001)
Study Reports Immunization Delays Among Low-Birthweight Children (2/08/2001)
Report Outlines the Effects of Non-USDA Foods Sold in Schools(2/08/2001)
Report Highlights States' Efforts to Expand Health Care Coverage(2/08/2001)
Males Exposed to Violence During Childhood are More Likely to Impregnate Adolescent Females, Finds Study (2/08/2001)
Too Few Pregnant Women Are Screened for Partner Violence, Claims Study (12/15/2000)
Study Examines Long-Term Effects of Extremely Low-Birthweight Births on Families(11/22/2000)
Report Proposes New Guidelines for Promoting Breastfeeding(11/17/2000)
Breastfeeding Rates Affected by Fathers' Attitudes, According to Study (11/10/2000)
Report Gives Nation Poor Grade for Women's Health(8/25/2000)
Task Force Report Outlines National Agenda on Newborn Screening(8/11/2000)
Study Examines Incidence of Disability After Extremely Preterm Birth(8/11/2000)
Study Looks at Barriers to Medicaid Enrollment and Issue of Stigma(8/11/2000)
Many Parents Are Unaware That Their Children Are Eligible for Health Insurance(8/11/2000)
CDC Releases Adolescent Health Chartbook(8/11/2000)
Study Finds Association Between Early Postpartum Discharge and Infant Mortality(7/28/2000)
Report Indicates That Pregnant Women May Need to Limit Intake of Fish and Seafood(7/28/2000)
Researchers Find Molecular Link Between SIDS and Rare Heart Disorder(7/28/2000)
Article States That HIV-Infected Adults Need Family-Centered Support(7/28/2000)
Barriers to TANF Enrollment Associated with Higher Uninsurance Rates (6/30/00)
DHHS Releases Report on Well-Being of Children and Youth (6/23/00)
IOM Report Calls for Increased Funding for Immunizations (6/23/00)
Article Examines Gender Differences in Health Care Access(6/16/00)
Study Investigates Women's Feelings About Early Breastfeeding Cessation(6/16/00)
Effects of Medicaid Expansions and Welfare Declines on Prenatal Care Use(5/26/00)
Information Review: Racial and Ethnic Disparities in Health(5/26/00)
US Prenatal Care Rates Increase Overall but Lag for Certain Groups(5/19/00)
Rehospitalization Rate Analyzed for Cesarean and Assisted Vaginal Deliveries (5/12/00)
Maternal Depression May Impede Child Health Prevention Practices(5/12/00)
Study Finds Low Rates of Family Violence Detection by Pediatricians(5/12/00)
Questions Raised About Fortifying Foods with Folic Acid(5/12/00)
Report Ranks Mothers' Well-Being for 106 Countries(5/12/00)
OB-GYNs Surveyed on Patients' Alcohol Use During Pregnancy (5/5/00)
Study Finds Shifts in Insurance Coverage of Low-Income Children (4/28/00)
Home Visits to Low-Income Mothers Have Lasting Health and Life Effects (4/28/00)
Report Profiles SCHIP/MEDICAID Outreach Program and Its Evaluation Efforts(4/28/00)
Information Review: Adolescent Pregnancy Prevention(4/28/00)
Study Calls for New Measures of Child and Family Well-Being(3/31/00)
Study Cites Need To Address Adolescents' Perceptions of Childbearing(3/3/00)
Bright Futures Nutrition Guidelines Released (3/3/00)
Study Finds Mothers' Misunderstanding of Infant Nutrition(2/25/00) More Information on Specific Topics
Topic: Brain Development
Topic: Health Related Information
Topic: Outcomes linked to Child Abuse and Neglect

Secretary Thompson, Seeking Fastest Possible Results, Names First Health Information Technology Coordinator

HHS Also Announces Milestones in Developing Health IT
Saying that "health information technology has the potential to greatly improve health care even as it yields huge savings," HHS Secretary Tommy G. Thompson today announced the appointment of David J. Brailer, M.D., Ph.D., to serve as National Health Information Technology Coordinator. This is a new position at HHS, created by President Bush last week to coordinate the nation's health information technology efforts.
