News and Views

Increased Need to Promote and Support Breastfeeding in the Face of Vertical Transmission of HIV

(This briefing note is in response to a recommendation of the ACC/SCN Working Group on Breastfeeding and Complementary Feeding at the 26^th Session of the SCN, held in Geneva from 12-15 April 1999. The recommendation stated that "UNICEF should prepare a briefing note explaining the continued relevance of the Code in the context of prevention of mother-to-child-transmission (MTCT) of HIV, explaining particularly the provisions concerning free and low cost supplies.")

The fact that the HIV virus can be passed by an HIV-positive mother to her child through breastmilk should not be allowed to undermine breastfeeding for the majority of infants around the world whose health and chances of survival are and will be greatly improved by it. While many governments are considering ways to make alternative feeding options available to HIV-positive mothers who have decided not to breastfeed, this must not lead to a spill-over of artificial feeding to infants of HIV-negative mothers. Even greater attention should be paid to the regulation of commercial promotion of breastmilk substitutes. The International Code of Marketing of Breastmilk Substitutes is of particular relevance since it aims to:

à Regulate the distribution of free or subsidized supplies of breastmilk substitutes to prevent spill-over to babies who would benefit from breastfeeding

à Protect artificially fed children by ensuring that

Product labels carry necessary warnings and instructions for safe preparation and use
The choice of product is made on the basis of independent medical advice, and not commercial influence.

The Code does not prevent governments making breastmilk substitutes available to HIV-positive mothers, free or at a subsidized price, when the government has purchased them.

The Code aims to prevent manufacturers from donating supplies of breastmilk substitutes, or providing them at a reduced price, to any part of the health care system. There are several reasons for this ban:

à Experience shows that when free supplies are made available by manufacturers to health facilities, they become too easily available. Many mothers who do not need them use them. These mothers often lose confidence in their ability to breastfeed, and may unnecessarily give up breastfeeding.

à If hospitals and health centres have to buy formula, as they usually buy drugs and food, it is more likely that they will ensure that it is given out in a carefully controlled way, and not wasted or misused.

à Donations make health facilities and infants dependent on them. If the donations cease - which often happens - there may be no alternative source of milk available, and no provision in the health service budget to buy them.

à Donations are a very successful form of promotion - which encourages families to buy the same product when they return home. The code does not allow any form of promotion.

à be given only to infants who have to be fed on breastmilk substitutes - including infants of HIV positive mothers who have chosen this option.

à be given "for as long as the infant needs them" - which in the case of an infant of an HIV positive mother should be for a minimum of six months. Giving a few tins is not allowed since the mother or orphaned child may be left with nothing when the few tins are finished.

à not be used as a sales inducement. One way to avoid the supply being used as a sales inducement is for it to be provided in generically labelled containers without a brand name.

à Mothers need to be able to obtain their supplies easily, so that their confidentiality and self-respect are maintained. For example, they should not have to stand in a long public queue. They need to be able to get supplies at convenient times -perhaps outside health centre working hours.

à Supplies must be reliable in the short term, so that they do not suddenly stop and leave the mother with nothing for a week or two.

à Supplies must be sustainable in the long term - so that they are not discontinued after a few months, leaving mothers without any form of help.

Prepared by UNICEF for the Secretariat of the ACC/SCN Working Group on Breastfeeding and Complementary Feeding, September 1999

Mother-to-Child Transmission of HIV Through Breastmilk

A prospective study has been done on mother-to-child transmission of HIV through breastmilk using the correct definition for exclusive breastfeeding. The study concluded that when breastfeeding is exclusive, the entire time from birth, it does not appear to transmit HIV from an HIV-positive mother to an HIV-negative baby. The paper is entitled, "Influence of infant feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa: a prospective cohort study" and is published in the medical journal Lancet (1999 Aug 7; 354(9177):471-6). The authors, A Coutsoudis, K Pillay, E Spooner, L Kuhn and HM Coovadia found that transmission rates among those who were exclusively breastfed from birth were actually lower at three months than among those not breastfed at all, and much lower than those breastfed but not exclusively. Though the difference was not statistically significant for those not breastfed at all, the authors write that this "raises a possibility that virus acquired during delivery could have been neutralized by immune factors present in breastmilk but not in formula feeds."

