Chronic diseases are the biggest killer of adults

The report also highlights the spread in developing countries of epidemics of heart disease, stroke and other chronic diseases, which in addition to communicable diseases create a "double burden" of premature death and ill-health. The report proposes a "double response" to this burden by integrating prevention and control of both communicable and noncommunicable diseases within a comprehensive health care system.

Of the 45 million deaths among adults worldwide in 2002, almost three-quarters were caused by noncommunicable diseases. These are the main cause of death in all regions, except Africa where HIV/AIDS has become the leading cause of mortality among adults aged 15-59 years. In this age group, the leading killers in 2002 were:

Respiratory infections, 1.9 million deaths
Diarrhoeal disease, 1.6 million deaths
Malaria, 1.1 million deaths.
Neglect of health systems has international consequences

The continuing HIV/AIDS epidemic, deadly outbreaks of diseases such as SARS and the challenge of completing the eradication of polio are all symptoms of a failure to invest in health systems. This failure can have rapid and devastating international consequences, the report says. "Even before I took office, I travelled to China to view the impact of SARS and appreciated the importance of stronger health systems to deal with this latest epidemic. There will be more to come, hence the urgency of strengthening our ability to respond to and prevent epidemics, whether they be local or global," said Dr Lee.

The lessons learnt from such health emergencies are helping to shape strategies for an urgent health system response to the prevention and care of HIV/AIDS. This will involve complex health interventions that WHO recognizes as being not only feasible in resource-poor settings, but precisely what is needed. "The experience we will gain in responding to HIV/AIDS will eventually be applicable to the full range of chronic conditions, from diabetes to stroke," said Dr Lee.

The report suggests ways in which international support can counter some of the main health care systems weaknesses, including critical shortages of health workers, inadequate health information, a lack of financial resources and the need for more government leadership aimed at improving the health of the poorest members of society. The report calls for rapid increases in training and employment of health care workforces, and stronger government-community relationships.

"Effective action to improve population health is possible in every country but it takes local knowledge and strength and sustained international support to turn that possibility into reality. We have learned this through successes such as controlling the SARS epidemic and major advances in the polio eradication campaign, and we have learnt it through setbacks as well, such as the continuing rise of AIDS, TB and malaria. All of these lessons have prepared us for the tasks ahead," said Dr Lee. -Keralamonitor.com

 

Demographics Said Key To Understanding Internal Conflicts

Washington Dec 18: High birth and death rates can fuel rebellion, ethnic warfare and domestic terrorism, according to a report released yesterday by Population Action International, a Washington-based advocacy group.

The Security Demographic: Population and Civil Conflict After the Cold War draws on existing data on civil conflicts during the 1990s and earlier to analyze the role that demographics play in shaping internal security. The study identifies four factors that may aggravate civil unrest: a high proportion of young adults, a rapidly expanding urban population, scarce supplies of cropland and water, and a sharply declining death rate among middle-aged people due to HIV/AIDS.

How countries stack up with respect to these factors depends in large part upon how far along they are in the "demographic transition" toward lower birth and death rates, the report says. Countries in the early stages of this transition - including much of Africa and the Arab world - are just beginning to see reduced death rates as a result of improved health care. Birth rates remain high, however, because of tradition and low availability of contraception, leaving those countries with a high youth population and other "stress factors."

"We're not claiming in this work that demography is destiny," report co-author Robert Engelman, the vice president of research at PAI, said at the report's launch. "Population doesn't kill people," he said. "To borrow a phrase, people kill people."

But demographics "either encourage or discourage conflict," he said, as nations in earlier stages of the demographic transition are at greater risk of internal turmoil. "In countries where demographic transition moves into its final stages," Engelman added, "new conflicts will be less likely to emerge than in the past. That's a powerful concept for the future of global security."

Of the 180 countries analyzed, 76 states included the mix of demographic factors that could spur civil conflict, including sub-Saharan African countries as well as Iraq and Afghanistan.

Richard Cincotta, a PAI researcher and primary author of the report, said yesterday he believes the demographic stress factors in those two countries could impede their transition toward stability and democracy. "How to employ such a massive group of people in such a short time," how to address the discontent of a largely youthful population and how to provide adequate resources present significant obstacles to security, he said.