Secretary Thompson announced the appointment at a Secretarial Summit on health information technology (IT) convened in Washington today.
"Health information technology promises huge benefits, and we need to move quickly across many fronts to capture these benefits," Secretary Thompson said. "I asked the leaders of the health IT community to join me at this summit to see how we can press down on the accelerator and bring about the benefits of health IT even faster. The benefits are enormous, but the task is also enormously complex. We need more than a business-as-usual approach."
At the summit, Secretary Thompson also announced several new accomplishments in developing standards to help bring about electronic medical records and other health IT benefits:
HHS and other federal agencies will adopt 15 additional standards agreed to by the Consolidated Health Informatics (CHI) initiative to allow for the electronic exchange of clinical health information across the federal government.
HHS also announced that, starting today, the medical vocabulary known as SNOMED CT can be downloaded for free for use in the United States through HHS' National Library of Medicine. SNOMED CT, created by the College of American Pathologists, is a key clinical language standard needed for a national health information infrastructure.
With HHS support, the voluntary international health standards-setting organization known as Health Level 7 (HL7) today is announcing a favorable vote on a functional model and standards for the electronic health record. The model is a significant step toward establishing nationwide guidelines for electronic health records.
Today's actions move the nation closer to a national, interoperable health information infrastructure that would allow quick, reliable and secure access to information needed for patient care, while protecting patient privacy. Such a system would allow a doctor or health care provider to access an always-up-to-date electronic health record of a patient who has agreed to be part of the system, regardless of when and where the patient receives care. President Bush last week established a national goal of assuring that most Americans have electronic health records within 10 years.
Today's summit brought together more than 100 leaders in the area of health information technology, including Veterans Affairs Secretary Anthony J. Principi, former Speaker of the House Newt Gingrich and leaders in IT and health care, health information exchange projects, employers, physicians, health plans and patient advocates. Secretary Thompson convened the meeting to brainstorm on ways to speed up the development and implementation of electronic health records and local health information infrastructures.
National Health Information Technology Coordinator
Dr. Brailer, a national leader in harnessing health IT to promote safe, quality and efficient health care, will head a new office at HHS, created by a directive from President Bush. The office will support efforts across government and in the private sector to develop the standards and infrastructure to allow more effective use of information technology to promote higher quality care and reduce health care costs. One of the office's first tasks will be to study options to create incentives in Medicare and other HHS programs to encourage the private sector to adopt interoperable electronic health records. It is estimated that a national health information network can save about $140 billion per year through improved care and reduced duplication of medical tests.
President Bush already has proposed an additional $50 million in his fiscal year 2005 budget to support the development of local health information networks, which would enable a physician treating a patient to have information about all other care the patient has received. These local networks would be able to communicate with one another in a dispersed national network of local and regional systems.
In addition, the new office will work closely with the other components of HHS that are responsible for medical privacy and security regulations to ensure these efforts continue to secure and protect individually identifiable health information. The office will prepare recommendations on methods to assure that the interoperable health information technology appropriately addresses privacy and security issues, such as appropriate authorization, authentication and encryption of data that is being transmitted over the Internet.
Dr. Brailer currently is a senior fellow at Health Technology Center in San Francisco, where he has advised various regional and national efforts on IT and health information exchange. He previously served for 10 years as chairman and CEO of CareScience Inc., one of the nation's leading health care management companies. While at CareScience, Dr. Brailer designed and oversaw the development of the health information exchange technology implemented in Santa Barbara County, Calif. Dr. Brailer holds doctoral degrees in both medicine and economics.
"Dr. Brailer is one of the pioneers in developing community health information exchanges and will now help jumpstart our efforts to improve the quality of care available across America by speeding the nation's progress in implementing these kinds of solutions," Secretary Thompson said.
