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    • The modern family planning movement was the result of two

    2019-04-29

    The modern family planning movement was the result of two separate schools of thought and action that coalesced in the middle of the 1960s. The ideology was a hybrid of the pioneering work of Margaret Sanger and others, which focused on prevention of unintended pregnancy and women\'s empowerment, with neo-Malthusians who emphasised Z-VAD-FMK Supplier control. These groups found common ground in promotion of family planning programmes, and efforts centred on the need for married couples to space apart children and to limit family size.
    According to , worldwide obesity rates have doubled since 1980. In 2008, 35% of adults older than 20 years of age were overweight, and in 2011, 40 million children younger than 5 years old were given this label. In the USA, according to data from the , more than 35% of adults are obese, which is associated with increased risks of non-communicable diseases, such as cardiovascular disease, diabetes, and cancer. The old paradigm of obesity being a disease of highly developed countries is now far behind us. In most countries in the world it is now recognised that overweight and obesity kill more people than does undernutrition. Obesity rates are rapidly increasing in countries regardless of their development status—in urban Samoa, for instance, obesity rates have been estimated to be greater than 75%—and countries that are already tackling problems of undernutrition are beginning to face the double burden of both undernutrition and overnutrition. Obesity-associated disorders are pushing the health-care expenditure of high-income countries to breakpoint; there is little hope that the already overstretched health systems of many low-income and middle-income countries will be able to cope.
    Despite progress in many countries, about a third of the world\'s population does not have regular access to essential medicines. The responsibility to resolve this problem lies with many, including the pharmaceutical industry. Since 2008, the Access to Medicine Index (the Index) has ranked the 20 largest research-based pharmaceutical companies according to their efforts in making relevant products more available, affordable, and accessible in developing countries. The 2012 Index ranking is based on companies\' commitments and actions to provide medicines, vaccines, and diagnostic tests in 103 low-income and middle-income countries, focusing on 33 high-burden communicable, non-communicable, and neglected tropical diseases, as well as a range of maternal and neonatal disorders. Information received from companies is cross-checked with other sources, and peer reviewed by experts. The ranking is based on 101 indicators in seven technical areas: organisation and management of access programmes; conduct of relationships with policymakers, competitors, customers, and the public; research and development on relevant products; pricing policies and distribution; patent and licensing practices; capacity building in developing countries; and product donations and philanthropic activities. For each technical area four aspects are assessed: company commitment, transparency, performance, and innovation. To complement the relative rankings of the 20 companies in the biennial index, we did an assessment of absolute changes in company performance over time. We did two analyses: a crude assessment of change in overall company scores, and a more detailed analysis of changes in the individual indicators that could be reliably compared across timepoints and which showed the highest correlation with overall company scores. We also identified the six most representative indicators for research activities and used the underlying absolute figures to assess progress in company financial investments, research partnerships, and the pipeline of relevant molecules. Details of the methods and full results of our study are available elsewhere. Of 101 indicators in the Index, ten fulfilled all comparability criteria for the detailed longitudinal analysis, and six core-scored indicators with the highest correlation with overall scores were used for the detailed longitudinal analysis. We made several important observations. First, the crude analysis of all 101 indicator scores showed that 17 of 20 companies increased the overall score underlying their Index ranking between 2010 and 2012 (). Although many indicators cannot be compared fully, Elongation factors finding presents a first indication of change. Second, 50 (42%) of 120 company scores for the six core indicators increased in value, whereas only two (2%) of 120 decreased. These changes represent a very strong signal on the direction of change in company behaviour. The size of this change is not easy to measure, but an observed 84% rise in the overall average of the six indicators from 1·45 to 2·67 (scale 0–5) is the best available estimate. This difference is not significant because of the wide variation between the companies, but all six underlying average scores are also rising (). Finally, we found that all six average numbers underlying the research indicators are also increasing, with a median increase of 132% (range 49–348%), suggesting that companies have more than doubled their research and development activities in diseases covered by the Index.