Beyond the World Food Summit

While most speakers at the 1996 World Food Summit expressed concern about the injustice that forces more than 800 million people worldwide to live with hunger, some sought solutions through economic and social development while others called for a more liberal marketplace. Among world leaders, only Fidel Castro raised issues and challenges that addressed some of the underlying causes of malnutrition. The Plan of Action that grew out of the Summit has only one measurable commitment, which is to halve the number of undernourished people by 2015. The other six commitments, while diluted, contain important objectives even though they give little emphasis to the underlying causes of poverty or hunger. The Summit process, however, did contribute to the fact that food-related issues are now placed higher on the world agenda because many of these issue were raised by civil service organizations (CSOs) at the Summit's parallel NGO (nongovernmental organization) forum. In fact, one of the most positive outcomes of the Summit may prove to be the increased effectiveness of the CSOs as a result of the creation of improved networks in preparation for the Summit. The CSOs contributed examples of how food security could be improved, published an active site on the World Wide Web, and challenged the statements of governments. In addition to raising trade issues, CSOs also lobbied for sustainable agriculture and agricultural biodiversity. In fact, CSOs may have to set a new action agenda for the formal sector to encourage development of new institutions and new global forums that give NGOs a place at the table.     

EEOC guidance on psychiatric disabilities: many problems, few workable solutions

The EEOC recently issued "Enforcement Guidance" on psychiatric disabilities under the Americans with Disabilities Act. Although the Guidance provides clarification of a few issues involving mental disabilities under the ADA, in most respects the Guidance is problematic. For example, the Guidance suggests that the inability to get along with a supervisor or coworkers may constitute a disability under the ADA, that an employer may have to "accommodate" a disabled employee's misconduct, that an employer cannot require an employee to follow doctor's orders as a condition of employment, and that an employer may be obligated to modify work rules and procedures to accommodate a mentally disabled employee but is prohibited from explaining to coworkers why it is making such modifications. As the EEOC's Guidance exceeds or conflicts with the ADA in some respects and is largely unworkable in many respects, it remains to be seen how many courts will actually follow it.     

MEDGuide and patient package inserts--again?

This article will trace the history and effects of the PPI from the time of its original concept by the FDA in the early 1970's to its current status. It will also address the response to this FDA initiative by the industry, medical community and consumer groups. Initiatives in other countries and future issues will also be discussed.     

The State of American Federalism, 1996-1997

Federalism enjoyed political and popular salience during theperiod 1996–1997 as the so-called "Devolution Revolution"began to be implemented and analyzed in the United States. Whilethere were a few examples of important Revolutionary efforts,the federal government continued to hold much of the power andsignificance it has achieved over the past sixty years. Evenin the area of welfare policy, where in 1996 there were historicreforms enacted to end the federal entitlement, the federalgovernment maintained a significant presence that made the ideaof devolution of welfare policy responsibility some what questionable.Nevertheless, states continued to lead in policy innovationin areas ranging from education to health, and the U.S. SupremeCourt continued to question the limits of federal power. Thepast year illustrated, once again, the complexity of our federalsystem and how difficult it is to reform federalism—particularlywhen it involves a shift in power and creates the perceptionof winners and losers.