Submitted by Ted Greiner, World Alliance for Breastfeeding Action (WABA) Research Task Force Coordinator; PO Box 1200,10850 Penang, Malaysia; tel 60 4 6584 816; fax 60 4 6572 655; internet http://www.waba.org.br email: secr@waba.po.my or ted.greiner@telia.com

Nursing Mothers' Association of Australia

Those that wish to discuss any aspect of breastfeeding, but especially the "Breastfeeding topic of the Month", are invited to visit and register with <htpp://www.bftopics.org> Each month a presentation of a selected topic will be posted on this website. This interactive site lets others know how each topic is relevant to you in your part of the world on both personal and professional levels. Notice contributed by Dr Michael Golden's ngonut site <ngonut@abdn.ac.uk>

Click for Hunger

http://www.thehungersite.com

"The Net has pushed back many boundaries, including that of human compassion. A website that allows anyone to donate food to the starving without paying? It sounds too good to be true, but The Hunger Site, created by computer programmer John Breen, has achieved exactly that, channelling the cold, financial logic of online advertising to warmer, social purposes... Hunger Site users are met by a map of the world. Every 3.6 seconds, a country somewhere flashes black, signifying a death due to hunger... India... China... Mozambique... country after country dims in memoriam." (17.9.99 Sydney Morning Herald - Australia)

Click on this website, and each company sponsor will donate 1/4 cup of grain to the UN World Food Programme. On 8 November 1999 alone, almost 26 metric tons of food were donated to WFP, and an estimated 4 million servings of food have been donated since the site's launch last summer. Bookmark it and spread the word to friends and potential sponsors. One visit per day, please.

The Right to Adequate Food and to be Free from Hunger
UPDATED STUDY by Dr Asbjorn Eide

Dr Asbjorn Eide's updated study on the right to food (SCN News No. 18, p45) is completed and available on the website of the High Commissioner of Human Rights, http://www.unhchr.ch/ under 'documents', under 'charter-based', 'Sub-Commission', '1999', as document 12 (E/CN.4/Sub.2/1999/12). You may also obtain a hard copy from the documentation section of the High Commissioner's office. It will be published in printed form at a later date.

The contents of the report include: the issues and the mandate; malnutrition and hunger in dimensions, consequences and emerging issues; the World Food Summit commitments and their follow-up; clarifying the right to food and nutrition and the corresponding state obligations; ensuring freedom from hunger and implementing the right to adequate food at the national level; monitoring and dialogue in the relevant treaty bodies; the role of the Commission on Human Rights and its special rapporteurs; the evolving role of United nations bodies, specialized agencies and non-governmental organizations; globalization and the right to food; conclusions and recommendations; and the General Comment No. 12.

Dr Eide: tel +47 22 842 004; fax <47 22 842002; email: Asbjorn.eide@nihr.uio.no

The Department of Public Health, University Miguel Hernandez

The Department of Public Health of the University Miguel Hernandez in Spain is working on three areas of research with a major nutrition focus: adult nutrition as a determinant of cancer and other chronic diseases; child infection, malnutrition and growth in developing countries; and migration and health. A Regional Health and Nutrition Survey was conducted in 1994 in the Valencia Region of Spain. The survey included personal interviews and direct anthropometric measurements of a representative sample of 1800 people. Obesity is a major concern in the Valencia Region and Professor Jesus Vioque is now researching determinants of obesity that might be amenable to public health interventions, and in particular, with respect to television viewing and obesity. Care seeking practices for children with prevalent diarrhoea and malnutrition are being studied in Equatorial Guinea, following a National Child and Reproductive Health Survey that was conducted in 1997 in that country by a research team of the Instituto de Salud Carlos under the direction of Professor Alberto Torres, former Chairperson of the Department of International Health at the National School of Public Health. A preliminary report in Spanish was released last year and scientific publications should be available early next year. Health status of migrants is a growing concern in Spain, and is a subject of active research by this group.

For information or reprints of publications contact Prof Jesus Vioque email: jvioque@umh.es and Prof Alberto Torres email: atorres@umh.es

Debt Relief Policies for Poor Countries: Beyond the Cologne Debt Initiative
By Jeffrey Sachs, Professor of Economics, Harvard University
Chair, WHO Commission on Macroeconomics and Health

At a meeting on 8 October 1999 at WHO Headquarters in Geneva, Professor Jeffrey Sachs presented his recent analyses of the Cologne Debt Initiative, and options to better implement debt relief in heavily indebted poor countries (HIPC). Dr Sachs' analysis is summarized below.