The report recommends assisting those nations achieve the "security demographic" - mature age structures "favoring more adequate support for children and greater household savings" - by strengthening family-planning programs and efforts to improve the status, education and health options for women and girls.

Demographics can become a new type of soft power to reduce conflict at its roots, said former U.S. Army Deputy Chief of Staff for Intelligence Claudia Kennedy, who also spoke at the report's launch. It is a particularly salient idea, she said, in a post-Cold War world where militaries around the world are smaller and the active U.S. army is one-third the size it was in the Vietnam era.

By Caroline Preston
U.N. Wire

Human Trafficking In Balkans Growing, U.N., OSCE Say

Dec 18: The sale of women and girls into prostitution and children into forced labor is on the rise in the Balkans, according to a report published yesterday by the United Nations and the Organization for Security and Cooperation in Europe.

International efforts to stop the trafficking in and through Southeastern Europe have yielded "no actual decline" in the illegal trade, even though tougher police and border patrolling have cut off some transit routes from the region to the European Union, the Financial Times reports.

Instead, traffickers have abandoned old trade routes and adopted new methods, such as air travel. According to a new collective security strategy adopted by leaders of the EU's member states, "Balkan criminal networks" have illegally traded 200,000 women.

The Financial Times says that liberalized visa arrangements within the EU mean that citizens of Romania and Bulgaria, along with citizens of Moldova allowed to carry Romanian passports, can be smuggled more easily into the EU but cannot be traced because they carry legitimate papers."The reality is that there is no time to rest on our laurels," said Helga Konrad, head of anti-trafficking affairs for the EU-sponsored Stability Pact for Southeastern Europe (Eric Jansson, Financial Times, Dec. 18).

 

Kenya Looks To Retrieve At Least $1 Billion In Stolen Funds

Dec 18: A six-month inquiry into former Kenyan officials has revealed that at least $1 billion was stolen from the government and banked abroad. The amount siphoned out during the 24-year rule of former president Daniel arap Moi could be as high $4 billion, enough to fund universal primary education in the country for a decade (BBC Online, Dec. 16). If the stolen money amounts to $4 billion, it would be equivalent to one-third of Kenya's gross domestic product (Los Angeles Times, Dec. 18).

Investigators are seeking to retrieve the money, but it is not expected to be an easy task.

"Identifying the assets is just the first step," said Gladwell Odieno, executive director of Transparency International, a nongovernmental organization that monitors corruption issues. "Getting the money back is a much more questionable proposition. The people who got the money out obviously had enormous resources, and it's not easy for developing country governments to conduct these cases" (BBC Online).

Authorities looking to return the money to Kenya fear that most of what was sent to accounts in Switzerland, Monaco and the Cayman Islands may have shifted to African countries such as Zimbabwe, South Africa and Botswana. Robinson Githae, an assistant government minister, said the amount of money in question is too large to keep hidden forever.

Githae also said that the inquiry into corruption and theft allegations was not a political witch-hunt against Moi-linked officials.

"If that were the aim, there would be cheaper ways of doing it than setting up an expensive commission of inquiry," Githae said (East African Standard , Dec. 17).

According to Canada's National Post, the funds were stolen through phony payments on the foreign debt, looting the Central Bank, kickbacks and fake contracts.

Kenya's corruption problems have been known for years, the Post reports. President Mwai Kibaki, who took office last December, has vowed to pursue his anti-corruption drive wherever it leads (Peter Goodspeed, National Post, Dec. 18).

Iraq Governing Council Calls On Insurgents To "Return To Fold"

Dec 18: The Iraqi Governing Council yesterday appealed to militant insurgents to take advantage of a "spirit of forgiveness" and "return to the fold of the Iraqi people," although it stopped short of offering amnesty to the guerrillas.

Acting council president Adnan Pachachi said only Saddam Hussein and top officials from the former dictator's regime would be tried before Iraq's war crimes tribunal, and that Hussein loyalists would be treated fairly if they turned themselves in.

"There is no need for amnesty for those who haven't committed any crimes against humanity," Pachachi said. "They have simply to turn themselves in and express their willingness to participate with other Iraqis in the reconstruction of our country. Only those who committed war crimes will be sent to the special tribunal" (Williams/King, Los Angeles Times, Dec. 18).

