evance for developing countries and, most important of all, in fostering an indigenous capacity for understanding and resolving indigenous needs.

  • The third implication pertains to recognition of the simultaneous marginality and importance of external assistance. Economic assistance may be critical for the lowest-income countries, where it can constitute a significant proportion of national budgets. For other countries, the value of economic assistance is at the margin, where it can nevertheless affect national policies, the generation of new knowledge, and the building of indigenous capabilities for understanding and resolving indigenous needs.

  • The fourth implication has to do with acknowledgment that all approaches to development must shift, if only partially and incrementally, away from focused development projects and toward integrated development strategies that are the products of shared planning among cooperating countries.

  • The fifth implication goes toward affirmation of a basic principle of development cooperation as fostering creative interactions among the public (government), private (corporate), and independent (NGOs, foundations, universities) sectors, an implication of notable importance for the United States, where the corporate and nongovernmental sectors are so prominent.

  • The sixth implication relates to crediting the importance of measures of disease burdens and their use in guiding policy formulation and resource allocations, especially as constrained resources and shifting priorities promote the urgency of greater allocative efficiency.

  • The seventh implication is for understanding that science and technology are crucial enabling tools for national and global development and that the United States has particular (though not exclusive) strengths for sharing scientific advances and helping countries build research capacities relevant to their own development needs.

  • The eighth implication addresses appreciation of the critical role of the United States, in partnership with other countries, in addressing the serious problems of health and social development on a global scale with, again, special (though not exclusive) concern for those countries and populations that are most vulnerable and deprived.



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