Many developing country governments have been bankrupt or insolvent since the late 1970s. Unfortunately, there are no bankruptcy procedures for governments: no rules, no courts, no mechanisms of appeal, hundreds of creditors and no coordination among them - thus, trying to provide debt relief for HIPC is a very long and frustrating process. In fact, any US corporation receives much better treatment than any of these countries have in terms of discharging their debt. The World Bank and the IMF launched the HIPC Initiative for partial cancellation of debt in 1996; by November 1999 only two countries have been partially relieved of their debt.

If an HIPC is lucky enough to have a relatively high profile or desirable geopolitical position, it will receive "first" service. (For example, the very large Polish-American community in the US rallied successfully to get Poland's debt cancelled.) If an HIPC does not fit into this category, basically the country is run by the IMF. Without exaggeration, the IMF has control of dozens of the poorest countries. The IMF has no systematic way to discharge the debts of these countries unless the country is politically influential - and even then, the debt may only be "postponed". To have the IMF and World Bank impose an "enhanced" structural adjustment framework, or an "enhanced" HIPC Initiative on debt-burdened countries, seems like Bretton Woods continuing as before with a better public relations campaign. I lack confidence in failed programmes that are projected to succeed because they are now "enhanced". The IMF and the World Bank launch of the HIPC Initiative with caution and delay, rather than with a sense of urgency, worries me. Debt is not "tightening a belt"; it is LIFE AND DEATH. If the IMF and World Bank viewed this as an urgent problem, or valued this issue as important enough, they could reduce their own claims by re-evaluating a good portion of their 100 million ounces of gold now valued at $35 per ounce (vs market price of about $260 per ounce). The IMF and World Bank solution to keep debt relative to exports is an artificial remedy which draws a line devoid of real life experiences, and which does not leave the countries solvent in the end.

The Process: "Six lean years followed by six lean years"

The HIPC process takes a country approximately 6-12 years to obtain partial relief of their debt. A country must demonstrate a "good" performance rating by adhering to IMF and World Bank macroeconomic and structural adjustment policies for a three year period before HIPC debt relief is committed (not delivered). After another three years or so of 'good" behaviour, then a decision is taken to deliver the relief, called the completion point. Once at the completion point, it can then take up to three more years to calculate the amount of limited debt to be reduced. The "Enhanced" HIPC proposed by the Cologne Initiative intends to "speed things up" but how this will be done is still ambiguous. EHIPC also hopes to extend the relief to all needy countries; establish new targets, and to have one standard of relief (not 200-250% of the net present value (NPV) of debt to exports but 150% of NPV of exports OR no more than 250% of NPV of government revenue). Bilateral creditors have agreed to reduce their own claims by 90% on their noncommercial loans and 100% of the overseas development assistance loans, and will press the IMF and World Bank to do the same. The EHIPC would like 75% of qualifying countries obtain relief by the end of 2000.

What You Can Do

I urge all Ministers of Health and related departments (particularly nutrition departments), UN agencies, NGOs, and the whole of civil society to understand the dynamic nature of this Initiative. This past summer the White House confirmed "this process is set", then President Clinton spoke to the IMF, with a promise of relieving 100% of bilateral debt. We hope the US Congress will approve. The first and second solutions proposed by the G8 have not been accepted wholeheartedly by the people who say a first step has been taken but there is more we can do. The G8 moves by public pressure. This Initiative is now too limited in its ambition. It is erroneously targeted to export measures; it includes standard-setting by finance ministers and NOT by the social service sector ministers; it maintains the structural adjustment framework under a new name; and has a very uncertain timetable. This Initiative has brought new attention to reducing debt in developing countries, and has given greater attention to the global health and education crises. This is an opportunity to maintain political pressure to turn debt relief into real results - and poverty and basic health needs must be at the center of the agenda. The case needs to be made graphically and we need to hear from the HIPC.

