Uganda: why a re-think is needed of AIDS control policy.
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"In early 1987, we started an experiment in the rural areas in Shanghai suburbs on how to replace the elderly support system then in effect, which was funded by the community, with one that was to be jointly supported by the State, the community and private individuals. The two-year experiment has yielded a new elderly support system applicable to China's rural areas that have a more developed economy and a fairly large number of collectively owned township enterprises.... This article gives a brief introduction to the economic and social background and characteristics of the system."
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The conflict-ridden central African state of Burundi launched a campaign against AIDS as the health minister said 160,000 children were orphans as a result of the disease. "This day can be considered the real beginning of the war against AIDS in our country," said Leonce Ngendakumana National Assembly President. He was opening a workshop designed to develop strategies to combat the spread of HIV, which was attended by UN agencies, aid organizations, and members of the government. Health Minister Juma Kariburyo said 30,000 people had died of AIDS in 2 years in Burundi, which has a population of around 6 million. "We had less than 1% of infection in 1983, but today the urban area figures are more than 20%, and more than 14% in the rural areas," he added. But Jeanne Gapiya, president of a Burundian association for people who are HIV positive, said she feared the true figures could be far higher. Gapiya is HIV positive and has lost her husband, child, brother and sister to AIDS. Minister of Defense Colonel Alfred Nkurunziza told the workshop the disease was rampant within the army. Burundi's Tutsi-dominated army is fighting a bitter civil war against ethnic Hutu rebels. The conflict has caused large refugee movements, which has exacerbated the spread of infectious diseases.
"By ignoring individual unemployment compensation benefits and conditions of job termination, past migration research has concluded that personal unemployment doubles the likelihood of interstate labor-force migration. Findings from the present study indicate that aggregating the unemployed, without adjusting for these two factors, overstates the probability of migration for the involuntarily unemployed benefit recipient and understates the likelihood of migration for the voluntarily unemployed benefit recipient. The results suggest that federal discretionary unemployment-compensation programs, which are implemented during recessionary periods, likely serve to retard out-migration of those who are involuntarily unemployed." Data are from a 1982 sample of unemployed U.S. workers.
OBJECTIVES: In August 2004, a national organ transplant program utilizing the latest policies, procedures, and protocols was begun in Libya. During the first year of the program, 50 kidney transplantations from living donors were performed. MATERIALS AND METHODS: Forty-nine patients (aged 7 to 65 years) received kidneys from living-related donors (aged 19 to 54 years), and 1 husband received a kidney from his wife. Donor selection was based on human leukocyte antigen compatibility. Renal failure was due to chronic glomerulonephritis in most patients, diabetes in 5 adults, systemic lupus erythematosus in 2 adults, and congenital anomalies in 2 children. Sixteen patients matched the human leukocyte antigens of their donors, 28 matched 1 haplotype, and 6 did not match any haplotype. Immunosuppression was accomplished with methylprednisolone and basiliximab. Maintenance therapy was with mycophenolate mofetil, cyclosporine, and prednisone. The latter was completely discontinued 1 month after transplantation. In patients with resistant hypertension, unilateral native nephrectomy was carried out during transplantation. Donor nephrectomy was performed through an open mini-incision using a Thompson retractor. RESULTS: At the time of this writing, 49 patients are alive and well, and 48 of them have had functioning kidneys for 10 to 22 months. Three patients had acute rejections that were successfully treated with methylprednisolone (n=1) or methylprednisolone and antithymocyte globulin (n=2). At the time of this writing, all 46 adults and 2 pediatric recipients have excellent renal function and are living normal lives. CONCLUSIONS: In terms of patient survival and quality of life, transplantation is superior to dialysis. Also, transplantation is less expensive than dialysis. In Libya, establishing an active and successful transplant program with early steroid withdrawal has brought many benefits to patients and their families and great financial savings to the government. Our program hopefully will provide a model for similar programs in Asia and Africa and encourage local governments to legalize organ procurement from cadaveric donors.
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