SciDev.Net

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.

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 threat of climate change is perceived differently by different countries. This informal working paper, commissioned by the Organisation for Economic Co-operation and Development (OECD), comments on the key interactions between climate change and sustainable development in India. After outlining the risks climate change poses to India, it describes some of the national efforts that have been taken to reduce greenhouse gas emissions, including the promotion of renewable energy, carbon sequestration through afforestation programmes and price reforms for improving energy efficiency. The final section considers the options available to India for mitigating climate change and includes a cost-benefit analysis.