The council also met for the first time yesterday to look at ways of appointing judges to the tribunal, which Pachachi said would welcome "foreign judges if we feel it's necessary."

Another council member, Mouwafak al-Rubaie, said a committee of highly qualified lawyers could recommend candidates to serve as judges. Al-Rubaie said the trial of Hussein and other members of the former regime would be "the trial of all times," adding that it would "reveal secrets, expose presidents, kings and intellectuals" in the West and Middle East (Sarah El Deeb, Associated Press/Yahoo! News, Dec. 18).

At the United Nations, Iraq Foreign Minister Hoshyar Zebari yesterday defended remarks he made to the Security Council on Tuesday, when he accused the United Nations of failing to help free Iraqis from tyranny and said the Governing Council was the most "representative and democratic governing body in the Middle East."

Zebari said that airing grievances was part of Iraq's reconciliation process. "It was important for us to be straight. It was not meant to offend anyone at all, but this is a strong feeling among the people of Iraq."

U.N. Secretary General Kofi Annan offered a pointed response to Zebari's critique. "I think the U.N. has done as much as it can for Iraq. This is not the time to pin blame and point fingers, when everybody is trying to figure out how creatively we can organize ourselves to help the Iraqis," Annan said (Mark Turner, Financial Times, Dec. 18).

U.S. Soldier Reported Killed In Ambush

On the ground in Iraq, a U.S. military patrol was ambushed late last night, with one soldier reported killed. U.S. forces have stepped up their campaign to track down insurgents, and yesterday they encircled the town of Samarra, 60 miles north of Baghdad, as part of a major raid on the area.

Samarra, in the violent Sunni Triangle region, is home to 1,500 insurgents, according to the U.S. military. "Samarra has been a little bit of a thorn in our side," said Lieutenant Colonel Nate Sassaman. "It hasn't come along as quickly as other cities in the rebuilding of Iraq. This operation is designed to bring them up to speed" (Dafna Linzer, AP/Yahoo! News, Dec. 18).

Bush Says Hunt For Hussein Justified

In an interview with a U.S network television station broadcast Tuesday night, President George W. Bush said removing Hussein from power was justified even though no weapons of mass destruction were uncovered. Bush said the fact Hussein was pursuing a WMD program was sufficient reason to oust the former Iraqi leader.

"If he were to acquire weapons, he would be a danger," Bush said, referring to Hussein. "That's what I'm trying to explain to you. A gathering threat, after 9/11, is a threat that needed to be dealt with, and it was done after 12 long years of the world saying the man's a danger."

Bush said his decision to invade Iraq would be judged well by history. "I'm telling you - I made the right decision for America because Saddam Hussein used weapons of mass destruction, invaded Kuwait, but the fact that he is not there ... means America's a more secure country" (Richard W. Stevenson, New York Times, Dec. 18).

Halliburton Responsible For Overcharging, Pentagon Says

The Pentagon said yesterday that defense contractor Halliburton Co. would be responsible for paying back the $61 million it overcharged the Pentagon for oil deliveries to Iraq. The comptroller for the Pentagon, Dov Zakheim, said the Halliburton subsidiary responsible for oil deliveries to Iraq, KBR, had failed to fully analyze the price it was charged by a Kuwaiti supplier for the oil, resulting in the markup. An aide to Zakheim said the issue was "not one of concealment," but that the markup resulted from KBR's using "a rather antiquated accounting system."

"If they cannot recover, if auditors determine that there was X dollars in overpricing, then it's the company that will be out, not the taxpayer," Zakheim said (John Hendren, Los Angeles Times, Dec. 18)

Koizumi Approves Troop Deployment

Japanese Prime Minister Junichiro Koizumi yesterday approved the sending of 1,000 soldiers to Iraq to support humanitarian operations there, marking the country's first dispatch of troops to a combat zone since World War II.Koizumi approved Defense Agency chief Shigeru Ishiba's proposed dispatch schedule and directed Ishiba to start preparing troops for noncombat duty in southern Iraq. Ishiba is expected to issue an order tomorrow for the troops to begin packing for Iraq (Kenji Hall, AP/Yahoo! News, Dec. 18).