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Nurses and nursing students from the UK and overseas are learning in each other's countries [ABSTRACT FROM AUTHOR]

Female genital mutilation (FGM) refers to alteration of the external genitalia of girls without medical benefit. It is estimated by United Nations agencies that 200 million living girls and women have been subjected to different forms of FGM worldwide. Despite the criminalization of the procedure in the vast majority of countries where it is practiced, the decline in the incidence of this ritual is far from satisfactory. Immediate and long-term ill effects are well documented. Most publications of relevance originate from countries outside the map of FGM. In addition, there are major gaps in research related to this issue, considering the magnitude of the problem. International medical organizations and societies should assume their responsibility by providing a platform to professionals engaged in the prevention and treatment of the consequences of FGM, especially those living in the communities where the practice is endemic. [ABSTRACT FROM AUTHOR]

We analyze the connections between scientists and physicians in relation to the development and therapeutics of trachoma in Argentina, contagious eye infection, considered a dangerous social disease worldwide. This question is especially linked to the contexts of knowledge construction at the international level and to the colonial domination of the European powers. These contacts have been studied since the late nineteenth century, when the disease began to be detected in Argentina until the 1930s, when the participation of Argentine doctors in different ophthalmological associations related to trachoma would indicate a local concern to join international circles. We review manuals and journals published in Argentina and national and international congress proceedings, as well as The British Journal of Ophthalmology and the Revue Internationale du Trachome. [ABSTRACT FROM AUTHOR]

Information is provided on the workshop titled "Global Circuits of Expertise and the Making of the Post-1945 World" at Columbia University in New York City, New York from April 29-May 1, 2016. Topics, including Chinese medical assistance to Algeria in the post-World War II period, Polish scientists in India during the 1950s, intercultural policy between China and East Germany, Albania's relations with China in the 1960s and international cooperation in science, are discussed.

A letter to the editor is presented regarding the advocacy of the INDO-US group on the need for pediatric emergency medicine (PEM) in India.

A review of the regulatory status of herbal drugs/products was done for few countries forming part of Asia, Africa, America, Europe, and Australia, to understand various categories under which the trade of herbal products is permitted and their premarketing requirements. A critical assessment was done, to know the hindrances in the process of harmonization of herbal products. It has been found that there is a lack of harmonization in the regulatory requirements of herbal products internationally, besides the issues of availability of herbs and their conservation. These are hindering the international trade and growth of the herbal products segment. [ABSTRACT FROM AUTHOR]

Background: Despite common recognition of joint responsibility for global health by all countries particularly to ensure justice in global health, current discussions of countries' obligations for global health largely ignore obligations of developing countries. This is especially the case with regards to obligations relating to health financing. Bearing in mind that it is not possible to achieve justice in global health without achieving equity in health financing at both domestic and global levels, our aim is to show how fulfilling the obligation we propose will make it easy to achieve equity in health financing at both domestic and international levels. Discussion: Achieving equity in global health financing is a crucial step towards achieving justice in global health. Our general view is that current discussions on global health equity largely ignore obligations of Low Income Country (LIC) governments and we recommend that these obligations should be mainstreamed in current discussions. While we recognise that various obligations need to be fulfilled in order to ultimately achieve justice in global health, for lack of space we prioritise obligations for health financing. Basing on the evidence that in most LICs health is not given priority in annual budget allocations, we propose that LIC governments should bear an obligation to allocate a certain minimum percent of their annual domestic budget resources to health, while they await external resources to supplement domestic ones. We recommend and demonstrate a mechanism for coordinating this obligation so that if the resulting obligations are fulfilled by both LIC and HIC governments it will be easy to achieve equity in global health financing. Summary: Although achieving justice in global health will depend on fulfilment of different categories of obligations, ensuring inter- and intra-country equity in health financing is pivotal. This can be achieved by requiring all LIC governments to allocate a certain optimal per cent of their domestic budget resources to health while they await external resources to top up in order to cover the whole cost of the minimum health opportunities for LIC citizens. [ABSTRACT FROM AUTHOR]

The authors describe the efforts exerted by the Global Paediatric Surgery Network (GPSN) Collaborative to foster global subspecialty cooperation in surgery. They discuss the poor surgical conditions, particularly in pediatrics, in low and middle-income countries (LMIC), the actions taken by the global surgery movement to address LMIC surgical problems and the programs launched by the GPSN Collaborative in relation to surgeon networking, education, research, practice and advocacy.