We need to prove that: (1) Savings on debt can be translated into social progress, nutrition, health and primary education. (2) Savings on debt can be monitored: there are mechanisms to do this. (3) Technically WHO, UNICEF, NGOs and others can begin to demonstrate efficacy in spending by making their programme interventions concrete (e.g. to return vaccine coverage from 50% back to 85%; to advance anti-malarial programmes; to provide drugs to HIV patients; to reduce subclinical vitamin A deficiency; to reduce iron deficiency anaemia). Further we need to calculate, for instance, hypothetically, every $1 of debt relief = 10 capsules of vitamin A. The IMF and World Bank need to be confronted with real choices such as: a 60% reduction in debt gives us A, B, and C; an 80% reduction means..., 100% reduction translates into....

Sharper and better tools are needed and WHO is playing an extremely important active role by beginning to cost out these interventions, sharing information about how this can be done, planning for expanded budgets, and showing the trade-offs clearly on paper; translating the savings from debt relief into real health improvements. We want President Clinton to reduce the bilateral debt by 100%; and we want the other G8 countries to follow the US lead. We need developing countries, especially the HIPC and the HIPC African countries to come forward so we can work together to make your case for debt relief.

For further information contact: fax: 617 495 8685; email: Jeffrey_Sachs@harvard.edu [Response by the World Bank was not available at press time, however, World Bank and IMF views on the HIPC Debt Initiative can be found at http://www.worldbank.org/hipc/ and http://www.imf.org/external/np/hipc]

Global Ecological Integrity and Sustainable Development: Cornerstones of Public Health
Discussion Document by Colin Soskolne and Roberto Bertollini

This Discussion Document stems from a WHO (Rome Division) Workshop, December 1998. It summarizes the Workshop discussion and subsequent exchanges of opinions of experts worldwide. The authors believe that global change has become an issue warranting public health involvement. The public health community needs to face the challenges presented by global change and equip itself with the necessary scientific and technical means to anticipate and, where possible, prevent adverse consequences to human health arising from degrading life-support systems. The document is neither intended to be conclusive nor to reflect a WHO position on these matters. Rather, it is a contribution to the discussion on the consequences of global change on human health. It is provided for the scientific community at large as a basis for future thinking and planning in this area. Comments, suggestions and criticisms are encouraged. The deadline for feedback is December 31, 1999.

The intent behind the Discussion Document is to extend the thinking embodied in previous reports cautioning about the implications for both human and other forms of life on earth should life-support systems be degraded. Life-support systems of concern include fresh and ocean waters, fisheries, forests, climate, soils, air, as well as biodiversity. Current indications suggest that not only are certain life-support systems malfunctioning, but some are even collapsing. Where this document differs from its predecessors is in its framing of the issue and in its timing. The information upon which concerns are now based draws upon more systematic data and reflects longer-term trends. Hence, the concerns are more compelling. Furthermore, the political climate now may have become more receptive to new priorities, packaged differently, in order to have access to options that are conducive to a sustainable future. The combination of these circumstances means that the message contained in this document could actually trigger global actions where previous efforts, whether in the form of conference reports, books, agency reports or movies, did not. This Discussion Document also differs from all prior reports in that it calls upon WHO to recognize the issue of global ecological integrity as one of its foci for future activities. It calls upon WHO to consider placing the issue squarely onto its agenda for health in the new millennium, working jointly with related UN agencies playing their respective full and integrated roles. A follow-up Workshop is anticipated (in about one year) to subject the content of this Discussion Document to a broader range of critique.

This jointly-authored 74-page document is accessible on the Web site of the WHO European Centre for Environment and Health, Rome Division: http://www.who.it The Preface, Executive Summary, Foreword and Table of Contents, as well as a PDF version for download, are available at http://www.who.it/docs/globaleco.htm C Soskolne, Dept of Public Health Sciences, Faculty of Medicine and Dentistry, 13-103 Clinical Sciences Bldg, University of Alberta, Edmonton, Alberta, Canada, T6G 2G2; tel 780 492 6013: fax 780 492-0364; email colin.soskolne@ualberta.ca

