Subject(s)
Global Health/legislation & jurisprudence , HIV Infections , Health Policy , Social Responsibility , Global Health/statistics & numerical data , HIV Infections/diagnosis , HIV Infections/drug therapy , HIV Infections/epidemiology , HIV Infections/prevention & control , Humans , International Agencies/legislation & jurisprudence , International Agencies/organization & administration , United Nations/legislation & jurisprudenceABSTRACT
BACKGROUND: Consensus is growing that policy reform programmes by the International Monetary Fund (IMF)-an international organization mandated with upholding global financial stability and assisting countries in economic turmoil-produce adverse effects on public health. However, this consensus is unclear about which policies of these programmes underlie these effects. This article fills parts of this gap by examining the impact of four kinds of IMF policies (fiscal policy, public-sector employment, privatization of state-owned enterprises and price liberalization) on public-health expenditure, child vaccination and child mortality. METHODS: We conducted time-series cross-section analyses for up to 128 developing countries over the 1980-2014 period using observational data on health outcomes and IMF conditionality for different policy areas. IMF effectiveness research faces two types of potential biases: self-selection into IMF programmes and IMF policy conditions. We deployed instrumental variables in a seemingly unrelated regression framework to address both types of endogeneity, besides traditional remedies such as the use of fixed effects on countries and years. RESULTS: IMF policy conditions on public-sector employment are negatively related to child health. A change from the minimum to the maximum number of such policy conditions decreases vaccination (which ranges from 0 to 100) by 10.97% [95% confidence interval (CI): 1.16 to 20.79]. This effect is robust against different sets of control variables. In addition, IMF programmes increase the share of government expenditure devoted to public health in developing countries by 0.91 percentage points (95% CI: 0.15 to 1.68). CONCLUSIONS: These findings suggest that IMF policies-particularly those that require public-sector reforms-undermine health by weakening the capacity of states to deliver vaccination. Therefore, international financial institutions need to increase their awareness of the public-health impact of their policy prescriptions. Strengthening state capacity in times of economic crisis would ensure that increased health spending also delivers quality healthcare.
Subject(s)
Child Health/economics , Health Expenditures/trends , Health Policy/legislation & jurisprudence , International Agencies/legislation & jurisprudence , Vaccination/economics , Child , Child Mortality/trends , Cross-Sectional Studies , Developing Countries/economics , Government , Humans , Multivariate Analysis , Qualitative Research , United Nations/economics , United Nations/legislation & jurisprudenceABSTRACT
A review of the world-wide regulations pertaining to spices, extracts, and flavorings. The areas covered include (1) guidance documents from trade organizations as well as international and regional regulatory bodies, (2) decontamination of spices and herbs, (3) extraction solvents used to make spice and herb oleoresins, and (4) general flavoring regulations. Specific links and references to guidance documents and regulations have been provided where they have been published on government, organization, and trade association websites.
Subject(s)
Drug Contamination/prevention & control , Herbal Medicine/legislation & jurisprudence , Herbal Medicine/standards , International Agencies/legislation & jurisprudence , Spices/standards , Guidelines as Topic , International CooperationABSTRACT
The International Radiation Protection Association, IRPA, promotes the excellence in radiation protection by providing benchmarks of good practice, as well as enhancing professional competence and networking. In relation to emergency situations, including post-accident and recovery phases, a key issue is the ability of the system of protection to take a broader view of societal values, along with the need to develop processes which support and respect the dignity and well-being of the affected populations. Regarding the various situations of radiation exposure, IRPA's activities include aspects which can contribute to medical preparedness in radiation emergencies, focusing particularly on stakeholder engagement, radiation protection culture, the ethical dimensions of radiation protection and public understanding of risks. As it is a combination of science, experience, ethical and social values, radiation protection culture promotes radiation risk awareness in the different exposure situations, including the implementation of countermeasures in radiation and nuclear emergencies and post-accident situations, with attention also on medical countermeasures.