Consolidated Health Informatics Initiative
As part of the CHI initiative, HHS and the other federal departments that deliver health care services -- the Departments of Defense and Veterans Affairs -- are working with other federal agencies to identify appropriate, existing data standards and to endorse them for use across the federal health care sector.
The 15 new standards build on the existing set of five standards adopted in March 2003. The new standards agreed to by federal agencies will be used as agencies develop and implement new information technology systems.
"Today we sit at the cusp of creating a 'virtual health system', one that will greatly improve the quality, safety and efficiency of health care for Americans through effective use of electronic health records, personal health records, and standards-based information technology tools," said Veterans Affairs Secretary Anthony J. Principi. "Two years of close collaboration among VA, HHS and DoD have brought about this historic opportunity. The federal government has taken a strong leadership role and helped lay the critical groundwork for a national public-private health IT partnership."
"Adoption of these standards will increase our ability to share medical data within the health community," said Dr. William Winkenwerder, assistant secretary of defense for health affairs. "Interoperability through standards will enable us to share electronic patient records which will improve the quality of health care. Better access to medical information means improvements in patient safety and military medical readiness, and a reduction in health care costs."
The CHI initiative is part of President Bush's eGov Initiatives, which includes a cross-government effort to develop a federal health architecture that would encompass the CHI standards, as well as compatible software and business systems to promote efficient, effective communication to improve quality of care.
"The CHI standards will help improve quality of care by making it easier to coordinate care and exchange needed information across federal agencies and will serve as a model for the private sector," said Karen Evans, administrator for E-Government and Information Technology within the Office of Management and Budget.
The specific new standards are:
Health Level 7 (HL7) vocabulary standards for demographic information, units of measure, immunizations, and clinical encounters, and HL7's Clinical Document Architecture standard for text based reports. (Five standards)
The College of American Pathologists Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) for laboratory result contents, non-laboratory interventions and procedures, anatomy, diagnosis and problems, and nursing. HHS is making SNOMED-CT available for use in the United States at no charge to users. (Five standards)
Laboratory Logical Observation Identifier Name Codes (LOINC) to standardize the electronic exchange of laboratory test orders and drug label section headers. (One standard.)
The Health Insurance Portability and Accountability Act (HIPAA) transactions and code sets for electronic exchange of health related information to perform billing or administrative functions. These are the same standards now required under HIPAA for health plans, health care clearinghouses and those health care providers who engage in certain electronic transactions. (One standard.)
A set of federal terminologies related to medications, including the Food and Drug Administration's names and codes for ingredients, manufactured dosage forms, drug products and medication packages, the National Library of Medicine's RxNORM for describing clinical drugs, and the Veterans Administration's National Drug File Reference Terminology (NDF-RT) for specific drug classifications. (One standard.)
The Human Gene Nomenclature (HUGN) for exchanging information regarding the role of genes in biomedical research in the federal health sector. (One standard.)
The Environmental Protection Agency's Substance Registry System for non- medicinal chemicals of importance to health care. (One standard.)
SNOMED CT Medical Vocabulary
Secretary Thompson also announced that SNOMED CT, a standardized medical vocabulary is now available for download as part of the National Library of Medicine's Unified Medical Language System (UMLS) Metathesaurus at http://umlsinfo.nlm.nih.gov. The vocabulary is available free for anyone in the United States. Users must register via the Web for a free UMLS license before downloading the data or requesting a copy on DVD.
With terms for more than 300,000 current medical concepts, the College's standardized system has been recognized as the world's most comprehensive clinical terminology database available. With its free availability within the United States, it is now possible for health care providers, hospitals, insurance companies, public health departments, medical research facilities and others to easily incorporate this uniform terminology system into their information systems.
More information about HHS' efforts to promote health IT is available at http://www.hhs.gov/news/press/2004pres/20040427a.html.

