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ECOLOGY

2 Mixed signals from climate change body _ Chakravarthi Raghavan

A recent meeting in Geneva of a subsidiary body of the UN Convention on Climate Change suggests that while there is at last some movement towards substantial negotiations on a protocol which would commit developed nations to limit and reduce Greenhouse Gas emissions, it is open to question whether, by the time the full Conference of the Parties to the Convention meets in Japan next year, such a protocol can, in fact, be realised.

COVER

Bleeding to Death Health care in the marketplace

7 Experts attack shift in global health strategy _ Martin Khor

The principles of primary health care to provide health services for all (irrespective of whether the patient can pay) have guided global and national health policies. But they are under threat from a dramatic change in health strategies, and this may cause a serious deterioration in people's health worldwide. MARTIN KHOR reports.

10 Economic recession, structural adjustment and health

Reports and studies from a number of sources including government health ministries, UNICEF, non-government agencies and even sections of the World Bank, point to significant welfare reversals over the past decade in many countries implementing structural adjustment programmes (SAPs). These reports are contradicted by the World Bank's 1993 World Development Report which maintains that adjusting is more beneficial to health and welfare than non-adjustment, and that any negative impact is limited and temporary. The following statement from the International People's Health Council (IPHC) and the Third World Network outlines the process whereby SAPs are likely to affect health, summarises the empirical evidence for such effects, draws conclusions about the impact of SAPs on health and makes recommendations regarding their future application.

13 SAPs and the privatisation of health care _ A recipe for disaster _ K Balasubramaniam

The following article shows that the privatisation of health care and the imposition of user-fees which are both an integral part of the World Bank/IMF-directed Structural Adjustment Programmes are no answer to the problems of providing health care for the people of the South.

17 Neo-liberalisation and health care in India _ P Zachariah

The adoption by the Indian government of a New Economic Policy in which profits and market forces play a pivotal role can only aggravate the adverse consequences of India's already overwhelmingly privatised and commercialised health care system.

21 The impact of economic reforms on health and health care in Sub-Saharan Africa _ Meredeth Turshen

Over the past decade, the International Monetary Fund and the World Bank have prompted and pressured countries in Sub-Saharan Africa to institute economic reforms. These reforms have reduced the public provision of health, education and other social services and have resulted in a catastrophic deterioration in health standards in the continent.

24 Nicaragua: Privatisation results in health crisis _ Maria Zuniga

Nicaragua's highly acclaimed National Unified Health System under the Sandinistas is being dismantled to make way for the World Bank's programmes for the 'modernisation and democratisation' of the health sector _ a euphemism for the privatisation of that sector.

ECONOMICS

26 World Bank's privatisation proposal for Vietnam makes no sense _ Peter Limqueco There is something frightfully wrong with the World Bank's recommendation for full privatisation of Vietnam's non-strategic state enterprises, since by its own admission, Vietnam's record of success since 1989 has been due principally to the exceptional performance of these same enterprises. WORLD AFFAIRS 29 Security Council submits to US pressure on Cuba censure move _ Phyllis Bennis The success of the US in pressurising members of the Security Council to accept its statement denouncing Cuba's action in shooting down two planes piloted by Miami exiles without even affording the Cuban government an opportunity to explain its action, shows how completely this organ of the UN is under US domination. 32 Hawala scandal: The MNC nexus _ Prakash Karat India is in the grip of a financial scandal which has shaken the whole political establishment. Dubbed the 'Hawala (scam) scandal', the case involves the payment of bribes by a businessman, S K Jain to politicians, presumably for favours. Most of the names of these politicians were found in a diary kept by S K Jain. While much has been written on it, one aspect of the scandal which appears to have been overlooked is _ the role of multinationals. 34 Venezuela: The wolf is at the door _ Humberto Marquez Time seems to be running out for Venezuela as its cumulative problems appear to be pushing that country towards a social explosion. However, there is a debate as to when the detonation will occur or even if it ever will. ACTION & ALTERNATIVES 35 Indian farmers' rally announces anti-MNC programme _ Kusum Menon At a major rally held in Delhi on 7 March 1996, farmers from all parts of India issued an ultimatum to the government on their inalienable rights to water, land and seed and issued a charter against multinationals, and the new World Trade Organisation (WTO) regime in agriculture. 38 Why the corporatisation of agriculture is against India's interests _ Vandana Shiva The corporatisation of agriculture in India will lead to a 'TNC totalitarianism' in agriculture, marginalise the small farmers and undermine the whole basis of food security. POETRY 40 Two poems by Chairil Anwar


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