Subject(s)
Civil Defense/ethics , Emergencies , Ethics, Medical , Guidelines as Topic , International Agencies/organization & administration , Radiation Injuries/prevention & control , Radiation Protection/standards , Humans , International Agencies/legislation & jurisprudence , Organizational Objectives , Radiation Monitoring , Radiation Protection/legislation & jurisprudence , Radiation Protection/methodsABSTRACT
BACKGROUND: It has long been contested that trade rules and agreements are used to dispute regulations aimed at preventing noncommunicable diseases (NCDs). Yet most analyses of trade rules and agreements focus on trade disputes, potentially overlooking how a challenge to a regulation's consistency with trade rules may lead to 'policy or regulatory chill' effects whereby countries delay, alter, or repeal regulations in order to avoid the costs of a dispute. Systematic empirical analysis of this pathway to impact was previously prevented by a dearth of systematically coded data. METHODS AND FINDINGS: Here, we analyse a newly created dataset of trade challenges about food, beverage, and tobacco regulations among 122 World Trade Organization (WTO) members from January 1, 1995 to December 31, 2016. We thematically describe the scope and frequency of trade challenges, analyse economic asymmetries between countries raising and defending them, and summarise 4 cases of their possible influence. Between 1995 and 2016, 93 food, beverage, and tobacco regulations were challenged at the WTO. 'Unnecessary' trade costs were the focus of 16.4% of the challenges. Only one (1.1%) challenge remained unresolved and escalated to a trade dispute. Thirty-nine (41.9%) challenges focussed on labelling regulations, and 18 (19.4%) focussed on quality standards and restrictions on certain products like processed meats and cigarette flavourings. High-income countries raised 77.4% (n = 72) of all challenges raised against low- and lower-middle-income countries. We further identified 4 cases in Indonesia, Chile, Colombia, and Saudi Arabia in which challenges were associated with changes to food and beverage regulations. Data limitations precluded a comprehensive evaluation of policy impact and challenge validity. CONCLUSIONS: Policy makers appear to face significant pressure to design food, beverage, and tobacco regulations that other countries will deem consistent with trade rules. Trade-related influence on public health policy is likely to be understated by analyses limited to formal trade disputes.
Subject(s)
Economics/legislation & jurisprudence , Health Policy/legislation & jurisprudence , International Agencies , Noncommunicable Diseases/prevention & control , Policy Making , Humans , International Agencies/legislation & jurisprudence , International CooperationABSTRACT
No disponible
Subject(s)
Humans , Occupational Risks , Health Surveillance/legislation & jurisprudence , Health Surveillance/organization & administration , Mythology , Social Conformity , Social Norms , International Agencies/legislation & jurisprudence , International Agencies/organization & administrationABSTRACT
The recent classification by International Agency for Research on Cancer (IARC) of the herbicide glyphosate as a probable human carcinogen has generated considerable discussion. The classification is at variance with evaluations of the carcinogenic potential of glyphosate by several national and international regulatory bodies. The basis for the IARC classification is examined under the assumptions that the IARC criteria are reasonable and that the body of scientific studies determined by IARC staff to be relevant to the evaluation of glyphosate by the Monograph Working Group is sufficiently complete. It is shown that the classification of glyphosate as a probable human carcinogen was the result of a flawed and incomplete summary of the experimental evidence evaluated by the Working Group. Rational and effective cancer prevention activities depend on scientifically sound and unbiased assessments of the carcinogenic potential of suspected agents. Implications of the erroneous classification of glyphosate with respect to the IARC Monograph Working Group deliberative process are discussed.
Subject(s)
Carcinogens/toxicity , Glycine/analogs & derivatives , International Agencies/standards , Neoplasms/prevention & control , Animals , Carcinogenicity Tests , Glycine/toxicity , Humans , International Agencies/legislation & jurisprudence , Models, Animal , Neoplasms/etiology , GlyphosateABSTRACT
BACKGROUND: The sanction that an athlete receives when an anti-doping rule violation has been committed depends on the specific circumstances of the case. Anti-doping tribunals decide on the final sanction, following the rules of the World Anti-Doping Code. OBJECTIVES: To assess the athletes' degree of fault based on the length of sanctions imposed on them to feed policy-related discussions. METHODS: Analysing data from the results management database of the World Anti-Doping Agency for anonymous information of anti-doping rule violations in eight selected sports covering the years 2010-2012. RESULTS: Four out of ten athletes who committed an anti-doping rule violation received a suspension that was lower than the standard. This is an indication that tribunals in many instances are not convinced that the athletes concerned were completely at fault, that mitigating circumstances were applicable, or that full responsibility of the suspected violation should not be held against them. Anabolic agents, peptide hormones, and hormone modulators lead to higher sanctions, as do combinations of several anti-doping rule violations. CONCLUSIONS: This first analysis of information from the World Anti-Doping Agency's results management database indicates that a large proportion of the athletes who commit anti-doping rule violations may have done this unintentionally. Anti-doping professionals should strive to improve this situation in various ways.