HIV/AIDS Fight Targets Health, Related Development Issues

Washington -- Twenty-five years into the global struggle against HIV/AIDS, international partners are calling for a redoubling of effort, coordination and funding to battle an infectious disease whose burden stretches beyond the health care system to affect development.
The United States is a world leader in the response to HIV/AIDS, and on September 26, as part of its 2007 commitment to the Global Fund to Fight AIDS, Tuberculosis and Malaria, the U.S. government transmitted more than $531 million to that organization.
The contribution, made through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), brings the total investment of the American people in the Global Fund to more than $2.5 billion since its launch in 2001.
“On the ground, where it matters most,” PEPFAR’s coordinator, Ambassador Mark Dybul, told USINFO, “there is strong coordination of PEPFAR and Global Fund programs to ensure that they complement each other.”
Through PEPFAR's partnerships with the Global Fund, and with private-sector, community and faith-based organizations, he added, “the people of many developing nations are now confronting this pandemic in an effective and coordinated manner."
On May 30, President Bush announced that he would work with Congress to reauthorize PEPFAR -- which expires at the end of fiscal year 2008 -- for another five years and $30 billion. This proposal would double the initial $15 billion commitment made in 2003. (See related article.)
But during a September 20 briefing on PEPFAR and the Global AIDS Response at the Woodrow Wilson International Center for Scholars in Washington, Dr. Peter Piot, executive director of the Joint United Nations Programme on HIV/AIDS, urged the United States to give even more to PEPFAR so other nations will do the same.
“We saw that when President Bush announced in his State of the Union in 2003 that this country will put $15 billion on the table in the fight against AIDS. This was followed by others -- the first one being the United Kingdom -- and then others. This has happened again and again. That is the power of American leadership.”
PREVENTION
It takes large numbers to tell the AIDS story. Around the world, 39.5 million people live with HIV/AIDS; there were 4.3 million new infections in 2006; 32 million people have died since the beginning of the pandemic; and every day, 8,500 people die of AIDS.
Today, thanks largely to PEPFAR, 1.1 million people are receiving treatment. But it is not enough.

A lab technician for a youth foundation checks blood samples at the International Conference on HIV/AIDS in Africa. (© AP Images)
“In 2006,” U.S. House of Representatives member Nita Lowey said during the PEPFAR briefing, “for every person who received treatment, another six people became infected. This statistic translates into an additional 60 million infections by 2015 if the world has not dramatically shifted its prevention paradigm.”
The first PEPFAR program changed the world forever by initiating treatment, she added. “Our next program must reflect a true commitment to prevention.”
PEPFAR supports prevention activities that focus on sexual transmission, mother-to-child transmission, transmission through unsafe blood and medical injections and greater HIV awareness through counseling and testing.
In 2006, some 22.6 percent of PEPFAR funds for the 15 focus countries, or $396 million, went to resources for prevention, treatment and care.
“In the next iteration of what the Global Fund does,” said Kent Hill, assistant administrator in the Bureau for Global Health at the U.S. Agency for International Development (USAID), “we are going to [need] an increase in the amount and quality of effort on prevention to make a difference there.”
BEYOND HEALTH CARE
Equally important to the struggle against HIV/AIDS is addressing what the authorizing language of the Leadership Act, which created PEPFAR, called “related activities.” Hill calls these “wraparound” issues, and they are linked intimately with the disease.
“Gender issues are related to human rights,” he said in prepared remarks. “Orphans’ issues are immediately connected to education and access to all sorts of other health interventions. Economic growth issues are involved because HIV undermines the work force, and HIV-positive individuals often cannot work or face discrimination. HIV-positive women ... need mosquito nets and access to reproductive health information and services.”
To deal with these wide-ranging issues, PEPFAR is “connecting the dots of international development” by increasingly linking its programs with other development initiatives that are having a real impact in countries and communities.
These include the President’s Malaria Initiative, to increase the impact on public health and reach more at-risk populations; the African Education Initiative, to improve educational opportunities for Africa’s children; U.S.-supported food aid programs, to bolster nutrition among those with AIDS; and the Millennium Challenge Corporation, to promote sustainable economic growth.