"Terminator" Seed Sterility Technology Dropped

PRESS RELEASE New York, NY, 4 Oct 1999...The Rockefeller Foundation supports the Monsanto Company's decision not to commercialize sterile seed technologies, such as the one dubbed "the terminator". "We welcome this move as a first step toward ensuring that the fruits of plant biotechnology are made available to poor farmers in the developing world," said Professor Gordon Con-way, President of the Rockefeller Foundation. However, the Rockefeller Foundation continues to challenge Monsanto and other multinational seed companies to support labelling, use the plant variety protection system - not patents - in developing countries, and to make other concessions necessary to insure that plant biotechnology is better accepted by US consumers and can deliver its benefits to poor farmers in developing countries. The idea of using "terminator" technologies designed to prevent germination of harvested grain as seed, thereby blocking farmers in developing countries from saving their own seed for re-sowing, has engendered strong opposition in most quarters. The possible consequences if farmers who are unaware of the characteristics of such seed purchase it and attempt to reuse it are certainly negative and may outweigh any social benefits in protecting innovation. The Rockefeller Foundation challenges all of the major multinational seed companies and life sciences companies to work toward improving the acceptance of plant biotechnology in both the developing and the industrialized worlds. They suggest the following actions:

1. Consumers have a right to choose whether to eat genetically modified (GM) foods or not. Monsanto and others should come out immediately and strongly in favour of labelling.

2. Phase out the use of antibiotic resistance markers. The likelihood of such genes generating antibiotic resistance in livestock or humans is small, but alternatives exist and should be used.

3. Agree to use the plant variety protection system in developing countries, rather than the use of expensive patents. This will allow farmers to retain the seed and public plant breeders to continue to innovate.

4. Establish an independently administered fellowship program for training developing country scientists in crop biotechnology, biosafety and intellectual property.

5. Donate a number of useful technologies, for example, the agrobacterium transformation system, to developing countries.

6. Agree to share the financial rewards from intellectual property rights on varieties such as basmati or jasmine rice with the countries of origin.

7. Develop a new way of talking about plant biotechnology and reaching decision through a fully inclusive, global public dialogue.

[Ed. Note: "Nutrition and Agriculture" is the topic for the July 2000 issue of SCN News No. 20. This item should be food for thought -send in your contributions.]

Nutrition Software Program
University of Hohenheim/Stuttgart and German Agency for Technical Cooperation (GZT)

A software program designed specifically for carrying out nutrition baseline surveys has been developed by the Work Group on International Nutrition of the University of Hohenheim/Stuttgart in cooperation with the German Agency for Technical Cooperation (GTZ). The software is based on the Guidelines for Nutrition Baseline Surveys in Communities (BASELINE) published by GTZ. The main purpose of the program is to integrate all steps of BASELINE into a single program. The program contains the standard BASELINE questionnaire, which can easily be customized for the specific site, a function for printing out the questionnaire, a data entry unit which controls the data being entered, a specially adapted plausibility check, a report function and a graphics section. The report function produces, with one click, the full set of descriptive statistics of a baseline survey. The graphics section contains, in addition to the standard graphs, specially designed graphics for the anthropometric indices with comparison to the NCHS standard. The anthropometric indices (Z-scores of height-for-age, weight-for-height, weight-for-age) and the prevalence of stunting, wasting, underweight and overweight of children are calculated automatically. For further statistical evaluation the data can be exported to SPSS or any other statistical program. The program can be downloaded for free at the following homepage: <http://www.nutrisurvey.de> In addition to analyzing the nutritional situation of communities, the software package contains also a program to analyze the nutrient intake of individuals. The homepage also contains the online version of the Guidelines for Nutrition Baseline Surveys (BASELINE), a description of the software and some useful internet links.

For further information, comments or suggestions please contact Dr. Jürgen Erhardt (erhardtj@uni-hohenheim.de) or Dr. Rainer Gross (urgross@ibm.net).

Nutrition Training for the New Millennium

The Wellcome Trust is just about to launch an interactive nutrition CD Rom. Part of the award winning Topics in International Health series, the nutrition disc will be launched in December of this year. The disc provides an illustrated introduction to the causes, epidemiology, treatment and prevention of malnutrition in developing countries. Topics in International Health is a CD-based series of training materials specifically written for international health professionals. Each disc consists of three distinct but interrelated parts: a set of interactive tutorials, a complementary image collection and an electronic glossary of terms. The nutrition disc contains 12 tutorials, each of which will take the user between 60-90 minutes to work through. Assessments are built into the tutorials, as are up-to-date references, summaries and suggestions for further reading and other activities. The topic areas covered are: vitamin A deficiency, maternal and child health, epidemiology and aetiology of malnutrition, malnutrition and infection, prevention of malnutrition, iron deficiency anaemia, iodine deficiency disorders, assessment of nutritional status, treatment of severe malnutrition in children, emergency situations, diet and chronic diseases and an overview. The image collection consists of almost 900 images, which have been carefully selected to complement the tutorials. Each image is accompanied by a description and key words, which allow the user to search through the database to collate sets of images on topics of interest. The disc has been created by an in-house team at the Trust's Tropical Medicine Resource, supported by input from a wide range of internationally renowned nutrition experts, including contributions from UNICEF, WHO, Save the Children, and leading academics from Europe, North America and Australia. There are 11 titles in this series: malaria, trachoma, sickle cell disease, sexually transmitted diseases, leprosy, schistosomiasis, diarrhoeal diseases, tuberculosis, nutrition, HIV/AIDS and leishmaniasis.

