SciDev.Net

This report highlights the key findings of the Health and Environment Linkages Initiative, set up by the WHO and UN Environment Programme to identify ways of integrating environment and health considerations into decision-making. The report outlines the ways in which health and environment linkages are usually defined and framed by policymakers, and describes the most common institutional and political barriers they face.

A review of formal impact assessment tools is given, along with a 'menu of options' for good practice application of impact assessment. The report highlights the importance of measuring the impacts of decisions made in terms that can be understood by policymakers. And it offers guidance on how to combine health and environment issues with economic considerations, describing real-world experiences from Jordan, Thailand and Uganda.

In 2005, the World Health Assembly called on WHO member states to tackle their growing rates of cancer by developing rigorous cancer control programmes. To help guide the process, the WHO developed a series of six modules that provide practical advice for programme managers and policy-makers on how to advocate, plan and implement effective cancer control programmes, particularly in developing countries.

Individual modules focus on planning; prevention; early detection; diagnosis and treatment; palliative care; and policy and advocacy. As of May 2008, all but the one on policy and advocacy have been published.

Worldwide, cancer kills more people than HIV/AIDS, malaria and TB put together. In developing countries where chronic diseases are now growing alongside infectious diseases, new strategies need to be developed.

This article outlines how to develop an effective cancer strategy in African countries on the basis of discussions at the recent African Cancer Reform convention. A cancer control plan clearly needs to take into account African countries' financial constraints and the authors outline six key essentials that would offer most health gain for money invested. These are: setting up cancer intelligence units to collect data on cancer incidence; controlling tobacco use; early diagnosis and prevention; offering treatment wherever possible; palliative care when treatment is no longer useful; and training and educating future generations of African oncologists.

Developed countries can offer crucial expertise and experience and collaborate on cancer information networks. Educating local communities about a disease that is relatively new but growing quickly will also be essential to stop it spiralling when many cancers are preventable or treatable when detected early enough.

In 2003, the Gates foundation infused new vigour into global health efforts by declaring that the 21st century's "grand challenges" included developing new vaccines and overcoming drug resistance. This new grand challenges initiative, launched by a collaboration of top global chronic disease experts, identifies priorities in tackling diseases like diabetes and cardiovascular disease, and explains in detail how research should be directed to meet each challenge (a challenge was defined as a critical barrier that if removed would help solve an important health problem).

To distill the range of opinions and priorities, the coordinators sought input from 155 stakeholders from different countries and disciplines. The initiative requires the participation of agencies like the WHO, individual governments, and non-governmental organisations as well as civil society and business if it is to succeed. The authors point out that the Gates initiative was linked to large funding, whereas this project will rely on multiple funding agencies to coordinate on these priorities.

Global health experts have watched with increasing alarm as the waistlines of people in developing countries have started to widen with the adoption of a "Western" lifestyle. Obesity is of such concern because of its heightened risks for other diseases, such as heart disease, cancer, and diabetes.

In developing countries, the number of people with diabetes is set to rise to 228 million by 2030 from 84 million estimated in 2000. The link between obesity and diabetes is so strong because obesity renders individuals unable to properly process glucose — about 90% of type 2 diabetes is due to being overweight. Obesity and diabetes also raise the risk for cardiovascular disease and kidney disease. Diabetic nephropathy was the most common cause of end-stage renal disease in 9 out of 10 Asian countries, say the authors, which could be deadly for countries unable to cope with the health repercussions.

The problem of antibiotic resistance is not easy to solve. In an attempt to tackle the issue, policies are being implemented with some successes. But the successes, however encouraging, will not be enough to stop the spread of resistance, say the authors. Advice to restrict the use of antibiotics so that they are prescribed only when necessary (e.g. not for viral infections just to placate a patient) is useful, say the authors, but, they say, we might need to go further. They make the controversial argument that antibiotic resistance might be stopped only by putting society before the individual, perhaps by banning antibiotic treatment for mild bacterial infections, or using them only for life-threatening illnesses. Everyone has the right to treatment, and acting against the patient's interest is not usually considered ethical. In some situations, however, what is good for an individual patient may not be good for the health of society as a whole, say the authors – drastic problems sometimes necessitate drastic solutions.