With a focus on sustainability, Hill said, PEPFAR support is allowing USAID’s energy office in the Bureau for Economic Growth, Agriculture and Trade to work with partners to provide technical assistance on integrating energy issues into overall planning.
Applications range from identifying electrification rates in country districts to investigating solar energy options.
“The people of severely affected nations have accomplished so much in their fight against HIV/AIDS,” Hill said, “and the American people are privileged to partner with them through PEPFAR.”
More information about PEPFAR is available on the program’s Web site.
(USINFO is produced by the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)

International Health

Centers for Disease Control and Prevention (CDC)The Centers for Disease Control and Prevention (CDC) is the major branch of the U.S. Department of Health and Human Services that focuses on national and international disease prevention and control and infectious disease surveillance. CDC’s international activities are spearheaded by The Office of Global Health. Among its international health activities are collecting data and statistics on the incidence of global health problems, information on travelers’ health, the International Classification of Diseases (ICD), a system designed to promote international comparability in the collection, processing, classification, and presentation of mortality statistics and the International Micronutrient Malnutrition Prevention and Control Program (IMMPaCt), which targets CDC resources to the global effort to eliminate malnutrition.
Commonwealth Fund: International Health Policy & PracticeThe Commonwealth Fund’s International Program in Health Policy and Practice provide grants to researchers and other professionals with the intention of building an international network of policy-oriented health care researchers, sparking innovative health policy thinking and high-level exchanges, and encouraging cross-country comparative research and collaboration.
Family Health InternationalFamily Health International (FHI) is a U.S.-based Non-governmental Organization (NGO) that conducts research, education, and service delivery on HIV/AIDS, reproductive health, and children’s healthcare. FHI provides Country Profiles that specify the goals and efforts by nation in these areas o as well as more in depth evidenced-based publications on sexually transmitted infections, infectious diseases, reproductive health, maternal health, adolescent health, contraceptive technology, and gender issues.
Bill and Melinda Gates FoundationThe Gates Foundation is a U.S.-based philanthropy working on expanding access to technology and improving global health care. The Foundation’s Global Health Program is focused on reducing global health inequities by accelerating the development, deployment and sustainability of health interventions to dramatically reduce the impact of infectious disease in developing countries, particularly HIV/AIDS and Tuberculosis (TB), and reproductive and child health.
The George Institute for International HealthThe Policy and Practice group undertakes policy oriented research and consulting projects pertaining to the growth in non-communicable disease and injury, particularly in the Asia-Pacific region.
The Global Fund to Fight AIDS, Tuberculosis and MalariaInitiated formally in 2002, The Global Fund is a unique international, public-private partnership aimed at attracting and disbursing funds for the prevention, detection, and treatment of AIDS, tuberculosis (TB), and malaria. The Fund is a financing partnership that includes governments, civil society, the private sector, and affected communities, and disburses funds to national governments, local communities, and individual service programs.
Global Health CouncilGlobal Health Council (GHC) is a U.S.-based membership organization that conducts analysis, research, training, and sponsors international health meetings to inform and educate opinion leaders, policy-makers, the media and concerned citizens on women’s health, children’s health, HIV/AIDS, infectious diseases, and emerging threats. GHC.
GlobalHealthReporting.orgSponsored by the Kaiser Family Foundation and the Bill and Melinda Gates Foundation, this website is designed to help journalists, researchers, policymakers, and NGOs efficiently sort through the latest and most accurate information on HIV/AIDS, tuberculosis, and malaria. This website provides the latest news, information and data on the three diseases, information by country, glossaries, and reporting resources for journalists.
Health Policy Monitor (Bertelsmann Stiftung)The Health Policy Monitor serves as a network for groups that are involved in health policy and reform. The organization offers professional international networking, expertise in cross-country comparative social and economic studies, and benchmarking advice.
