The effects of the current war on the Iraqi population should deeply
shock anyone with a minimum of humanitarian concern (regardless of their
political and ideological convictions). The institutional fragility for
dealing with the war and its dire consequences is also extremely
troubling. It is painful to observe the deplorable bankruptcy of channels
for intermediation of such manifestations of unavoidably insane traits...
The effects of the current war on the Iraqi population should deeply
shock anyone with a minimum of humanitarian concern (regardless of their
political and ideological convictions). The institutional fragility for
dealing with the war and its dire consequences is also extremely
troubling. It is painful to observe the deplorable bankruptcy of channels
for intermediation of such manifestations of unavoidably insane traits in
the human species.
Under such crucial circumstances, the international community must
quickly mobilize the largest possible number of health professionals to
develop ways to publicize, deal with, and minimize the intense suffering
resulting from another inhumane war. The current initiative by the JECH is
immediately legitimized by the present situation’s urgency. Both the text
provided by Barr & Miranda and further comments by Baum, Tao et al. and
Milio explores properly this worrying 'zeitgeist'.
To orient ourselves in this grievous moment, we must try to
understand this situation in order to devise possibilities for action with
some expectation of effectiveness. Beyond the health sphere itself, we may
very well assume the signs of a major crisis in our civilization, the
result of the political and economic dynamics dating to the last decades
of the 20th century.
Along with increasing affluence in certain regions of the so-called
First World, we observe the hegemony of global volatile capitalism and its
glaring ethical flaws, the expansion of economic inequalities affecting
the economically weaker countries, the impoverishment of social relations
(increasingly affected by violence and insecurity), and the alarming
outburst of extremist manifestations. All of this could already be
glimpsed before the tragic events of 9-11-2001. The current abominable war
in Iraq appears as a paroxysmal, depressing emblem of a hazardously
uncontrolled process.
A characteristic of the crisis is the coexistence of an impressive
local rationality and an alarming global irrationality. Unfortunately, one
of the apparent symptoms of this statement appears precisely in the field
of public health with the ‘timely’ link – viewed as ‘favorable’ – between
two terrible current events. Consider the following, published on the
ABCnews.com website on March 30, 2003, by Peter N. Spotts of the The
Christian Science Monitor: “As public-health officials worldwide ended a
second week of efforts to quash the spread of a previously unknown illness
traced to Asia, bioterrorism specialists were watching their progress for
lessons that might be applied to the aftermath of a bioterror attack (…).
The outbreak of severe acute respiratory syndrome, or SARS, has shown that
‘pathogens do not recognize political boundaries,’ says David Heyman, a
bioterrorism specialist at the Center for Strategic and International
Studies in Washington, DC ‘You need a global response to bioterrorism,
not just a domestic one.’ In that respect, he adds, ‘This is a great test
case.’”[1]
In fact, the suggestion that two tragic and alarming foci of extreme
insecurity provide a ‘logically’ advantageous opportunity only makes sense
contextually in light of an absurd lack of overall meaning. Perhaps a good
point of departure would be for us to not take satisfaction in accepting
such precarious localized coherence, that is, to not lose sight of the
fact that more is needed to disarm the disastrous escalation in the
apparent current global lack of meaning.
While media attention is captured by war, national priorities are being locked-in through arcane maneuvering making the ten-year Federal budget plan, further entrenched through Executive Orders, regulations, and court appointments that will have fundamental effects on the tenor and direction in the US and in the world. Dramatic changes could not have been made without the fears from September 11, 2001 terrorism and the militar...
While media attention is captured by war, national priorities are being locked-in through arcane maneuvering making the ten-year Federal budget plan, further entrenched through Executive Orders, regulations, and court appointments that will have fundamental effects on the tenor and direction in the US and in the world. Dramatic changes could not have been made without the fears from September 11, 2001 terrorism and the military road taken by the Administration to combat it.
The budget casualties are the majority of Americans, especially the less advantaged and their children's generation, as well as countless others in the world community.
The proposed package requires over $500 billion cut primarily from health, education, child, environmental, and income security programs over 10 years. Defense has the largest increase, rising to $500 billion in 2009 to maintain troops in 85 countries-not counting $20-$80 billion yearly for occupation and reconstruction in Iraq. Child care cuts will mean that 268,000 fewer children will be served in 2013 than today. Food stamp cuts will mean the amount will drop from 91 to 84 cents per meal; currently, only 20 of 33 million. eligible people get food stamps. The net fiscal effect is to add almost $2 trillion to projected deficits in the next decade.