The Wellcome Trust has five free copies of the disc to give away to SCN News readers. These discs will go to the first five people drawn at random from our postbag on 31 January 2000. To be included in the draw, write to: Denise Chew, The Tropical Medicine Resource, The Wellcome Trust, 183 Euston Rd, London, NW1 2BE, UK. Full CD Rom details: CAB International, Wallingford, Oxon, OX10 8DE UK; tel +441491 832111; fax +441492 929292; internet: htpp://www.cabi.org

USAID/Leland Internet Training in Africa

The USAID Leland Initiative (http://www.info.usaid.gov/leland) is a five year, US$15 million project set up to help improve Internet conditions in 21 Sub-Saharan countries, through policy reform, technical assistance and end-user connectivity. The two-day training sessions are conducted for decision-makers and staff of NGOs, educational institutions and government agencies that do not have, or have very limited access to the Internet. Topics covered include Internet terminology, evaluating a webpage, creating a website, structured searches on the web, cost-benefit analysis of using the Internet, and email. A summary of the training and the topics listed above may be found on their website. If your country or organization lacks hardware, USAID Leland Internet trainers can supply you with the growing list of NGOs who will provide used computer equipment (computer, modem, UPS, Internet software) in excellent condition and up to speed.

World Income Inequality Database (WIID)

UNU/WIDER and UNDP are pleased to announce the official launch of the World Income Inequality Database (WIID), which can be accessed at the following web-sites: http://www.wider.unu.edu/wiid/wiid.htm and http://www.undp.org/poverty/initiatives/wider/wiid.htm WIID has been compiled over the period of 1997-99 in the context of the UNU/WIDER-UNDP joint project on 'Rising Income Inequality And Poverty Reduction: Are They Compatible?' One of the project's main outputs, the WIID, is now available to download from the internet and on CD-ROM in order to facilitate further analysis and debate on inequality. WIID collects and stores information on income inequality for industrialized, developing and transition countries in an easily retrievable, exportable and analyzable format The WIID database is particularly suitable for an analysis of changes in inequality within countries over time. Analysis based on the data contained in the WIID points to a widespread rise in income inequality since the early 1980s and to its acceleration in the 1990s in several countries, including all economies in transition. These conclusions -and many others that can be drawn from the database - are highly relevant for the current policy debate on inequality and poverty reduction. Indeed, the rise in income inequality poses a severe challenge to the poverty reduction targets adopted by the international community, and may also jeopardize economic growth, social cohesion and governance. We hope, therefore, that the WIID database will help stimulate research and debate in this area. We would very much appreciate it if you could take a moment to browse through the WIID User Manual and database, and send us your opinion on the usability and possible improvement of the software and the data. The web version is accessible directly from the internet. The downloading and installation of the full version of WIID should not take more than some 30 minutes and not much more will be needed to make yourself familiar with its utilization procedure. We look forward to your comments.

GA Cornia, Director, UNU/WIDER, email: kiiski@wider.unu.edu

ELDIS Development Reporter

ELDIS is considered to be the information gateway to new information sources on development issues. All documents are available free on the Internet (or you can try their experimental email-only option). ELDIS currently includes descriptions and links to over 3000 organizations and over 6000 full-text online documents covering development and environmental issues. ELDIS research themes include: "Participatory monitoring and evaluation": conceptual background and methodologies to PM&E; How do organizations accurately determine whether they are progressing towards, or achieving their goals and objectives? Includes key references, and training manuals <http://nt1.ids.ac.uk/eldis/hot/pme.htm> Other topics are: the "Internet in Developing Countries": a guide to project experiences and connectivity issues; the UNDP Human Development Report 1999, Donors and population programmes UNFPA, and Agriculture, food and nutrition for Africa: a resource book for teachers of agriculture by FAO.