Subject(s)
Athletes/legislation & jurisprudence , Athletes/statistics & numerical data , Doping in Sports/legislation & jurisprudence , Doping in Sports/statistics & numerical data , International Agencies/legislation & jurisprudence , International Agencies/statistics & numerical data , Mandatory Reporting , Social Control, Formal , Athletes/psychology , Data Interpretation, Statistical , Doping in Sports/psychology , Humans , Intention , Policy MakingSubject(s)
International Agencies/legislation & jurisprudence , Nuclear Medicine/legislation & jurisprudence , Radiation Exposure/legislation & jurisprudence , Radiation Protection/legislation & jurisprudence , Radiopharmaceuticals , Europe , Health Physics , Humans , Informed Consent/legislation & jurisprudence , Interdisciplinary Communication , Nuclear Medicine/standards , Precision Medicine , Radiation Dosage , Radiation Protection/standards , Radiation, Ionizing , Radiopharmaceuticals/administration & dosage , Radiopharmaceuticals/analysis , Radiopharmaceuticals/pharmacokinetics , Radiotherapy/standards , Spain , Tissue DistributionABSTRACT
How do International Monetary Fund (IMF) policy reforms-so-called 'conditionalities'-affect government health expenditures? We collected archival documents on IMF programmes from 1995 to 2014 to identify the pathways and impact of conditionality on government health spending in 16 West African countries. Based on a qualitative analysis of the data, we find that IMF policy reforms reduce fiscal space for investment in health, limit staff expansion of doctors and nurses, and lead to budget execution challenges in health systems. Further, we use cross-national fixed effects models to evaluate the relationship between IMF-mandated policy reforms and government health spending, adjusting for confounding economic and demographic factors and for selection bias. Each additional binding IMF policy reform reduces government health expenditure per capita by 0.248 percent (95% CI -0.435 to -0.060). Overall, our findings suggest that IMF conditionality impedes progress toward the attainment of universal health coverage.
Subject(s)
Health Expenditures/trends , Health Policy/legislation & jurisprudence , International Agencies/legislation & jurisprudence , Africa, Western , Cross-Sectional Studies , Developing Countries/economics , Government , Humans , Qualitative Research , United Nations/economics , United Nations/legislation & jurisprudenceABSTRACT
Impressive numbers of global and regional governmental and non-governmental organizations are working in the field of the marine environment and its resources. Many of these organizations operate within international legal frameworks ranging from comprehensive global conventions, such as the United Nations Convention on the Law of the Sea to regional agreements aiming at protection and development of regional seas. Characteristic for the management of these seas, both at the national and international level, is that sectoral approaches predominate. Over time, several initiatives have been taken to improve cooperation, coordination and integration to achieve greater coherence of policies and strategies between different organizations dealing with marine and maritime management, within and outside the United Nation system. However, the success has been limited. The weaknesses of international organizations depend fundamentally on problems at the national level. The international organizations are no stronger than their Contracting Parties allow them to be.
Subject(s)
Conservation of Natural Resources/legislation & jurisprudence , International Agencies/legislation & jurisprudence , International Cooperation/legislation & jurisprudence , Caribbean Region , Europe , Oceans and SeasABSTRACT
Work has been underway to increase the availability of parenting options for people living with and affected by HIV. One option, adoption, has not yet been explored in the literature. The study aimed to gain a better understanding of the potential of adoption for individuals/couples living with HIV in Ontario, and to assess potential structural barriers or facilitators that may impact their experience navigating the adoption system by conducting an environmental scan of adoption service providers in Ontario. A list of adoption service providers was compiled using the Ontario government's website. Information relevant to the study's measures was collected using service providers' websites. Service providers without websites, or with websites that did not address all of the research measures, were contacted via telephone to complete a structured interview. Online data extraction was possible for 2 and telephone surveys were completed with 75 adoption service providers (total n = 77). Most service providers reported that HIV status is not an exclusion criterion for prospective parents (64%). However, more than one-fifth of the participants acknowledged they were not sure if people with HIV were eligible to adopt. Domestic service providers were the only providers who did not report knowledge of restrictions due to HIV status. Private domestic adoption presented social barriers as birth parent(s) of a child can access health records of a prospective parent and base their selection of an adoptive parent based on health status. Adoption practitioners and licensees involved in international adoptions reported the most structural barriers for prospective parent(s) living with HIV, attributed to the regulations established by the host country of the child(ren) eligible for adoption. Although international adoptions may present insurmountable barriers for individuals living with HIV, public and private domestic adoption appears to be a viable option.