Transnational physician migration has concerned states' health and migration policies for many years. Recent developments have increased attention to the outcomes of these flows in the global south, where physician emigration is undermining public health policies. Cuba's exporting of medical professionals presents an alternative dynamic, based upon both an ideology of humanitarian solidarity and a need to secure hard currency earnings. The benefits and challenges arising from a bilateral agreement between Cuba and South Africa to supply Cuban doctors to South Africa and training at the Latin American Medical School (ELAM) for South African medical students are addressed. The benefits of skills enhancement and professional development are noted, as well as the economic benefits for both the Cuban government and individual doctors, while concerns with the appropriateness of the medical training provided at ELAM for the South African health context and the sustainability of the current policy are discussed. [ABSTRACT FROM AUTHOR]

This article revisits the United Nations Millennium Development Goals (mdgs) set in 2000, timely now because policy makers are currently making plans for the period after 2015. After laying out a critical analysis of the mdgs, the article focuses on Millennium Goal 8, the global partnership for development. The argument made is that the absence of any goal to reset the asymmetrical power relations between the North and the South reveals the limitations of the endeavour. The pharmaceutical industry is discussed in detail because mdg8/Target 6 deals with access to affordable, essential drugs in developing countries. This target seems emblematic of a problem found throughout the millennium project: the unaddressed need for real economic development. Target 6 exemplifies both North–South and public–private conflicts of interest, which are carefully hidden in official documents behind the euphemism of ‘partnership’, as if countries of such unequal power could be partners. [ABSTRACT FROM PUBLISHER]

The article presents a review of a conference on the contributions of universities in developed countries to international cooperation in medicine and public health, convened at the Institute for the History, Theory and Ethics of Medicine of the RWTH Aachen University in Aachen, Germany, from November 21-22, 2013. Topics of discussion included medical research and international development aid, public health in Latin America, and postcolonialism and medicine.

One hundred years after the Flexner Report recommended major changes to medical education, an international panel has released a vision of medical education for the 21st century. Two major features of this detailed report that were not adequately articulated or developed were (1) the values that underpin care of individual patients and how these could be sustained and promoted, and (2) the values required to promote global health at a time when health disparities are widening. After reviewing the timeless scientific and humanistic foundations of clinical medicine that are essential for the care of individuals, we consider the role of virtue both in relation to individual patient care and in promoting an ethical framework for population health within a cosmopolitan global health perspective, and suggest that many organs of society should contribute to promoting such progress. [ABSTRACT FROM AUTHOR]

This article argues that during the four decades following World War II, New Zealand medical specialists worked within a professional fi eld that was fundamentally international in nature. In contrast to the predominantly nation-centred narratives that characterise much of New Zealand's medical historiography, this article suggests that the structures, conventions, and values that underpinned the work of New Zealand specialists were to a large extent derived from, and sustained by, a complex network of international exchanges. The article focuses in particular on the temporary--but almost universal--overseas migration of New Zealand medical graduates in pursuit of post-graduate specialist training, and discusses the implications of the resulting international network for the development of post-World War II medical specialisation in New Zealand, and in many other Commonwealth countries. [ABSTRACT FROM AUTHOR]

The article discusses Cuban medical internationalism, a system in which Cuba sends medical aid to countries across the globe, with attention to the effects of the program under President Raúl Castro in the early years of the 21st century. A history of Cuba's medical international cooperation since 1960 is provided, including descriptions of initiatives such as assistance for victims of the Chernobyl nuclear accident of 1986 in the Ukraine, the training of doctors from developing countries at no cost starting in 2005, and work in East Timor. Cuba's medical internationalism is also discussed within the context of Cuba's political and economic restructuring as outlined in the document "Lineamientos de la política económica y social," published in 2010 by the Communist Party of Cuba.

