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SOUTH AFRICA'S FIRST NONRACIAL ELECTIONS, AND THE DRAFTING OF AN INTERIM CONSTITUTION WILL BRING THE COUNTRY TO A CRITICAL THRESHOLD. EVERY ASPECT OF THE SOCIETY NEEDS TO BE RETHOUGHT OR THE COUNTRY WILL BE UNABLE TO MEET THE BASIC NEEDS OF ALL 39 MILLION SOUTH AFRICANS AS OPPOSED TO THE FIRST-WORLD WANTS OF 5 MILLION WHITES. THIS ARTICLE EXPLORES THE NEED TO BALANCE AT THE CENTER, BUTHELEZI'S DECLINING ROLE, AND, THE ECONOMIC CHALLENGE. IT WORRIES THAT WHITE RACISM IS AS PREVALENT AS EVER AND FEW WHITES HAVE EVEN BEGUN TO CONSIDER THE NEED TO ALTER THEIR VIEWS AND BEHAVIOR GIVEN THE IMPENDING TRANSITION.

Instead of trying to escape political authority, large numbers of people across the continent are now migrating toward the cities, especially the capital city, which are the centres of political power in all countries south of the Sahara. Many aspects of African politics can only be understood within the context of the changing accessibility of the traditional exit option. (SJK)

AFRICAN ONE-PARTY STATES THAT HAVE EMBRACED SOCIALISM ARE NOW FINDING THEIR SEVERE ECONOMIC WOES COMPOUNDED BY A LACK OF SYMBOLS CAPABLE OF IMPARTING EVEN A VENEER OF POLITICAL LEGITIMACY. THIS ARTICLE EXAMINES THE RISE AND FALL OF MARXIST ECONOMIES, THE PERSISTENCE OF LENINISM, OBSTACLES TO DEMOCRACY, AND THE PROSPECTS FOR DEMOCRATIZATION. IT CONCLUDES THAT THE WEST MUST APPRECIATE THE GREAT DELICACY OF THE POLITICAL CALCULATIONS THAT AFRICAN LEADERS WILL HAVE TO MAKE AS THEY REDESIGN THEIR POLITICAL SYSTEMS; OTHERWISE THERE MAY BE LITTLE PROGRESS TOWARD DEMOCRACY, BUT MUCH DETERIORATION IN THE RELATIONS BETWEEN AFRICA AND THE REST OF THE WORLD.

Examines the institutions that formulated the decision-making rules for the creation and maintenance of boundaries, discusses the conditions under which cooperation among states has occured, and explores the prospects for future changes in the borders of African states. (Abstract amended)

THE LAST STAGE OF RACIAL RECONCILIATION IN ZIMBABWE BEGAN IN NOVEMBER 1987 WHEN PRESIDENT ROBERT MUGABE ANNOUNCED THE VOLUNTARY APPOINTMENT OF 11 WHITES TO PARLIAMENT. THE BRITISH-SPONSORED CONSTITUTION ADOPTED AT INDEPENDENCE IN 1980 REQUIRED ZIMBABWE'S NEW BLACK LEADERS TO HAVE 20 WHITES SEATS IN THE PARLIAMENT OF 100 FOR THE FIRST SEVEN YEARS OF INDEPENDENCE, BUT THE BLACK GOVERNMENT WAS FREE AFTER APRIL 1987 TO REMOVE ALL THE MANDATED SEATS. BY SO PROMINENT WHEN NO LONGER REQUIRED TO DO SO, ZIMBABWE'S LEADERS HAVE DRAMATICALLY ILLUSTRATED THE EXTENT OF RECONCILIATION IN A COUNTRY THAT SUFFERED FROM A BRUTAL CIVIL WAR BETWEEN BLACKS AND WHITES. AS RACIAL RECONCILIATION IN ZIMBABWE IS ONE OF THE FEW SIGNS OF HOPE FOR STABILITY IN THE BLEAK LANDSCAPE OF SOUTHERN AFRICA, MANY SCHOLARS AND OBSERVERS HAVE CITED THE COUNTRY AS A MODEL FOR RACIAL RECONCILIATION IN A POST-APARTHEID SOUTH AFRICA. THIS ARTICLE ARGUES THAT THE PROCESS OF RACIAL RECONCILIATION THAT HAS OCCURRED IN ZIMBABWE CANNOT BE DUPLICATED IN SOUTH AFRICA, BECAUSE OF CRUCIAL DIFFERENCES IN THE WHITE POPULATION THERE. EXAMINING THE ZIMBABWE EXPERIENCE STILL YIELDS VALUABLE LESSONS, HOWEVRE, FOR WHAT MUST BE DONE IF THERE IS TO BE PEACE AFTER APARTHEID IN SOUTH AFRICA.

