New European Community Strategy for Health and Safety: The Elephant in the Room

Abstract

Although Lithuania has comprehensive health and safety legislation in line with EU requirements, on a range of general health and occupational health and safety (OHS) indicators, it is a poor performer. Survey data suggest that the norm for work in Lithuania is based on a regime of intensification without a participative working environment in which employees have a voice in safety management. Although European-style legislative reforms appear to be having no measurable effects on CHS performance in post-communist New Member States, the EU OHS strategy for 2007–2012 fails to take account of the deteriorated working environments in these states, suggesting that prospects for harmonization of working environment standards in the enlarged Europe may recede with eastward expansion.     

Drug Use and Drug Policy in Hong Kong: Changing Patterns and New Challenges

This paper is a sociohistorical examination of drug misuse and drug policy in Hong Kong. It briefly traces the history of drug policy since Hong Kong became a colony of Britain in the nineteenth century, and then highlights the major drug issues that have emerged in the past several decades. Drug policy in Hong Kong has gone through three stages, from “Government Opium Monopoly” (1841–1945) to “The Prohibition Era” (1946–1960) to “Enlightened Prohibition” (1961–1995). The evolution in drug policy is analyzed in the light of both domestic and international social, economic, and political forces affecting Hong Kong. The major drug issue in the past two decades has been the trends of rising levels of drug use among young people and the increasing popularity of psychoactive drugs among young drug users. It is argued that these trends may be understood in terms of rapid social change resulting from industrialization and socioeconomic growth since the 1960s, and the presence of conditions favorable to the demand and supply of psychoactive drugs. Lastly, major challenges to future drug policy in Hong Kong are discussed. [Translations are provided in the International Abstracts Section of this issue.]     

Ageing as a global public health challenge: From complexity reduction to aid effectiveness

Since 2002, ageing populations worldwide have received increasing attention by global policy-makers. However, resources committed by inter-governmental donors and US-based private foundations in support of ageing-related policies and interventions in non-Organisation for Economic Co-operation and Development (OECD) countries have remained minimal during this decade and, where mobilised, have rarely responded to actual country-level demographics and institutional capacities. We argue that this lag between issue recognition and effective resource mobilisation, while mirroring known dynamics in global agenda-setting, has also been caused by a depiction of ageing as a uniform trend across the Global South. We develop and apply a comprehensive analytical framework to assess the state of ageing dynamics at the country level and uncover substantial regional and sub-regional variation. In response, we suggest replacing complexity reduction in the interest of issue recognition with targeted support for a more nuanced research agenda and policy debate on country-specific ageing dynamics in order to inform and catalyse effective international assistance.     

Provision of healthcare in the context of financial crisis: approaches to the Greek health system and international implications

Both healthcare professionals and the healthcare system must defend each patient's health individually while simultaneously seeking to protect the population's health in general. Nowadays, there is an important increase in the cost of healthcare supply, mainly due to the developments of medical science, the public's expectations and the demographic ageing. Since healthcare resources are not unlimited, it is obvious that immoderate consumption of them by certain patients limits the use of the same funds by others. Therefore, we have to seek an optimal distribution of the existing resources in order to manage a constriction of expenses, especially under the circumstances of the modern economic crisis. The criteria of effectiveness and efficiency should be used. Health policies focus on both the public's behaviour and the rules of medical practice. Under the modern challenges the physician's role is particularly important for the protection of the patient's health and the promotion of public health.     

Alcohol misuse,policy and treatment responses in Sub-Saharan Africa: The case of Uganda

Abstract

Alcohol has become an important feature in the lives of many inhabitants of Sub-Saharan Africa and is increasingly associated with excessive consumption and negative personal and social consequences. Uganda is one of the Sub-Saharan countries with the highest rate of alcohol-related burden in the world, but supply and demand reduction strategies such as regulatory measures, prevention and treatment programs are hardly available. Consequently, the aim of this article is to critically review the situation in Uganda as part of a regional trend. First, the origins of alcohol misuse and emerging policy initiatives in Sub-Saharan Africa are discussed. Then, the consequences of alcohol misuse in Uganda are highlighted, as well as policy and treatment responses. Recommendations are formulated for developing more effective and culturally adapted treatment programs and policies.     

Problematizing official narratives of HIV and AIDS education in Scotland and Zimbabwe

When human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) are framed within an intersectional approach, they have the potential to transform understandings of social justice within the curriculum and education policy and practice in general. Yet, this transformative potential is often hampered by official narratives that fail to position HIV and AIDS as an integral component of overlapping systems of oppression, domination and discrimination. This article explores how official HIV and AIDS narratives tend to promote systemic injustice and inequality within education policy and practice in both Scotland and Zimbabwe, despite their good intents. We frame our argument within a transformative education discourse which seeks to create participatory and emancipatory HIV-related messages at school, tertiary and community levels. Using a narrative enquiry design, a Foucauldian theoretical lens was used to analyse the narratives derived from key informant responses, supplemented by analysis of key documents that deal with HIV and AIDS in both Scotland and Zimbabwe. Four broad narratives emerged: the ‘Gay’ Narrative; the Migration Narrative; the Conspiracy Narrative; and the Religious Narrative. We discuss how each of these narratives entrench stigma across both developed and developing world contexts, and propose how a more intersectional interpretation would contribute to a deeper and less stigmatizing understanding of HIV, thus offering more useful insights into related policy and educational practices. This article will thus contribute to the growing body of intersectional HIV and AIDS knowledge that is relevant for schools, teacher education, public health and community settings, not only in the countries studied, but the world over.     

Lee Robins' studies of heroin use among US Vietnam veterans

The work of Robins and her colleagues on heroin addiction among Vietnam veterans sets out in microcosm many of the key factors that play out in the development and maintenance of substance addiction beyond the pharmacology of the drug: price, availability, the process of delivery of the addictive substance, availability of other substances, social norms, education and life circumstances. Robins' studies found high rates of heroin use (34%) and symptoms of heroin dependence (20%) among US soldiers while serving in Vietnam. In the first year after returning to the United States only 1% became re‐addicted to heroin, although 10% tried the drug after their return. Like other seminal studies, this work needs to be read in the original, because relying upon secondary interpretations risks being given a selectively edited version of their findings in service of varied policy and theoretical agendas.