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Abstract: Tajikistan, a Central Asian state of 7.4 million inhabitants, is facing particular health policy challenges: not only is the country the poorest of the former Soviet republics, but its capacity to deal with post-communist transition and economic crisis has been further undermined through civil war and large-scale migration. This paper, examining the introduction of the basic benefit package and formal co-payments, elucidates how international involvement in Tajikistan’s health sector has impacted on national health governance. Based on documentary sources and information provided by key informants, we find that external agencies have both strengthened and weakened national health governance. Although they have played a major part in supporting Tajikistan’s health sector, these efforts have often been fragmented, as donor coordination was at times less than optimal. A key challenge for national health governance is the limited technical and institutional capacity of the Ministry of Health and further efforts are needed to build national capacity. [Copyright &y& Elsevier]

Abstract: The North American Alzheimer''s Disease Neuroimaging Initiative (ADNI) was originally conceived as a study to develop markers of disease progression, but has also become a strong technological platform for the multi-centric collection of clinical data and imaging and biological markers. Because the ADNI platform was first imported in Europe, thanks to the pilot European ADNI, several ADNI-related initiatives have flourished, funded by the European Commission''s 7th Framework Programme, national governments, and the Alzheimer''s Association aimed at: (i) collecting fresh data ADNI style (FP7 AddNeuroMed, Innovative Medicine Initiative Pharma-Cog/European ADNI, Swedish ADNI, and Italian ADNI); (ii) developing standard operational procedures for the collection of markers (International Harmonization of CSF Abeta42 and tau, and European Alzheimer''s Disease Consortium–ADNI Harmonization of Hippocampal Volumetry); and (iii) developing infrastructures for the treatment of ADNI data (FP7 neuGRID and outGRID, and the French Centre pour l''Acquisition et le Traitement de l''Image). Although this fragmented scenario is not surprising given the structure of scientific funding in Europe, opportunities are being developed for high order networking and harmonization at the continental level (Joint Programming for Neurodegenerative Diseases). [Copyright &y& Elsevier]

Objective: To report clinical data from six centres in the US, Western Europe and Asia which have used phase-shift sound wave cancellation for treatment of predominant tone tinnitus, from the first treatment in 2000 to 2009. Method: Clinical data were obtained from New York City, London, Erie (Pennsylvania, USA), Antwerp, Grottamare (Italy) and Kuala Lumpur, and summarised. Results: A total of 493 patients were treated. A reduction in tinnitus volume (defined as >6 dB) was seen in 49-72 per cent of patients. [ABSTRACT FROM AUTHOR]

Since 2003, Cuba has dramatically expanded its decades-long program of international humanitarian missions. This article explores the political, economic, gender and racial equality dimensions of Cuba's international missions at various scales of analysis. At the macro-level, medical export services have in recent years replaced tourism as a source of hard currency in Cuba, with positive political and economic results. Their impacts on the domestic front are complex. In Cuba, health workers' devalued salaries in a dual economy are a substantive incentive to volunteer for missions abroad. The expansion of international medical missions is thus a means for health professionals--a large part of whom are female, black or mulato--who are otherwise disadvantaged in the dual economy, to improve their livelihoods. It is also re-structuring the delivery of health care in Cuban neighborhoods. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the author discusses the applicability of the World Health Organization healthcare system frameworks to Libya.

