The 1972 abortion-initiative campaign in North Dakota provides an example where elites on one side of an issue were able to provide cues and get supporters to participate in an election while the other side was unable to do so. North Dakota Right to Life through the formation of branch chapters and its work with the Catholic churches became the focus of the anti-initiative campaign. Flush with resources, the NDRL made sure that its supporters turned out to such an extent that initiative voters outnumbered presidential voters in most counties. While the pro-initiative elements proved effective at getting the question on the ballot, they were unable to get their message out, let alone galvanize supporters. The result was confusion among potential supports and lower turnout rates in the most populous counties.

Objectives: The aim of this study was to provide evidence about the design and implementation of policies for advancing the sustainability of knowledge translation (KT) initiatives and policies in Uganda's health system.

Methods: We searched for and reviewed evidence about KT sustainability issues in Uganda, the impacts of options, barriers to implementing these options, and implementation strategies to address such barriers. In instances where the systematic reviews provided limited evidence, these were supplemented with relevant primary studies. Documents such as the government reports and unpublished literature were also included in the search. Key informant interviews and a policy dialogue were conducted, and an expert working group guided the study.

Results: The KT sustainability issues identified were: the absence of a specific unit within the health sector to coordinate and synthesize research; health worker not familiar with KT activities and not often used. Furthermore, Uganda lacks a mechanism to sustain its current national health frameworks or platforms, and does not have a system to ensure the sustained coordination of existing national health KT platforms. The policy options proposed include: (i) the identification of a KT champion; (ii) the establishment of an operational KT framework; (iii) KT capacity building for researchers and research users, as well as policy and decision makers.

Conclusions: The sustainability of KT will be influenced by the prevailing context and concerns within healthcare both in Uganda and internationally. Furthermore, the availability of resources for KT advocacy, communication, and program design will impact on the sustainability of Uganda's KT activities.

Problems with regard to the recruitment and retention of general practitioners (GPs) have been largely attributed to disquiet over ongoing government health reforms, together with increased administrative and surgery workloads, low morale and stress. This study aimed to provide empirical evidence of the scale of the workforce crisis in GP recruitment and retention, and the type of initiatives being developed to address local problems. Postal questionnaires were sent to directors of primary care in all 100 health authorities in England, and to directors of postgraduate GP education. Problems associated with recruitment and retention were mainly confined to less attractive locations, primarily deprived urban areas. Sources of new recruits mainly consisted of local training schemes. Numerous initiatives had been set up to address local problems, but these tended to be piecemeal and small scale. Although there was widespread awareness of problems with regard to the recruitment and retention of GPs, there was little evidence of co-ordinated approaches to offset future problems.

This is the text for the Opening Address for the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The frightening reality of the costs (human and material) must be balanced by what has been and can be learned that, if applied, can make the world more resilient for the next event. At the time of this Conference, we are moving from response to recovery. The immediate conclusion relates to the consequences of the realization of a truly interdependent world. Given the huge resourcesmade available, there is an increased need for accountability. Several factors will bear heavily on the outcomes: (1) risk of loss of momentum; (2) ensuring that no gaps in services occur; (3) ensuring that already marginalized communities do not become forgotten or even more marginalized; (4) support and respect of national leadership; (5) commit to enhanced coordination; and (6) develop mechanisms for joint and shared assessments. The available resources must be used to stablize the livelihoods of people for years. Lastly, the reliability and sustainability of the important contributions of the military and the commercial private sectors for future events must be established