The central unspoken strategy of the Plan devolves policy and financing to states and the corporate and religious private sector while centralizing military and security control; deregulates commercial and religious groups but not other non-profits and labor unions, and defunds Federal government programs by reducing revenues to force program cuts. Meanwhile, wealth and power are being concentrated. Some examples:
The effect of huge new tax cuts will make almost all investment income tax exempt, leaving wage earners to pay almost all taxes. Half of taxpayers get less than $100 in cuts; those earning $1 million get over $90,000.
The de-unionization of 170,000 jobs at the new Dept. of Homeland Security will allow staff reductions and "outsourcing" of DHS tasks to nonunion commercial firms.
Enforcement funds in the Dept. of Labor are to monitor new regulations requiring unions to itemize every expense above $2000 spent on organizing and strike services, lobbying or political activities
Enforcement funds for the Office of Safety and Health Administration are cut, limiting monitors of violations of minimum wage, family and medical leave, and child labor laws
Dept. of Housing & Urban Development newly requires "equal treatment" of faith-based organizations for grant making under a new Presidential Order, and unprecedently allows partial funding of construction of facilities to be used for both religious and government-funded purposes.
Funds are being re-routed from international agencies and placed under Federal executive control. Although $10 billion in new AIDS money is budgeted for the decade, there is to be less than $1 billion in 2004, but a half billion is cut from international child health programs. AIDS monies are to be administered by the US, while only $200 million will go to the Global Fund for AIDS, which has a delivery system but is short of over $2 billion in promised funds from donor nations.
The Global Gag Rule, which restricts foreign voluntary organizations who need US birth control funds from using their own, non-US funds to provide legal abortion services, has been expanded to include programs that support maternal and child health, sexually-transmitted diseases, AIDS, and violence-against-women services.
The Administration has withdrawn $34 million from UN Family Planning Association and added $33 million to its domestic abstinence-until-marriage "sex-education" program in the welfare program
Information output by the Dept of Health and Human Services is now centralized under a new Deputy Secretary , a longtime religious conservative who did not like CDC's health education materials about gay sex and portrayed condoms for disease prevention; he ordered them removed from the Website.
The proffered new America augurs less economic, health, welfare, and environmental security, less secure civil liberties, less public accountability, and at best, uncertain international relations, law, trade and global finance.
Two important events, the war in Iraq and the outbreak of Severe Acute Respiratory Syndrome (SARS), have hit the headlines recently. Although seemingly independent events, they are both very important public health problems and will have a long term impact on global public health
policy.[1,2]
I would like to thank JDA Barr and JJ Miranda for their special article: "Iraq: Time
to focus our response" and JECH for provid...
Two important events, the war in Iraq and the outbreak of Severe Acute Respiratory Syndrome (SARS), have hit the headlines recently. Although seemingly independent events, they are both very important public health problems and will have a long term impact on global public health
policy.[1,2]
I would like to thank JDA Barr and JJ Miranda for their special article: "Iraq: Time
to focus our response" and JECH for providing a platform. I
agree - on that point, the role of the medical profession is now more important than ever, even if its involvement with politics is controversial. For some researchers, medicine may be nothing more than finding the cause of disease and method of treatment, but public health is important too. The war in Iraq and outbreak of SARS are good examples.
At first glance these two events may appear very different but they have some important characteristics in common which can help us better understand how we should face these problems in the future.
The war in Iraq is partly due to the impact of the 9/11 terrorism attack on America. The US government missed some clues to prevent this disaster and now President Bush wants to defend the world from grave danger without support.[3] In the case of the outbreak of SARS, China has been criticised for being slow to acknowledge the disease and warn its neighbours [4,5]. But the Chinese Health Minister argued: "As SARS is not on the list stipulated in China's Prevention and Control Law of Epidemics, we have to collect enough information about the appraisal of the epidemic to establish a new epidemic reporting method and regulation".[6] That is to say, the disease is too new to be reported on in the medical literature.
In his book, "Guns, Germs, and Steel: The Fates of Human Societies", Jared Diamond wrote that wars and deadly disease are the ajor risk factors for public health.[7] For the two events discussed here, no-one doubts that the US will win the war in Iraq and also that SARS will be brought under control. But no-one can say that there will be no more wars, terrorism attacks, or fatal disease outbreaks forever. So we should all make an effort and work together to meet these threats and not spend our time censuring each other.