Abstract: A yearly TB case collection system, in the form of a register, was implemented by the former International Immigration Agency (OMI) and continued by the National Agency for Foreigners and Immigrants (ANAEM). Year after year, it gives remarkably coherent results. The 2006 inquiry concerned 653 cases with a strongly male sex ratio. This male trend is sharply more marked than in the control samples in “given week” studies. The 653 cases were distributed in 440 sequel cases (62.9%) and 143 evolutive cases (21.9%), (unknown: 15.3%). The populations investigated during the “given week” and for the register differ strikingly: in their age distribution: the populations investigated for the register were much younger, especially those with contagious forms; by their geographical origin: sub-Saharan Africans and Asians were strongly overrepresented even more for contagious tuberculosis; in their mode of entrance to France as legal immigrants: family patterns prevail, students are very under represented. In 88.6% of the cases, the screening was based on radiology alone and in 8.2% of the cases radiology was correlated to the clinical examination. In 19% of the cases, the diagnosis of evolutive and contagious TB was proved after isolating BK. In 13%, the diagnosis was suggested by a treatment with two major ATB. The ratio sequel TB/contagious and evolutive TB has not changed much since 2001. [Copyright &y& Elsevier]

Chronic abacterial prostatitis (or prostatitis Category III according to the National Institutes of Health terminology) is subject to re-evaluation. Organizations such as the International Continence Society, the International Association for the Study of Pain and the European Association of Urology have been involved in a continuous endeavour to design a more accurate taxonomy system. The term prostate pain syndrome (PPS), as a subcategory of chronic pelvic pain syndromes, has recently been suggested as the most relevant. This condition is common, very bothersome and enigmatic. Symptoms are usually prolonged and, generally speaking, treatment results are unsatisfactory. During the last decade, research has focused on the distress caused by the condition, but although our knowledge has certainly increased there have been no real breakthroughs; controversies and many unanswered questions remain. Examples of pertinent issues are as follows: the criteria that need to be fulfilled for a diagnosis; the significance or lack of significance of leucocytes in expressed prostatic secretion; and the association between erectile dysfunction and PPS. The fundamental question remains: is the prostate really involved in the majority of men with PPS? This article focuses on some of the controversies. [ABSTRACT FROM AUTHOR]

This article argues that to advance the struggle for access to essential medicines, it is necessary to identify the global and local regimes that shape the rules that give impetus to particular policy options, while undermining others. In exploring the role of law and politics in this process, the author first outlines the globalization of a standardized, corporate-inspired, intellectual property regime. Second, the author uses the example of the HIV/AIDS pandemic to demonstrate how the stability of this new regime came under pressure, both locally and globally. Finally, it is argued that while the global HIV/AIDS pandemic and the social movements that emerged in response to government inaction have effectively challenged the TRIPS regime, this complex contestation has reached an unsustainable stalemate in which development aid, corporate, and non-governmental philanthropy is simultaneously providing increased availability to drugs while precluding a more lasting solution to the crisis of access to essential medicines in developing countries. [ABSTRACT FROM AUTHOR]

This article analyzes international law claims in human subject litigation, arguing that the failure of federal courts or Congress to oversee this kind of litigation by providing or recognizing a federal cause of action for research torts is an injustice. It is about two distinct and somewhat arcane areas of the law, international law and the law of human subjects research. Because they draw on different historical, social and conceptual frameworks, each has its own descriptive section in the article. In the first section, the author briefly describes international law and its place in the U.S. constitutional order. This section explains why international law claims are routinely rejected by the courts. In the second section, the author discusses the moral underpinnings of the research enterprise and explains how the values of science contradict the values of human rights and medicine. The author concludes that Congress or the judiciary should recognize the social magnitude of the research enterprise, the difference between the values of science and the values of medicine, and the meaninglessness of individual informed consent when considered on a population level. Citizens should be provided with a clearly defined cause of action for research harms to human subjects. [ABSTRACT FROM AUTHOR]