At WHO's behest, the Alliance for the Prudent Use of Antibiotics (APUA) undertook a review of 25 key reports on antibiotic resistance to identify areas of consensus in expert recommendations and to suggest ways of translating the advice into action.

The reports were chosen because they were highly cited in medical literature and had input from a wide variety of expert policy groups. The review authors separated their comments into five areas: surveillance; education of patients and providers; prevention; R&D; and antibiotic use in animals.

Education, says the review, needs to happen in medical schools and among the general public. Surveillance of antibiotic resistance occurs but is fragmented – coordinated local surveillance networks could do much to tackle resistance before it spreads. Healthcare institutions need committees to assess antibiotic use data and enforce infection control measures. In terms of use in animals, the review recommends that farmers prevent infection with good hygiene and not just antimicrobials, and calls for the reduced use of antibiotics as growth promoters.

This draft policy brief says African, Caribbean and Pacific (ACP) countries can use local natural resources — such as sugarcane and jatropha — to meet energy requirements through biofuels, curtailing dependence on fossil fuels.

But the authors warn of challenges for developing countries, including economic and trade issues, and suggest practical steps for meeting these. They also present various bioenergy options for households, such as BioGel — a solid wood-substitute made from low-grade ethanol mixed with a gelling agent.

The brief makes a number of policy recommendations, including national strategies for promoting and sustaining local demand, and more funding for local and regional ACP research.

Bhutan's National Adaptation Programme of Action was established to ascertain the country's particular vulnerabilities to climate change. The report gives a background on Bhutan's geography, economic situation, and climate trends, recognising its fragile mountain ecosystems, high dependency on monsoon rains for agriculture and hydropower, and the threat of glacier lake outburst floods as major climate change vulnerabilities.

The report describes the process of assessing vulnerabilities and then developing key adaptation strategies to address them. During consultations with political and community stakeholders, the best possible adaptation strategies were agreed upon and specific projects prioritised.

Strategies that will directly help vulnerable communities were chosen, including disaster management planning, the lowering of glacial lakes, watershed management, weather forecasting and flood damage prevention. A detailed profile of each project, its cost, and how it will be implemented is given.

The report recognises that without these measures, advancement in rural development, health, education and infrastructure made over the past 40 years will fast deteriorate.

This policy review gives an account of community forestry programmes in Nepal, and the influence that institutions and policy initiatives have had on their progress.

The report tracks the evolution of forest management policies, listing key existing legislation and the circumstances in which they were formulated. The report also covers the role institutions have had in implementing these policies.

The authors highlight the links between forest management and local people, and how forest management policies have impacted on their livelihoods and poverty levels.

The report also reviews ongoing projects, and suggests future trends in forest management policy.

The African Union (AU) developed the African Model Law on Safety in Biotechnology to help countries across the continent fulfil their obligations under the Cartagena Protocol on Biosafety and manage related issues.

The AU encourages the development of a common position on biosafety regulation (see AU Biosafety Project) across the continent. It does not have the authority to legislate on behalf of its members — but it promotes the Model Law as a framework for individual countries to use in creating their own laws and institutions.

The Model Law is being revised through an ongoing consultation process before submission to AU governments for possible adoption at national level.

This document attempts to inform and re-invigorate the debate on international technology transfer. The author, John H. Barton at Stanford School of Law, argues for the need to revisit this issue in line with the recognition that economic activities are more globalised than they were in the 1970s, and developing countries have greater scientific and technological capacities.

Barton focuses on three mechanisms of international technology transfer: the flow of human resources; the flow of public-sector technology support; and the flow of private technology from multinational corporations to developing countries. He recommends ways to remove barriers to each. He argues for greater mobility within, and globalisation of, the world’s scientific enterprise and reasserts an economic rationale for investing in public-sector research in developing countries.

The paper is likely to be useful to developing country policymakers interested in intellectual property rights, trade and development, as well as scientists and technologists more generally.

This analysis looks at lessons learnt from the 132 countries that participated in a UN and Global Environment Facility project supporting developing countries to design and implement national biosafety frameworks.