One of the defining features of public health is a commitment to collective action to protect populations as a whole. The current global peace movement is an expression of public health advocacy against a supremely unhealthy action - the invasion and waging of war on another nation. In February 2003 millions of people around the world marched against the war on Iraq. In Adelaide, a city of some 1.1 million in Southern Australi...
One of the defining features of public health is a commitment to collective action to protect populations as a whole. The current global peace movement is an expression of public health advocacy against a supremely unhealthy action - the invasion and waging of war on another nation. In February 2003 millions of people around the world marched against the war on Iraq. In Adelaide, a city of some 1.1 million in Southern Australia 100,000 people joined the march to the State Parliament, representing about 9% of the city's population. (See photos: Photo 1 and Photo 2) The high number of protesters reflects a very active local peace campaign (see http://www.nowar-sa.net). Like other marchers the crowd contained people from all political persuasion, all ages and religions. The world wide protest felt many feel that there was a global community that wants to make health not war. This kind of collective action warms the hearts of those involved and reminds us all that there are alternatives to war that will be much better for our collective health.
The main reasons people were opposing war in the February 2003 protests can be summarised as:
The process of weapons inspection by the United Nations was far from exhausted and there is a widespread belief that the UN should be the forum to resolve international disputes not unilateral action. War should be an absolute last resort.
While everyone would agree that Saddam Hussein is a tyrant, people did not believe invasion by a foreign power is a way to remove a dictator.
There is no evidence of a link between Al Qaida and the Iraqi regime.
Suspicion about the USA's motivation for the war with placards proclaiming messages such as "No blood for oil".
The inevitability of significant numbers of civilian casualties, both through warfare itself and through disease following homelessness, shortages of food and water and infrastructure destruction.
A reluctance for Australia to be involved in another US war. For many the Iraqui conflict has many similar hallmarks to Vietnam.
The government had no mandate for war because a majority of Australians were opposed to war without a UN resolution.
Takano and colleagues’ paper [1] on the association between proximity
to ‘walkable green spaces’ and longevity in senior citizens in Tokyo will
be of interest to those involved in promoting health in its broadest
sense. However, this study has a number of methodological limitations,
the authors draw conclusions that are not supported by their results and
the study does not merit the largely uncritical r...
Takano and colleagues’ paper [1] on the association between proximity
to ‘walkable green spaces’ and longevity in senior citizens in Tokyo will
be of interest to those involved in promoting health in its broadest
sense. However, this study has a number of methodological limitations,
the authors draw conclusions that are not supported by their results and
the study does not merit the largely uncritical responses published
elsewhere in the Journal.[2-5]
Only 3144 individuals of 7362 contacted (42.7%) agreed to take part
in the survey. This response rate leads to the potential for substantial
selection bias which is not discussed by the authors.
The questions used to determine proximity of participants to
“walkable green spaces” are not explicitly described and their
appropriateness can not be determined. Asking if participants lived
“near” to a place for taking a stroll will lead to highly subjective
answers. In particular, those who do take strolls may be more likely to
report proximity to such places merely because they are more aware of
them. An objective measure of proximity to green spaces and a clear
definition of what constitutes ‘green’ would have significantly
strengthened the study.
Takano et al. claim that they make adequate control for socio-economic
factors by including a measure of “monthly living expenses”. However, it
is not clear how this is calculated and whether it is an appropriate and
recognised measure of socio-economic status in Japan.
The measure of functional status used – whether participants required
help to get out of bed – is simplistic. Considering the number of
validated measures of functional status available, the use of this measure
requires further justification.
In view of these limitations, it is clear that a number of the
conclusions drawn in the paper are unfounded. The authors find an
association between their measures of proximity to green spaces and
longevity in this cohort. This is not evidence of causation and certainly
not evidence that “walkable green…spaces near the residence significantly
and positively influenced five year survival”.
As discussed above, socio-economic factors may not have been
adequately controlled for. The association reported may not remain “even
after excluding the influence of socioeconomic conditions”. In
particular, it is possible that more affluent individuals, who generally
live longer,[6] are also likely to live in ‘greener’ neighbourhoods.
Finally, the authors suggest throughout this paper that proximity to
green spaces has a positive influence on longevity via an effect on
physical activity. However, no data is supplied on the physical activity
of participants. Such data would have added substantially to the authors
ability to conclude that such a causal chain exists.