ELDIS is funded by Danida and hosted by the Institute of Development Studies, Sussex, Brighton BN1 9RE, UK. Contact T Zussman-Kay, tel +441273 877330; fax +441273 621202; email: eldis@ids.ac.uk

The UK's Nutrition Society's List of Free/Low Cost Nutrition Training Materials

The following list of organizations produce useful nutrition materials (see SCN News No. 16 p50 for additional sources). Details of materials, prices and payment from the relevant organization can be obtained on their website. The Society accepts no responsibility for information which is out of date. Please send corrections to this list to annburgess@sol.co.uk Further information about the Nutrition Society can be found at htpp://www.nutsoc.org.uk/

DAB Computing, Dr D A Bender, University College, London, Department of Biochemistry & Molecular Biology, Gower St, London WC1E 6BT, UK. Fax +44 181 907 9933 dab@biochem.ucl.ac.uk http://biochem.ucl.ac.uk/~dab/dab.html Computer programme The food you eat (nutrient/energy analysis & comparisons)

Emergency Nutrition Network (ENN), Dept. Community Health & General Practice, Trinity College, 199 Pearse St, Dublin 2, Ireland. Fax +353 1 670 5384 foreilly@tcd.ie http://www.tcd.ie/enn Example: Report Infant feeding in emergencies 1999 IR£3, Newsletter

Healthlink Worldwide, 29-35 Farringdon Rd, London EC1M 3JB, UK. Fax +44 171 242 0606 info@healthlink.org.uk Examples: Briefing paper Caring with confidence (including feeding HIV+ children) Free/£10; Newsletters Free/£ 12-24

Institute of Nutrition Mahidol University (INMU), International Affairs Program, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand. Fax +662 441 9344 directnu@mahidol.ac.th

Liverpool School of Tropical Medicine, Unit for Statistics & Epidemiology, School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK. Fax +44 151 708 8733 LEP@liverpool.ac.uk Computer learning package Nutritional Surveillance Learning Module 1994

NGONUT Email discussion group on malnutrition. To join email owner-ngonut@abdn.ac.uk. Archives at http://www.univ-lille1.fr/pfeda

Secretariat of the Pacific Commission (SPC), B.P. D5, 98848 Noumea Cedex, New Caledonia Fax +687 263818 spc@spc.org.nc http://www.spc.org.nc Prices for outside S. Pacific. Examples: Colour posters $5; Leaflets on South Pacific foods $2; Handbook The leaves we eat $15; Flipcharts $10; videos First foods for my baby, Healthy food choices $20. Community Nutrition Books

University of the South Pacific, Continuing Education, Alafua Campus, Private Bag, Samoa. Fax +685 22933 fairdun@samoa.net.ws Examples: Nutrition community education, Family and community food supply, Food, drinks & diseases.

OBITUARIES

Lilian Tendayi Maovatsanga

For several years Dr Lilian Tendayi Maovatsanga served as a member of the SCN's Advisory Group on Nutrition (AGN) - a group which provided assistance and advice on policy and the science of nutrition to the SCN. It was a group comprised of nutritional scientists and practitioners of world repute from different regions of the world - that Lilian was so highly respected by her African colleagues is undisputed.

Since 1993 Lilian was the head of the Institute of Food, Nutrition and Family Sciences in Harare, Zimbabwe. She initiated the first regional BSc programme in Food Science and Technology at the University of Zimbabwe and established linkages with many institutions worldwide for collaborative research. She co-founded the Zimbabwe Society of Food Science and Technology and organized the first regional conference on Food Security, Safety and Quality at which the International Union of Food Science and Technology (IUFoST) regional association, ECSAFoST (East, Central and Southern Africa Food Science and Technology) was launched. She was recently elected President of IUFoST - this key position filled by a woman's voice from Africa was a proud "first' for Africa - and definitely a pioneering "first" for the food scientists.

Lilian and I knew each other professionally and socially since the ICN preparatory meetings in 1992. We shared the vision of an Africa free from hunger, malnutrition, and poverty - an Africa filled with the professional capability to deal with its own problems. The best tribute we can accord Lilian is to continue to champion her work towards a world where "access to nutritionally adequate and safe food is the right of every individual". Lilian's memory is still fresh in our minds - let's act on one of the following:

à Start a scholarship fund for young scientists in her field as she cared deeply about capacity building and training.

