BY-ELECTIONS-Bad News for Congress

to make decisions for itself spelling out the financial and other support needed. After touching upon other 'global' topics, a dire warning is issued: "If our population policy goes wrong, nothing else will have a chance to go right" So how is all this to be implemented? "A holistic and comprehensive approach would be identified and implemented" which, believe it or not, entirely comprises the following; a reproductive health care package which will be delivered through the primary health care system, integrating within itself not only MCH, reproductive and sexual health but also the national eradication of malaria, leprosy, tuberculosis, blindness, AIDS, etc. Why then should it be termed a reproductive health package' ? Clearly the package which originally did not contain any general health care components is being sought to be expanded, on paper, to quieten the criticism about its limited character In fact, the later elaboration of these services and the training and support required completely ignores any mention of the communicable diseases programme. Preparatory manuals for the new programme already in use have little to say on anything except the core family planning package, including now, reproductive illnesses. It must be remembered that communicable diseases programmes are vertical centrally-designed programmes which have defied integration even at the primary general health care levels. Integration of the various services is undoubtedly desirable, but it requires enormous groundwork and structural changes in the entire system of delivery of health care, which clearly is not the intention of the policy-makers.