When we ask people what they value most, health is usually top of the list. While effective care is available for many chronic diseases, the fact remains that for the patient, the tax payer and the whole of society: prevention is better than cure. Diabetes and its complications are a serious threat to the survival and well-being of an increasing number of people. It is predicted that one in ten Europeans aged 20-79 will have developed diabetes by 2030. Once a disease of old age, diabetes is now common among adults of all ages and is beginning to affect adolescents and even children. Diabetes accounts for up to 18 % of total healthcare expenditure in Europe. The good news is that diabetes is preventable. Compelling evidence shows that the onset of diabetes can be prevented or delayed greatly in individuals at high risk (people with impaired glucose regulation). Clinical research has shown a reduction in risk of developing diabetes of over 50 % following relatively modest changes in lifestyle that include adopting a healthy diet, increasing physical activity, and maintaining a healthy body weight. These results have since been reproduced in real-world prevention programmes. Even a delay of a few years in the progression to diabetes is expected to reduce diabetes-related complications, such as heart, kidney and eye disease and, consequently, to reduce the cost to society. A comprehensive approach to diabetes prevention should combine population based primary prevention with programmes targeted at those who are at high risk. This approach should take account of the local circumstances and diversity within modern society (e.g. social inequalities). The challenge goes beyond the healthcare system. We need to encourage collaboration across many different sectors: education providers, non-governmental organisations, the food industry, the media, urban planners and politicians all have a very important role to play. Small changes in lifestyle will bring big changes in health. Through joint efforts, more people will be reached. The time to act is now.

The prevalence and socioeconomic burden of type 2 diabetes (T2DM) and associated co-morbidities are rising worldwide.This guideline provides evidence-based recommendations for preventing T2DM.A European multidisciplinary consortium systematically reviewed the evidence on the effectiveness of screening and interventions for T2DM prevention using SIGN criteria.Obesity and sedentary lifestyle are the main modifiable risk factors. Age and ethnicity are non-modifiable risk factors. Case-finding should follow a step-wise procedure using risk questionnaires and oral glucose tolerance testing. Persons with impaired glucose tolerance and/or fasting glucose are at high-risk and should be prioritized for intensive intervention. Interventions supporting lifestyle changes delay the onset of T2DM in high-risk adults (number-needed-to-treat: 6.4 over 1.8-4.6 years). These should be supported by inter-sectoral strategies that create health promoting environments. Sustained body weight reduction by>or= 5 % lowers risk. Currently metformin, acarbose and orlistat can be considered as second-line prevention options. The population approach should use organized measures to raise awareness and change lifestyle with specific approaches for adolescents, minorities and disadvantaged people. Interventions promoting lifestyle changes are more effective if they target both diet and physical activity, mobilize social support, involve the planned use of established behaviour change techniques, and provide frequent contacts. Cost-effectiveness analysis should take a societal perspective.Prevention using lifestyle modifications in high-risk individuals is cost-effective and should be embedded in evaluated models of care. Effective prevention plans are predicated upon sustained government initiatives comprising advocacy, community support, fiscal and legislative changes, private sector engagement and continuous media communication.