Bulletin of the World Health Organization
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Bull. World Health Organ. · Nov 2004
Noncommunicable disease mortality in the Russian Federation: from legislation to policy.
Political, social and economic transitions that occurred as a result of the regime change in Eastern Europe and the Russian Federation from the late 1980s to the early 1990s led to a sudden increase in mortality across the region, with more than 80% of deaths being attributable to preventable causes, such as cardiovascular disease, lifestyle factors and injuries. The Russian Federation has experienced some of the most dramatic population declines in the world. ⋯ Improvements in mortality patterns in the Russian Federation are possible only with the broader engagement of organized nongovernmental groups within the civil society that is strongly supported by Federal legislation to address NCDs. We discuss the Russian Federal legislation germane to the prevention and control of NCDs in the light of the current mortality crisis and suggest possible policy responses to this crisis.
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Bull. World Health Organ. · Oct 2004
ReviewMaking research matter: a civil society perspective on health research.
Complex global public health challenges such as the rapidly widening health inequalities, and unprecedented emergencies such as the pandemic of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) demand a reappraisal of existing priorities in health policies, expenditure and research. Research can assist in mounting an effective response, but will require increased emphasis on health determinants at both the national and global levels, as well as health systems research and broad-based and effective public health initiatives. Civil society organizations (CSOs) are already at the forefront of such research. We suggest that there are at least three ways in which the participation of CSOs in research can be increased: namely, influencing commissioning and priority-setting; becoming involved in the review process and in conducting research; and through formal partnerships between communities and universities that link CSOs with academic researchers.
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Although a relatively recent phenomenon, the role of informed consent in human research is central to its ethical regulation and conduct. However, guidelines often recommend procedures for obtaining informed consent (usually written consent) that are difficult to implement in developing countries. This paper reviews the guidelines for obtaining informed consent and also discusses prevailing views on current controversies, ambiguities and problems with these guidelines and suggests potential solutions. ⋯ The onus for the oversight of this process is often left to overworked and ill-equipped local ethics review committees. Current guidelines and processes for obtaining informed consent should be reviewed with the specific aim of developing culturally appropriate methods of sharing information about the research project and obtaining and documenting consent that is truly informed. Further research is needed to examine the validity and user friendliness of innovations in information sharing procedures for obtaining consent in different cultural settings.