The Roll Back Malaria (RBM) partnership was established in 1998 to address the worldwide malaria burden through a new approach. It was founded by four multilateral agencies that were already committed to supporting malaria control: the United Nations Development Programme, the United Nations Children's Fund, the World Bank and the World Health Organization. In contrast to previous campaigns, RBM focuses on strengthening existing health services to ensure that malaria can be controlled through an integrated approach, rather than through creation and maintenance of a separate structure. Field experience of RBM is rarely documented in the open scientific literature, making it difficult to judge its success and apply lessons learned to other settings. This paper aims at improving on this by documenting experience of RBM support in Afghanistan during initial post-conflict reconstruction. From the analysis some recommendations emerged: (i) technical in-country support needs to be provided for a number of years, as short postings are likely to provide only temporary solutions and may fail to contribute towards medium or long-term development; (ii) the role and responsibilities of support staff need to be clear to all RBM partners; (iii) part of this role should be to act as focal point, in an attempt to improve on coordination and (iv) if possible, support staff should be seconded to the MoH, to avoid association of the RBM initiative with a specific international organization and to further the multi-sectorial partnership approach. [ABSTRACT FROM AUTHOR]

Severe Acute Respiratory Syndrome (SARS) is the first major international epidemic of the twenty-first century. In a few short months it spread to every continent, infected 8,096 people, and claimed the lives of 774. It hit older persons particularly hard; it killed 50 percent of the infected of that age category. The rate of plague's spread from one country to another has greatly increased as the globalization of the world's economy has produced rapid daily transportation of people, products, plants, animals, and, of course, microbes. Each day cities are at risk for the invasion of deadly infectious diseases. While international expert agencies such as the World Health Organization stand by to help fight outbreaks, ultimately, plagues are fought in the local community. I discuss two theses: (1) To successfully contain and fight a major epidemic the capacity of the community's health care system must be enhanced by its functional linkages to external expert and bridging organizations and systems of organizations: and (2) that the extent to which a community's health care system can draw on external expert and bridging organizations and systems is a function of the degree to which the political state in which the community is embedded facilitates (or fails to facilitate) those linkages. My focus is on Hong Kong and the cities of the People's Republic of China; they were at the epicenter of the SARS outbreak, and it was from them that the contagion spread to other countries. Findings show that plagues are not only matters of biology and health, but also matters of politics, power, and international relations. [ABSTRACT FROM AUTHOR]

Vaccines are among the most cost-effective interventions in health care, but economic factors may interfere with their optimal development and delivery in both industrialized and developing countries. For the United States, making the best use of available vaccines will require increasing the financing for vaccines via the public and private systems. For developing countries, innovative and promising approaches include pull mechanisms to establish predictable demand and push mechanisms such as targeted development programs. Partnerships between philanthropy and public resources have made progress in addressing gaps in vaccine financing and development for developing countries, but much remains to be done. [ABSTRACT FROM AUTHOR]

There are strong theoretical arguments for the creation of advance-purchase agreements to increase incentives for the development and production of vaccines for diseases concentrated in low-income countries. A Center for Global Development working group recently concluded that such agreements could be implemented successfully. We consider the practical economic and legal arrangements for such advance-purchase commitments. We identify several practical issues that we believe the public health and policy community should consider further in the design of an advance-purchase commitment. [ABSTRACT FROM AUTHOR]