à Contribute to a building in her name at the University of Zimbabwe.

à Establish an award scheme in her name for a young scientist to attend major IUFoST/Nutrition meetings.

à Establish a Trust Fund to take care of the education of her two children.

Prof. Ruth K. Oniang'o, PhD, SS, DSM
Professor of Food Science and Nutrition, Jomo Kenyatta University

P.O. Box 29086, Nairobi, KENYA; tel +254-2-631200/632220 fax +254-2-249799 Alternative Fax: +254-2-583294 email: oniango@iconnect.co.ke

The Honorable Julius Kambarage Nyerere (1922-1999)

Julius Kambarage Nyerere, who was the first president of the then Tanganyika and the present United Republic of Tanzania, died in London of chronic lymphocytic leukemia on Thursday, 14 October 1999. He was 77 years old. Mwalimu (teacher) Nyerere, as he was affectionately known in Tanzania, was a great statesman who contributed immensely to the identity of Tanzania: He was the father of our nation and an inspiring leader who earned international respect for our country.

Mwalimu Julius Nyerere cared a great deal about his people's welfare. President Mwalimu Nyerere spearheaded various social welfare and nutrition policies and campaigns. He declared war against ignorance, poverty and disease as these, he believed, were obstacles to national economic development. In 1967 he proclaimed the Arusha Declaration which contained a policy of Ujamaa (Socialism), and equity and self-reliance were proclaimed. This policy emphasized the development of people who would in turn develop things. Policies to bring about equity included: 1) fixing and regular revision of minimum wages; 2) a progressive tax system; 3) subsidizing production inputs and maize flour; and 4) redistributing income in rural and urban areas. Each of these policies underwent significant changes over time, due to limitations from a poor national economy, and also from pressures of external bodies such as the IMF and the World Bank.

His policy on food security for all had the objective of attaining food self-sufficiency. Its implementation was carried out through campaigns, programmes and reforms under the agriculture sector such as: Siasa ni Kilimo (Politics is Agriculture), Chakula ni Uhai (Food is Life), Kilimo cha kufa na kupona (Agriculture as a matter of life and death), Nguvu Kazi (Human Resource Deployment), The National Maize Programme, and The National Food strategy. Mwalimu Nyerere recognized good nutrition to be pivotal in national development and that malnutrition was the underlying cause of much of the morbidity and mortality among children. He noted that a nation with hungry and malnourished population cannot advance economically, culturally or politically. He said:

....I have talked at length about this question of food because the foundation of development is people. A hungry person cannot bring progress. He is weak of body and also weak of mind. This must always be remembered; especially in relation to children. When a child is not well fed, be will not grow properly - he will be deformed, and his intelligence will be affected also; he will not reach his full potential. The question of sufficient food and good food is absolutely vital to the development of our people in both towns and villages.

During his recent 75th birthday celebration, he expressed dissatisfaction that the infant and childhood mortality rate is still much higher compared to developed countries. And that those surviving to adulthood are weak and die too young - when the nation needs them the most to contribute to national development. He urged the Government of Tanzania needed to do something about poverty, which reduces opportunities and access to food quantity and quality, to essential and basic social services, and needed care. On the 20th anniversary of the TFNC in 1993, Mwalimu commended TFNC, noting that although malnutrition is still a major public health concern, more people are aware of it. He also observed that decisions for resource management and utilization are yet to be taken consciously for positive nutrition impact at all levels. He called upon TFNC workers to remember: "Malnutrition can be overcome: Play your part."

Mwalimu Nyerere retired from Presidency in 1985 but continued to provide wisdom and leadership in a variety of issues that touched the welfare of ordinary people at home and abroad. He served as the chairman of the South-South Commission and was Principal Mediator of the Burundi Peace talks. Following his death in London, an obituary in The Times included the paragraph: "In 1985 Nyerere paid a visit to Britain where he both lunched with the Queen and delivered a rebuke to the City for using its financial strength to impose onerous conditions on its debtors in the Third World." Mwalimu Nyerere was man of principle and one wishes that today there were leaders with his courage and mettle.

Wilbald Lorri, Godwin Ngossi, TFNC, PO Box 977, Dar es Salaam, Tanzania