Orphans And Incentives

Infectious diseases remain a leading cause of prolonged illness, premature mortality, and soaring health costs. In the United States in 1995, infectious diseases were the third leading cause of death, right behind heart disease and cancer. Mortality is mounting over time, owing to HIV/AIDS, pneumonia, and septicemia, with drug resistance playing an ever-increasing role in each of these disease categories. This book, a report from a Forum on Emerging Infections workshop, focuses on product areas where returns from the market might be perceived as being too small or too complicated by other factors to compete in industrial portfolios with other demands for investment. Vaccines are quintessential examples of such products. The lessons learned fall into four areas, including what makes intersectoral collaboration a reality, the notion of a product life cycle, the implications of divergent sectoral mandates and concepts of risk, and the roles of advocacy and public education. The summary contains an examination of the Children's Vaccine Initiative and other models, an industry perspective on the emerging infections agenda, and legal and regulatory issues.

The child is neither an adult miniature nor an immature human being: at each age, it expresses specific abilities that optimize adaptation to its environment and development of new acquisitions. Diseases in children cover all specialties encountered in adulthood, and neurology involves a particularly large area, ranging from the brain to the striated muscle, the generation and functioning of which require half the genes of the whole genome and a majority of mitochondrial ones. Human being nervous system is sensitive to prenatal aggression, is particularly immature at birth and development may be affected by a whole range of age-dependent disorders distinct from those that occur in adults. Even diseases more often encountered in adulthood than childhood may have specific expression in the developing nervous system. The course of chronic neurological diseases beginning before adolescence remains distinct from that of adult pathology – not only from the cognitive but also motor perspective, right into adulthood, and a whole area is developing for adult neurologists to care for these children with persisting neurological diseases when they become adults. Just as pediatric neurology evolved as an identified specialty as the volume and complexity of data became too much for the general pediatician or the adult neurologist to master, the discipline has now continued to evolve into so many subspecialties, such as epilepsy, neuromuscular disease, stroke, malformations, neonatal neurology, metabolic diseases, etc., that the general pediatric neurologist no longer can reasonably possess in-depth expertise in all areas, particularly in dealing with complex cases. Subspecialty expertise thus is provided to some trainees through fellowship programmes following a general pediatric neurology residency and many of these fellowships include training in research. Since the infectious context, the genetic background and medical practice vary throughout the world, this diversity needs to be represented in a pediatric neurology textbook. Taken together, and although brain malformations (H. Sarnat & P. Curatolo, 2007) and oncology (W. Grisold & R. Soffietti) are covered in detail in other volumes of the same series and therefore only briefly addressed here, these considerations justify the number of volumes, and the number of authors who contributed from all over the world. Experts in the different subspecialties also contributed to design the general framework and contents of the book. Special emphasis is given to the developmental aspect, and normal development is reminded whenever needed – brain, muscle and the immune system. The course of chronic diseases into adulthood and ethical issues specific to the developing nervous system are also addressed. A volume in the Handbook of Clinical Neurology series, which has an unparalleled reputation as the world's most comprehensive source of information in neurology International list of contributors including the leading workers in the field Describes the advances which have occurred in clinical neurology and the neurosciences, their impact on the understanding of neurological disorders and on patient care

Since 1994, the democratic government in South Africa has worked hard at improving the lives of the black majority, yet close to half the population lives in poverty, jobs are scarce, and the country is more unequal than ever. For millions, the colour of people's skin still decides their destiny. In his wide-ranging, incisive and provocative analysis, Hein Marais shows that although the legacies of apartheid and colonialism weigh heavy, many of the strategic choices made since the early 1990s have compounded those handicaps. Marais explains why those choices were made, where they went awry, and why South Africa's vaunted formations of the left -- old and new -- have failed to prevent or alter them. From the real reasons behind President Jacob Zuma's rise and the purging of his predecessor, Thabo Mbeki, to a devastating critique of the country's continuing AIDS crisis, its economic path and its approach to the rights and entitlements of citizens, South Africa Pushed to the Limit presents a riveting benchmark analysis of the incomplete journey beyond apartheid.

The authors analyze the relationship between orphan status, household wealth, and child school enrollment using data collected in the 1990s from 28 countries in Sub-Saharan Africa, Latin America, the Caribbean, and one country in Southeast Asia. The findings point to considerable diversity--so much so that generalizations are not possible. While there are some examples of large differentials in enrollment by orphan status, in the majority of cases the orphan enrollment gap is dwarfed by the gap between children from richer and poorer households. In some cases, even non-orphaned children from the top of the wealth distribution have low enrollments, pointing to fundamental issues in the supply or demand for schooling that are a constraint to higher enrollments of all children. The gap in enrollment between female and male orphans is not much different than the gap between girls and boys with living parents, suggesting that female orphans are not disproportionately affected in terms of their enrollment in most countries. These diverse findings demonstrate that the extent to which orphans are under-enrolled relative to other children is country-specific, at least in part because the correlation between orphan status and poverty is not consistent across countries. Social protection and schooling policies need to assess the specific country situation before considering mitigation measures.