Whilst this paper is certainly novel, the authors’ conclusions should
not be accepted uncritically. Readers and commentators should not allow
their personal convictions that green spaces must be a public good to
overshadow their critical appraisal skills. Evidence based policy making
is at least as important as evidence based medicine.[7]
References
(1) Takano T, Nakamura K, Watanabe M. Urban residential environments
and senior citizens' longevity in megacity areas: the importance of
walkable green spaces. Journal of Epidemiology & Community Health
2002;56:913-918.
(2) Baum F. Health and greening the city. Journal of Epidemiology &
Community Health 2002;56:897-898.
(3) Ashton J. Health and greening the city. Journal of Epidemiology &
Community Health 2002;56(896).
(4) McKenna J. Health and greening the city. Journal of Epidemiology &
Community Health 2002;56:896.
(5) Duhl L. Health and greening the city. Journal of Epidemiology &
Community Health 2002;56:897.
(6) Acheson D. Report of the independent enquiry into inequalities in
health . London: Stationary Office, 1998.
(7) Cummins S, Macintyre S. "Food deserts" - evidence and assumption in
health policy making. British Medical Journal 2002;325:436-438.
A recent article in Nature magazine Polls take heavy toll -- Suicide rises under
conservative rule, 20 September 2002 discusses the correlation of conservative governmental
rule, and suicide, in England and Australia, over the
last hundred years, and cites the article by Page A et al. as one of...
A recent article in Nature magazine Polls take heavy toll -- Suicide rises under
conservative rule, 20 September 2002 discusses the correlation of conservative governmental
rule, and suicide, in England and Australia, over the
last hundred years, and cites the article by Page A et al. as one of
two, in footnotes, in confirmation/support of this
finding.
Such a finding has immediately made its way into the
political pages here in the States, trumpted by the
Liberals as proof of the failings of conservative
rule. (The labels are different here in the US).
I differ with your conclusions, and support this
differing by referring you, on an inquiry basis,
between professionals, to: http://www.vakkur.com/psy/sui_medscape_excerpts.htm
This discusses suicide trends in many countries, and
shows that peaks occurred in the 1980s worldwide, at
least data-wide, more widespread than conservative
rule in UK/ Australia. Perhaps the studies findings
should be qualified accordingly.
Table 2 International General Population Suicide
Rates (fatalities per 100,000/year): 1970-1998
Country
1970
1975
1980
1985
1988
1994-98
Hungary
34.8
38.4
44.9
44.4
41.3
32.9
Finland
21.3
25.0
25.7
24.6
28.4
24.7
Belgium
16.5
16.2
21.7
23.1
22.7
21.3
Switzerland
18.6
22.5
25.7
25.0
22.4
20.6
Austria
24.2
24.1
25.7
27.7
24.4
19.6
France
15.4
15.8
19.4
22.6
20.7
19.3
Denmark
21.5
24.1
31.6
27.7
26.0
17.1
Czechoslovakia
25.2
21.9
20.0
18.9
17.7
15.9
Germany
21.3
20.9
20.9
20.7
17.6
14.4
Poland
11.2
11.3
10.7
13.3
12.2
14.4
Sweden
22.3
19.4
19.4
18.2
18.9
14.3
Norway
8.4
9.9
12.4
14.0
16.8
12.7
Ireland
1.8
4.7
6.3
7.8
7.5
11.4
United States
11.2
12.2
12.1
12.0
11.2
11.3
Iceland
13.2
10.1
10.5
13.2
14.0
10.1
Netherlands
8.1
8.9
10.1
11.3
10.3
10.1
Spain
4.2
3.9
4.4
6.5
7.2
8.6
Italy
5.8
5.6
7.3
8.3
7.7
8.3
United Kingdom
7.9
7.5
8.8
9.0
8.7
7.1
Portugal
7.5
8.5
7.4
9.7
8.0
5.7
Greece
3.2
2.8
3.3
4.1
4.1
3.6
Overall
14.5
14.9
16.6
17.2
16.6
14.3
Data are adapted from Mdkinen and Wasserman D, 1997
[71]; American
Association of Suicidology, Data for 1998[67]; and
WHO, 2001.[70]
Rates are ranked in descending order for the most
recent year.
MH- England (UK) is third from the bottom, the least
suicidal
societies are at the bottom, and Hungary Finland
Belgium and
Switzerland are at the top. I find it difficult to
classify these
four countries as MORE consevative, and England,
Portugal and Greece
as less conservative.