International Health Economics Association (iHEA)The International Health Economics Association increases communication among health economists, fosters a higher standard of debate in the application of economics to health and health care systems, and assists young researchers at the start of their careers.
International Association of Health Policy (IAHP)IAHP is membership group for an international network of scholars, health workers, and activists that aims to promote the scientific analysis of public health issues and a forum for international comparisons and debate on health policy issues.
International Federation of Pharmaceutical Manufacturers and Associations(IFPMA)IFPMA is a non-profit, non-governmental organization representing major global research-based pharmaceutical and vaccine companies from both developed and developing countries. IFPMA aims to contribute industry expertise and foster collaborative relationships and partnerships that are dedicated to the improvement of public health.
IpasIpas aims to protect women’s health and advance women’s reproductive rights. Ipas’s global and country programs include training, research, advocacy, distribution of equipment and supplies for reproductive-health care, and information dissemination.
John Snow, INC (JSI)Headquartered in Boston, Massachusetts, JSI and its affiliated organizations, including JSI Brazil and JSI United Kingdom, provide technical and managerial assistance, research and evaluation, education, and training to public health programs worldwide. JSI's International Division works in partnership with host-country experts, organizations, and governments to improve quality, access and equity of health systems, and focuses on multidisciplinary, gender-sensitive development approaches that assist countries, communities, families and individuals to develop solutions on their priority health and development issues.
Medical Care Development International (MCDI)An international division of the Medical Care Development, Inc., MCDI provides technical assistance in health and socio-economic development to disadvantaged and vulnerable communities around the world. MCDI strives to enhance the financial status of the organizations it assists.
Medicins Sans Frontieres (Doctors Without Borders)Medecins Sans Frontieres (MSF) is an international aid agency that provides direct medical care to underserved and crisis regions around the world. In addition to direct services, MSF leads a number of public health initiatives, including the Campaign for Access to Essential Medicines, which analyzes drug pricing and aims to lower prices of existing medicines, stimulate research and development for cheaper medicines for diseases that primarily affect the poor, and overcome other access barriers to medicines. National Institutes of Health (NIH)NIH is the major basic science research arm of the United States Department of Health and Human Services. There are 18 Institutes within NIH, each with its own mandate, activities, and funding. NIH funds also a broad range of research on international health concerns, including projects on laboratory science, application of emerging technologies, and global health pandemics. NIH agencies have a plethora of scientific and policy data on incidence, prevalence, regional variation and trends on their specific areas of research.
Presidential Advisory Council on HIV and AIDS (PACHA)The Presidential Advisory Council on HIV and AIDS (PACHA) is an advisory body that provides advice, information, and recommendations to the Executive Branch of the U.S. government regarding programs and policies related to prevention and research of HIV/AIDS.
Pan American Health OrganizationBased in Washington, D.C., the Pan American Health Organization (PAHO) is an independent NGO whose primary focus is to improve the health of the peoples of the Americas. PAHO promotes primary health care strategies, collects data and information on health trends in the Americas, and develops recommendations for addressing major health issues in these countries.
PATHPATH is a U.S.-based nonprofit, nongovernmental organization that provides technical and programmatic support on international health projects and strives to increase the reach of technologies, strengthen health systems, and promote healthy behavior abroad. PATH currently works in more than 100 countries in the areas of reproductive health; vaccines and immunization; HIV/AIDS and tuberculosis; and children's health and nutrition.
Population CouncilThe Population Council is an international, nonprofit, nongovernmental organization that conducts biomedical, social science, and public health research. The Council evaluates and develops sustainable approaches to enhancing people's health and well-being in the areas of gender and family dynamics; HIV/AIDS; reproductive health; and health of infants and children.
Research Triangle Park International (RTP)RTP is a consulting firm that delivers advisory and training services at the national, subnational, and local government levels, emphasizing institutional development through the transfer of analytical tools and methods. Current areas of interest are infectious diseases, reproductive health and family planning, health policy care and financing, and environmental health.