The report examines how participating countries tailored their regulations to meet national development priorities, policy contexts and legal and institutional frameworks. It describes different approaches to promoting public awareness, education and participation. A key message is the need to include all relevant stakeholders in the regulatory design and implementation.

This report may help other policymakers design biosafety regulations of their own and demonstrates how national priorities can be balanced against international obligations.

In June 2006, the UN emphasised the crucial role of food and nutrition in mitigating the effects of HIV/AIDS. This briefing paper explains how these issues are intertwined, and analyses why there has been little action in this area so far.

When food is scarce, women tend to get the smallest portion, leading them seek food elsewhere. This might include selling sex for food, putting them at a higher risk of HIV infection. Malnutrition can also weaken the immune system, making it easier to pick up infections but harder to get rid of them.

According to the report, health and food authorities each see it as the other's responsibility to integrate nutrition into HIV programmes. Donors and national policymakers have also been reluctant to support initiatives for integration. The first challenge, says the report, is raising awareness of the UN endorsement to secure action. Donors and governments should work to strengthen links between policies — the responsibility to reduce HIV/AIDS must not rest with the health sector alone. Finally, nutrition indicators should be included in clinical surveillance and reporting.

This briefing paper highlights the challenges in harmonising efforts to provide universal HIV/AIDS care. The 'Three Ones' principles, set in place to make the global fight against HIV/AIDS more efficient, advocate one action framework to coordinate all partners, one national AIDS authority and one country-level monitoring and evaluation system.

But, as the report points out, limited capacity in developing countries and a lack of incentives for donors to revise their practices are barriers to implementing these principles. There are also tensions between national ownership and accountability to donors.

By looking at countries that have been most successful in fighting the disease, such as Botswana and Malawi, the report outlines the keys to improving access to HIV/AIDS care.

Empowering national leadership is vital: what is needed are national HIV/AIDS strategies that have explicit priorities, are evidence-based, and link to other development plans. The multilateral donor community also needs to improve its delivery of technical support.

This article examines technological catch-up — how developing countries build up their technological capabilities to compete with industrialised nations — and the implications for donor agencies providing technical assistance.

It looks at how the literature on links between economic growth and technological change has evolved and discusses how the concept of technological catch-up emerged.

The authors argue that technical assistance programmes should focus on supporting education and training systems and fostering links between developing and developed countries' science and technology organisations.

This study examines technology transfer in the Nigerian oil industry, focusing on how the Nigerian National Petroleum Company acquires technologies and accumulates technological capabilities. It examines the training efforts used to master imported technologies and looks at how technical change affects the company's production and financial performance.

This paper examines how trade helps transfer knowledge to emerging economies. It reviews existing research and uses an analysis of patent statistics to track the spread of knowledge across 18 countries involved in bilateral trade.

The author argues that trade helps transfer technology across both countries and sectors, as seen by the positive relationship between trade activity and number of cites to foreign patents. But, he says, the extent to which knowledge is disseminated depends on cultural and historical proximities and the local technical capacity of acquiring countries.

This article examines the ways in which development aid is conceived and represented.

It presents the initial concept of technical assistance, and describes how it has shifted to include a more equal and interactive relationship between the giver and receiver in what is known as technical 'cooperation'.

The author also discusses the recent influence that knowledge management and innovation systems concepts have had on development assistance discourse and practice.

He adds that another shift is needed to incorporate situations where technology transfer stakeholders can jointly create knowledge, moving from a 'learning from' environment to a 'learning with' one.

This policy brief examines the importance of investment promotion agencies (IPAs), which endorse specific countries or locations to investors, in stimulating foreign direct investment (FDI). It discusses how policy incentives impact FDI and emphasises the importance of promoting investment opportunities in specific industries and businesses to match the interests of both the investors and the receiving country.

The brief describes the institutional characteristics of IPAs and considers how both their position within governments and their level of autonomy influence their ability to attract FDI. It concludes that an IPA's effectiveness depends on its political visibility, as well as on broader resources in the receiving country like market size, human capital and science and technology infrastructure.