Subject(s)
Adoption , HIV Infections , Organizations/standards , Parents , Adoption/legislation & jurisprudence , Humans , International Agencies/legislation & jurisprudence , Internationality/legislation & jurisprudence , Ontario , Organizations/legislation & jurisprudence , Surveys and QuestionnairesABSTRACT
Committee 3 of the International Commission on Radiological Protection (ICRP) develops recommendations and guidance for protection of patients, staff, and the public against radiation exposure when ionising radiation is used for medical diagnosis, therapy, or biomedical research. This paper presents a summary of the work that Committee 3 has accomplished over the past few years, and also describes its current work. The most recent reports published by the Commission that relate to radiological protection in medicine are 'Radiological protection in cone beam computed tomography' (Publication 129), 'Radiation dose to patients from radiopharmaceuticals: a compendium of current information related to frequently used substances' (Publication 128, in cooperation with Committee 2), 'Radiological protection in ion beam radiotherapy' (Publication 127), 'Radiological protection in paediatric diagnostic and interventional radiology' (Publication 121), 'Radiological protection in cardiology' (Publication 120), and 'Radiological protection in fluoroscopically guided procedures outside the imaging department' (Publication 117). A new report on diagnostic reference levels in medical imaging will provide specific advice for interventional radiology, digital imaging, computed tomography, nuclear medicine, paediatrics, and hybrid (multi-modality) imaging procedures, and is expected to be published in 2016. Committee 3 is also working on guidance for occupational radiological protection in brachytherapy, and on guidance on occupational protection issues in interventional procedures, paying particular attention to the 2011 Commission's recommendations on the occupational dose limit for the lens of the eye (Publication 118). Other reports in preparation deal with justification, radiological protection in therapy with radiopharmaceuticals, radiological protection in medicine as related to individual radiosusceptibility, appropriate use of effective dose (in cooperation with other Committees), and guidance for healthcare practitioners on radiological and patient protection. Committee 3 has also suggested specific priorities for research on radiological protection in medicine to the Commission.
Subject(s)
International Agencies/organization & administration , Occupational Exposure , Radiation Protection/standards , Radioisotopes , Humans , International Agencies/legislation & jurisprudence , Radiation ExposureABSTRACT
The focus of the work of Committee 2 of the International Commission on Radiological Protection (ICRP) is the computation of dose coefficients compliant with Publication 103 A set of reference computational phantoms is being developed, based on medical imaging data, and used for radiation transport calculations. Biokinetic models used to describe the behaviour of radionuclides in body tissues are being updated, also leading to changes in organ doses and effective dose coefficients. Dose coefficients for external radiation exposure of adults calculated using the new reference phantoms were issued as Publication 116, jointly with the International Commission on Radiation Units and Measurements. Forthcoming reports will provide internal dose coefficients for radionuclide inhalation and ingestion by workers, and associated bioassay data. Work is in progress to revise internal dose coefficients for members of the public, and, for the first time, to provide reference values for external exposures of the public. Committee 2 is also working with Committee 3 on dose coefficients for radiopharmaceuticals, and leading a cross-Committee initiative to give advice on the use of effective dose.
Subject(s)
International Agencies/organization & administration , Radiation Dosage , Radiation Protection/standards , Radiation, Ionizing , Radioisotopes , Humans , International Agencies/legislation & jurisprudence , Models, Theoretical , Phantoms, Imaging , Radiation Exposure/analysis , Radiation Monitoring/instrumentation , Radioisotopes/analysis , Risk AssessmentABSTRACT
This paper does not necessarily reflect the views of the International Commission on Radiological Protection. The author passed away on 13 November 2015.Committee 1 of the International Commission on Radiological Protection (ICRP) addresses issues pertinent to tissue reactions, risks of cancer and heritable diseases, radiation dose responses, effects of dose rate, and radiation quality. In addition, it reviews data on the effects of radiation on the embryo/fetus, genetic factors in radiation response, and uncertainties in providing judgements on radiation-induced health effects. Committee 1 advises the Main Commission on the biological basis of radiation-induced health effects, and how epidemiological, experimental, and theoretical data can be combined to make quantitative judgements on health risks to humans. The emphasis is on low radiation doses, in the form of detriment-adjusted nominal risk coefficients, where there are considerable uncertainties in terms of the biology and the epidemiology. Furthermore, Committee 1 reviews data from radiation epidemiology studies and publications on the molecular and cellular effects of ionising radiation relevant to updating the basis of the 2007 Recommendations published in ICRP Publication 103 This paper will provide an overview of the activities of Committee 1, the updated work of the Task Groups and Working Parties, and the future activities being pursued.