MH - Over time, starting with England, we see a peak
at the 1985
point, 9.0. Portugal and Greece also have this peak,
as does the
overall; Also peaking are, from the top, Belgium,
Swtzerland
(slightly more 1980), Austria, France, (Denmark in
1980), Czeckos
(1980), Germany, Poland, Sweden (1980), Norway,
Ireland, US, Iceland,
Netherlands, -- SPAIN is on a climb Italy is
plateauing, UK has
the spike these authors attributed to their own
policies, and at the
low end, the suicide immune societies, the 1985 data
also show
increases in this mid 1980s time period.
MH - Whatever was happening, it wasn't the Tories.
Britannia does not
still rule the waves.
MH- Further, in this article, regional differences are
noted within
countries, and the China Japan differences are noted.
Chine is pretty
high. Buncha Tories in rice paddies, eh, To Be Rich Is
Glorious.
"National and regional suicide rates vary widely. They
recently
averaged 14.5/100,000 per year internationally,
varying at least 10-
fold between countries. Rates per 100,000 population
ranged from 3.6
in Greece to 33 in Hungary, with intermediate rates of
10-20 in
central and northern Europe and the United States
(Table 2).
[67,70,71] In the United States, the annual rate per
100,000 has held
steady at about 11 in recent decades, but with wide
state and
regional differences, ranging from 22.7 in Nevada to
7.2 in New
Jersey and from 17.2 in the Mountain region to 11.3 in
the Pacific
region.[67]
Annual suicide rates in Asian countries include
300,000 reported
suicides in China (32.3/100,000), the only country
with a greater
risk among women than men.[72] In Japan, there are
about 20,000
suicides/year (17/100,000).[73]
[Editorial note: China's suicide rate (32.3) is
greater than Japan's
(17/100k) despite publicity of Japan's suicide rate;
both are higher
than the US rate (11/100k).]"
Thus the matter is not as simple as polls and pols.
Peruvians and Nepali people have something to share -
endless social violence. Nepal does not have a colonial ruler and so often does not have access to the modern world.
Our community has undergone very tramatic experiences of soldiers dying and rebels on the screen every day. This may account for the recent sharp rise in mental disorders.
Peruvians and Nepali people have something to share -
endless social violence. Nepal does not have a colonial ruler and so often does not have access to the modern world.
Our community has undergone very tramatic experiences of soldiers dying and rebels on the screen every day. This may account for the recent sharp rise in mental disorders.
The method applied in the article by JJ Miranda and E Vílchez is very
impressive and informative. We and our friends in the Psychiatry Department, would like to keep in touch with the authors to know more about the outcome of the program.
The straw poll was an interesting idea and an excellent and precise
result.
Now, we expect that the Ministers of Health, who actually are
voting, consider the capacity and experience of Dr Mirta Roses as the
voters in your poll did. Besides, this is an excellent opportunity to have
a woman in this position at PAHO, for the first time.
The great majority of South America and the Caribbea...
The straw poll was an interesting idea and an excellent and precise
result.
Now, we expect that the Ministers of Health, who actually are
voting, consider the capacity and experience of Dr Mirta Roses as the
voters in your poll did. Besides, this is an excellent opportunity to have
a woman in this position at PAHO, for the first time.
The great majority of South America and the Caribbean are suporting
this. Isn't it amazing that the North American countries and European
countries (except UK) are going in a separate way, using a more
"political" criteria rather than a technical one, different from the
Latina American countries?
The forthcoming election at PAHO ia a very serious matter. The Latin
American countries have passed, or are passing, through very hard times:
Mexico (Tequilla crisis), Colombia (Drugs and civil war) Argentina
(Economic crisis) etc. and the near future will be the most difficult in
relation to the expected social demands. Public Health should be prepared
to face important challenges.
The forthcoming election at PAHO ia a very serious matter. The Latin
American countries have passed, or are passing, through very hard times:
Mexico (Tequilla crisis), Colombia (Drugs and civil war) Argentina
(Economic crisis) etc. and the near future will be the most difficult in
relation to the expected social demands. Public Health should be prepared
to face important challenges.
Therefore, it is not time for a innexperient young professional, like
Mr Sepulveda, to try out some "new ïdeas". By the way, when we read
his statements we only see old and traditional approachs! This is not what
we need.