United NationsThe United Nations (UN) is a multi-national convening body of international law and development. Several UN agencies and departments are involved in international health policy:
UNAIDSUNAIDS leads, strengthens and supports an expanded response to the global AIDS pandemic and sponsors activities aimed at preventing transmission of HIV, providing care and support, reducing the vulnerability of individuals and communities to HIV/AIDS, and alleviating the impact of the pandemic. UNAIDS tracks and monitors the state of the global epidemic and provides country, regional and global statistics; epidemiological reports; news releases; case studies; and publications on other HIV-related topics.
UNIFEM (UN Development Fund for Women)UNIFEM provides financial and technical assistance to innovative programs and strategies to foster women's empowerment and gender equality. UNIFEM focuses its activities on four strategic areas reducing feminized poverty; ending violence against women; reversing the spread of HIV/AIDS among women and girls; and achieving gender equality in democratic governance.
UNFPA (UN Population Fund)UNFPA's three main areas of work are to help ensure universal access to reproductive health services by the year 2015; to support population and development strategies that enable capacity-building in population programming; and to promote awareness of population and development issues and collect resources necessary to accomplish this work. The UNFPA conducts research and analysis as well as provides funding to service providers around the world.
UNICEF (UN Children’s Fund)UNICEF is the UN agency charged with improving the health of young people and works on issues of child protection, girls’ education, general immunizations, and HIV/AIDS prevention. UNICEF works directly with communities and families, monitors and collects statistics on children’s health and applies research towards policy change.
US Agency for International Development (USAID)USAID is an independent, federal U.S. agency that provides economic, development and humanitarian assistance to developing nations in support of the foreign policy goals of the United States. USAID helps developing nations build medical care infrastructure and address global health problems such as HIV/AIDS and other infectious diseases and poor maternal and child health.
U.S. Department of StateThe Department of State is the federal department that oversees diplomacy and U.S. foreign policies. Health activities under the auspices of the U.S. State Department include:
GlobalHealth.govGlobal Health promotes the health of the people of the world by advancing global strategies and partnerships. Global Health provides world health statistics and country-specific data on health indicators
Office of U.S. Global AIDS CoordinatorThe Global AIDS Coordinator establishes primary responsibility for all resources and international activities of the U.S. Government to combat the HIV/AIDS pandemic, including U.S. contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and to advance the HIV/AIDS prevention, care and treatment goals laid out by the President’s Emergency Plan for AIDS Relief (PEPFAR).
The World BankThe World Bank is a major, international bank that provides loans, policy advice, and technical assistance to low and middle income countries to reduce poverty. The Bank promotes growth to create jobs and to empower poor people to take advantage of these opportunities.
The World Bank GroupThe Development Economics Center (DEC) is the research and development arm of the World Bank. The DEC seeks to increase understanding of development policies and programs by providing intellectual leadership and analytical services to the Bank and the development community through policy research reports, world development reports and indicators, and global economic/ finance prospectus on major health topics that include health and nutrition, water resources, labor and social protections, rural development, and agriculture.
World Health OrganizationThe World Health Organization is the United Nations specialized agency for world health issues.
Evidence and Information for Policy The WHO Evidence for Health Policy site presents current activities relating to epidemiology and the burden of disease, cost-effectiveness of health care interventions, and health systems assessment and reform, including quality of care, ethical issues, financing, resource allocation, regulation and legislation.
HIV InfectionsThe WHO HIV/AIDS Program works with U.N. agencies to facilitate multisectoral efforts to combat HIV/AIDS, including the 3 by 5 Initiative, which aims to provide treatment to three million HIV-positive people by 2005.
Information by CountryInformation specific to all WHO country participants: statistics, health expenditures, health system organization, human resources, etc.
WHO Statistical Information SystemThe WHO Statistical Information System is the guide to health and health-related epidemiological and statistical information available from the World Health Organization. One can search by keywords within the WHOSIS or throughout the entire WHO site for any statistical information available.