El objetivo de este estudio era evaluar la prevalencia y los factores predicativos del tratamiento antidepresivo en una muestra transnacional diversa de pacientes de asistencia primaria. Método: En diversos centros de asistencia primaria de seis países (España, Israel, Australia, Brasil, Rusia y Estados Unidos) se identificó, mediante un proceso de selección dividido en dos fases a 1,117 pacientes con un trastorno depresivo en curso. Todos los pacientes completaron en la evaluación inicial una entrevista diagnóstica estructurada y determinadas medidas de síntomas de ansiedad, consumo de alcohol, enfermedades físicas crónicas comorbidas y factores que, según ellos, dificultaban el tratamiento. Se informó a los médicos de asistencia primaria si la entrevista del estudio había dejado entrever un posible trastorno depresivo en sus pacientes. A los 3 ya los 9 meses, los participantes comunicaron todos los servicios sanitarios (incluyendo la asistencia médica especializada y la medicación antidepresiva) que habían utilizado durante los últimos 3 meses. Resultados: En los seis centros, el porcentaje de pacientes que recibieron algún tratamiento farmacológico antidepresivo osciló entre un máximo del 38% de Seattle y un mínimo del 0 % de San Petersburgo; el porcentaje de individuos que recibieron cualquier asistencia especializada en salud mental osciló entre el 29 % de Melbourne y el 3 % de San Petersburgo. Las características de los pacientes no se relacionaron, sistemáticamente, con el hecho de haber recibido farmacoterapia o asistencia especializada en salud mental. El coste económico fue el inconveniente principal para recibir tratamiento antidepresivo; el porcentaje de pacientes que comunicaron este impedimenta osciló entre el 24 % de Barcelona y el 75 % de San Petersburgo. Condusiones: La detección de depresión y su notificación a los médicos no son suficientes para garantizar un tratamiento adecuado de la depresión. La probabilidad de tratamiento depende, en mayor medida, de las características de los sistemas sanitarios que de las características clínicas del paciente. Los condicionantes económicos son un obstáculo más importante que el estigma para recibir una asistencia adecuada. [ABSTRACT FROM PUBLISHER]

Background: Medical ethics has existed since the time of Hippocrates. However, formal training in bioethics did not become established until a few decades ago. Bioethics has gained a strong foothold in health sciences in the developed world, especially in Europe and North America. The situation is quite different in many developing countries. In most African countries, bioethics -- as established and practiced today in the west- is either non-existent or is rudimentary. Discussion: Though bioethics has come of age in the developed and some developing countries, it is still largely "foreign" to most African countries. In some parts of Africa, some bioethics conferences have been held in the past decade to create research ethics awareness and ensure conformity to international guidelines for research with human participants. This idea has arisen in recognition of the genuine need to develop capacity for reviewing the ethics of research in Africa. It is also a condition required by external sponsors of collaborative research in Africa. The awareness and interest that these conferences have aroused need to be further strengthened and extended beyond research ethics to clinical practice. By and large, bioethics education in schools that train doctors and other health care providers is the hook that anchors both research ethics and clinical ethics. Summary: This communication reviews the current situation of bioethics in Africa as it applies to research ethics workshops and proposes that in spite of the present efforts to integrate ethics into biomedical research in Africa, much still needs to be done to accomplish this. A more comprehensive approach to bioethics with an all-inclusive benefit is to incorporate formal ethics education into health training institutions in Africa. [ABSTRACT FROM AUTHOR]

The ongoing public health crisis associated with injection drug use highlights the failure of prohibitionist policies. In contrast, harm reduction approaches aim to protect and promote the health of drug users. Supervised injection facilities (SIFs) are one important component of this approach. This article considers the international legal implications of establishing SIFs. It argues that implementing trials of SIFs is an appropriate measure that states should take pursuant to their international legal obligations to realize progressively the right of their nationals to the highest attainable standard of health. It argues that international drug control treaties do not prevent such measures, as is commonly claimed. The authors conclude that successful trials in Europe and Australia should be emulated elsewhere, in accordance with states' international obligations. [ABSTRACT FROM AUTHOR]

Abstract: Historically, the Agency for International Development (AID) health budget has been closely tied to overall development spending. A large increase in the international health appropriations in 1984 broke this pattern. Investigation shows that active grass roots organizing and congressional lobbying are the most likely responsible factors in the increase. Maintenance and expansion of this success will require increased recognition of and participation in these activities by individuals and organizations involved in international health. INSET: Johnson Foundation Announces Grant Program on Adolescent Health. [ABSTRACT FROM AUTHOR]