And it is said that he will use the advisors of the "World Bank" and
"Harvard" friends to tell him what to do! We had enough of them already
with disastrous results.
On the other side, the Argentinian candidate has an real impressive
curriculum and "gras root experience": worked in our caribbean setting for
several years, at the Epidemiological Center in Trinidad and Tobago, in
Dominican Republic and also in Bolivia. In the last few years she has
coordinated the cooperation of PAHO with the countries and have done a
very good job under dificult circumstances and minimal resources. She is
honest, transparent and a real team builder!
We expect our Ministers of Health to do the right thing. Dr Roses is
the person for this job at this time.
I would like to ask: where are the new ideas for PAHO?
Certainly not in the writings prepared by Dr Sepulveda for his
campaign.
On the other side, he has no proven experience with any international
program so far, much less in conducting a serious Institution like PAHO.
Latin America and the Caribbean are not places for an ambitious,
inexperienced person to try out "new ideas".
The professionals working for Public Health in the region and those
working with PAHO, fully committed with their work, like Dr Mirta Roses,
are well prepared for the challenges facing our countries in the near
future.
Dr Llanos also worked with PAHO before...he should knows that!
The effects of the current war on the Iraqi population should deeply shock anyone with a minimum of humanitarian concern (regardless of their political and ideological convictions). The institutional fragility for dealing with the war and its dire consequences is also extremely troubling. It is painful to observe the deplorable bankruptcy of channels for intermediation of such manifestations of unavoidably insane traits...
While media attention is captured by war, national priorities are being locked-in through arcane maneuvering making the ten-year Federal budget plan, further entrenched through Executive Orders, regulations, and court appointments that will have fundamental effects on the tenor and direction in the US and in the world. Dramatic changes could not have been made without the fears from September 11, 2001 terrorism and the militar...
Two important events, the war in Iraq and the outbreak of Severe Acute Respiratory Syndrome (SARS), have hit the headlines recently. Although seemingly independent events, they are both very important public health problems and will have a long term impact on global public health policy.[1,2]
I would like to thank JDA Barr and JJ Miranda for their special article: "Iraq: Time to focus our response" and JECH for provid...
One of the defining features of public health is a commitment to collective action to protect populations as a whole. The current global peace movement is an expression of public health advocacy against a supremely unhealthy action - the invasion and waging of war on another nation. In February 2003 millions of people around the world marched against the war on Iraq. In Adelaide, a city of some 1.1 million in Southern Australi...
Dear Editor
Takano and colleagues’ paper [1] on the association between proximity to ‘walkable green spaces’ and longevity in senior citizens in Tokyo will be of interest to those involved in promoting health in its broadest sense. However, this study has a number of methodological limitations, the authors draw conclusions that are not supported by their results and the study does not merit the largely uncritical r...
Dear Editor
A recent article in Nature magazine
Polls take heavy toll -- Suicide rises under conservative rule, 20 September 2002
discusses the correlation of conservative governmental rule, and suicide, in England and Australia, over the last hundred years, and cites the article by Page A et al. as one of...
Dear Editor
Peruvians and Nepali people have something to share - endless social violence. Nepal does not have a colonial ruler and so often does not have access to the modern world.
Our community has undergone very tramatic experiences of soldiers dying and rebels on the screen every day. This may account for the recent sharp rise in mental disorders.
The method applied in the article by JJ Mir...
Dear Editor
The straw poll was an interesting idea and an excellent and precise result.
Now, we expect that the Ministers of Health, who actually are voting, consider the capacity and experience of Dr Mirta Roses as the voters in your poll did. Besides, this is an excellent opportunity to have a woman in this position at PAHO, for the first time.
The great majority of South America and the Caribbea...
Dear Editor
The forthcoming election at PAHO ia a very serious matter. The Latin American countries have passed, or are passing, through very hard times: Mexico (Tequilla crisis), Colombia (Drugs and civil war) Argentina (Economic crisis) etc. and the near future will be the most difficult in relation to the expected social demands. Public Health should be prepared to face important challenges.
Therefore,...
Dear Editor
I would like to ask: where are the new ideas for PAHO?
Certainly not in the writings prepared by Dr Sepulveda for his campaign.
On the other side, he has no proven experience with any international program so far, much less in conducting a serious Institution like PAHO.
Latin America and the Caribbean are not places for an ambitious, inexperienced person to try out "new ideas"....
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