Subject(s)
Dose-Response Relationship, Radiation , International Agencies/organization & administration , Radiation Injuries/prevention & control , Radiation Protection/standards , Radiation, Ionizing , Humans , International Agencies/legislation & jurisprudence , Risk AssessmentSubject(s)
Cooperative Behavior , International Agencies/organization & administration , International Cooperation , Organ Transplantation , Tissue and Organ Procurement/organization & administration , Americas , Education, Medical, Graduate/organization & administration , Europe , Health Policy , Humans , International Agencies/legislation & jurisprudence , International Cooperation/legislation & jurisprudence , Models, Organizational , Organ Trafficking/prevention & control , Organ Transplantation/education , Organ Transplantation/legislation & jurisprudence , Policy Making , Tissue and Organ Procurement/legislation & jurisprudenceABSTRACT
Commission 1 of the International Commission on Radiological Protection considers the risk of induction of cancer and heritable disease (stochastic effects) together with the underlying mechanisms of radiation action. Committee 1 also considers the risks, severity, and mechanisms of induction of tissue/organ damage and developmental defects (deterministic effects). The Committee was significantly revamped in 2013 and last met in Abu Dhabi in October 2013. Committee 1 evaluated progress on two ongoing task groups: Task Group 64 'Cancer Risk from Alpha Emitters' and Task Group 75 'Stem Cell Radiobiology'. Following approval from the Main Commission, Committee 1 established two new task groups: Task Group 91 'Radiation Risk Inference at Low Dose and Low Dose Rate Exposure for Radiological Protection Purposes' and Task Group 92 'Terminology and Definitions'. This article presents a synopsis of the current status of Committee 1 and outlines the tasks that Committee 1 may undertake in the future.
Subject(s)
International Agencies/organization & administration , Radiation Protection , Radiation, Ionizing , Humans , International Agencies/legislation & jurisprudence , Radiation Protection/legislation & jurisprudenceABSTRACT
Over many years, Committee 2 of the International Commission on Radiological Protection (ICRP) has provided sets of dose coefficients to allow users to evaluate equivalent and effective doses for intakes of radionuclides or exposure to external radiation for comparison with dose limits, constraints, and reference levels as recommended by ICRP. Following the 2007 Recommendations, Committee 2 and its task groups are engaged in a substantial programme of work to provide new dose coefficients for various conditions of radiation exposure. The methodology being applied in the calculation of doses can be regarded as state-of-the-art in terms of the biokinetic models used to describe the behaviour of inhaled and ingested radionuclides, and the dosimetric models used to model radiation transport for external and internal exposures. The level of sophistication of these models is greater than required for calculation of the protection quantities with their inherent simplifications and approximations, which were introduced necessarily, for example by the use of radiation and tissue weighting factors. However, ICRP is at the forefront of developments in this area, and its models are used for scientific as well as protection purposes. This overview provides an outline of recent work and future plans, including publications on dose coefficients for adults, children, and in-utero exposures, with new dosimetric phantoms in each case. The Committee has also recently finished a report on radiation exposures of astronauts in space, and is working with members of the other ICRP committees on the development of advice on the use of effective dose.
Subject(s)
International Agencies/organization & administration , Radiation Protection/standards , Radiation, Ionizing , Humans , International Agencies/legislation & jurisprudenceABSTRACT
According to the 2011-2017 strategic plan, Committee 3 develops recommendations and guidance for protection of patients, staff, and the public against radiation exposure when ionising radiation is used for medical diagnosis, therapy, or biomedical research. This paper presents an overview of the work that Committee 3 has accomplished in recent years and describes its current work. The International Commission on Radiological Protection reports dealing with radiological protection in medicine from 2000 to the present cover topics on education and training in radiological protection; preventing accidental exposures in radiation therapy; doses to patients from radiopharmaceuticals; radiation safety aspects of brachytherapy; release of patients after therapy with unsealed radionuclides; and managing radiation dose in interventional radiology, digital radiology, computed tomography, paediatrics, cardiology, and other medical specialties. Current work deals with radiological protection in ion beam therapy, occupational protection in brachytherapy, justification in imaging, radiological protection in cone-beam computed tomography, occupational protection in interventional procedures, diagnostic reference levels for diagnostic and interventional imaging, and an update of an earlier publication on doses to patients and staff from radiopharmaceuticals. Committee 3 is also involved in preparation of a document on effective dose and its use in medicine.
Subject(s)
International Agencies/organization & administration , Occupational Exposure , Radiation Protection/standards , Radioisotopes , Environmental Exposure , Humans , International Agencies/legislation & jurisprudenceABSTRACT
The recently created Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES), originally focused on multilateral and global issues, is shifting its focus to address local issues and to include in its assessments local stakeholders and indigenous and traditional systems of knowledge. Acknowledging that full biodiversity governance is unavoidably rooted in participation of local actors and their problems and knowledge, we suggest that to deal successfully with the complexity and diversity of local issues, including indigenous knowledge systems, IPBES must recognize a key role of local institutions.