This article reports results of a survey of 1,257 potential employers of US health professionals overseas, interviews with informants in international health, an analysis of career patterns of a small group of international health workers, and a review of numbers of health professionals trained in schools of public health for international health work. There are approximately 9,000 US health professionals in the international health field. Doctors (1,400), nurses (1,500) and adminstrators (900) are the largest groups. Church-related agencies (2,200 people), private voluntary agencies (1,700 people), and universities (1,000 people) are the largest employers. [ABSTRACT FROM AUTHOR]

A review of the field of human teratoepidemiology—the epidemiology of congenital malformations—is presented here along with a discussion of the importance of international collaboration in monitoring congenital malformations. Studies implicating various environmental teratogens such as drugs, industrial and agricultural chemicals, intrauterine infections, radiation and nutritional factors are discussed at some length as well as problems encountered in detecting human teratogenic agents. [ABSTRACT FROM PUBLISHER]

The article looks back on how a scrotum surgery was practiced in China. In 1827, Thomas Colledge opened an ophthalmic hospital in Macao. He was besetted by Chinese laborer Hoo Loo who was developing a scrotal tumor. Though Colledge was undertaking eye surgery, Chinese law did not allow scrotum surgery. Because of this, Colledge has referred him to his other colleagues and this proves that collaboration among practitioners has made the surgery possible.

The article discusses Haiti's cholera epidemic. Topics include the Haitian government's plans in 2013 to eradicate cholera within 10 years, the impact of Haiti’s continual lack of water and sanitation infrastructure on the country's ability to fight the disease, the introduction of cholera into Haiti by United Nations (UN) peacekeepers from Nepal at a compound near Mirebalais, in the aftermath of the January 2010 earthquake, and the work of U.S. medical aid group Partners In Health (PIH).

In this Viewpoint, Gostin and colleagues review recommendations developed by experts convened by Georgetown University on how the international community can respond to the 2018 Ebola outbreak in the Democratic Republic of Congo (DRC) in the midst of active conflict and insecurity from armed rebels. [ABSTRACT FROM AUTHOR]

The Busan partnership adopted at the 4th High Level Forum on Aid Effectiveness at the end of last year is a significant step forward towards the improvement of aid quality and the promotion of development. In particular, the inclusiveness achieved in Busan and the shift in discourse from 'aid effectiveness' to 'development effectiveness' are emblematic. However, key challenges still remain. Firstly, decision-making should be more bottom-up, finding ways to take into account the populations' needs and experiences and to enhance self-learning dynamics during the policy process. Today, it is particularly necessary to define what 'development' means at country level, according to the aspirations of particular categories of people and meeting operational and local expectations. Secondly, changes in language should be followed by a real change in mindset. Development stakeholders should further adapt their procedures to the reality of complex systems in which development interventions are being dealt with. [ABSTRACT FROM AUTHOR]

The article discusses efforts to fight cancer in the developing world. According to the author, cancer and other chronic diseases in the developing world have received little attention from global health advocates, but is beginning to be seen as a priority by some oncologists in Europe and the U.S. who are taking the time to improve cancer care in low- and middle-income countries. Topics include the creation of the Global Task Force on Expanded Access to Caner Care and Control in Developing Countries (GTF.CCC) by U.S. health officials, the debate regarding whether fighting cancer is the wisest use of scare global-health money, and cancer types for which experts acknowledge major progress can be made, such as breast cancer. INSET: Making Her Life an Open Book to Promote Expanded Care.

The article discusses the author's views about the challenges posed to trans-national governance by medical tourism related to unregulated stem cell treatments. The challenges include the need to regulate the safety and quality of stem cell bioproducts and determining when stem cell treatment claims become criminal fraud. The author argues that because the private market for stem cells crosses national borders, states must devise new methods of market governance in order to protect the public.

The authors examine the complex relations between international health aid and government health funding. They assess the factors which contribute to the so-called crowding-out effects by providing a few data about changes in international health aid and government health funding taken from the National Health Accounts. Among the factors that contribute to crowding-out effects are the move by governments to compensate or exceptional international generosity to the health sector and the spread of aid across several years.