Inequities in health systematically put groups of people who are already socially disadvantaged (for example, by virtue of being poor, female, and/or members of a disenfranchised racial, ethnic, or religious group) at further disadvantage with respect to their health; health is essential to wellbeing and to overcoming other effects of social disadvantage. Equity is an ethical principle; it also is consonant with and closely related to human rights principles. The proposed definition of equity supports operationalisation of the right to the highest attainable standard of health as indicated by the health status of the most socially advantaged group. Assessing health equity requires comparing health and its social determinants between more and less advantaged social groups. These comparisons are essential to assess whether national and international policies are leading toward or away from greater social justice in health.
Equity in Health
Journal Of Health Economics Vol. 21 (Issue3 - May 2002) pp. 497-513. Copyright (c) 2002 Elsevier Science B.V. Antoine Bommier, Guy Stecklov. Institut National d'etudes Démographiques (INED), INRA-Jourdan, Paris, France; and Department of Population Studies, Department of Sociology and Anthropology, Mount Scopus Campus, Hebrew University of Jerusalem, Israel. While there has been an important increase in methodological and empirical studies on health inequality, not much has been written on the theoretical foundation of health inequality measurement the authors discuss several reasons why the classic welfare approach, which is the foundation of income inequality analysis, fails to provide a satisfactory foundation for health inequality analysis. They propose an alternative approach which is more closely linked to the WHO concept of equity in health and is also consistent with the ethical principles espoused by Rawls [A Theory of Justice. Harvard University Press, Cambridge, MA, 1971]. This approach in its simplest form, is shown to be closely related to the concentration curve when health and income are positively related. Thus, the criteria presented in the paper provide an important theoretical foundation for empirical analysis using the concentration curve. They explore the properties of these approaches by developing policy scenarios and examining how various ethical criteria affect government strategies for targeting health interventions.
"The scale of the Aids crisis now outstrips even the worst-case scenarios of a decade ago," according to a new UNAIDS Report on the Global HIV/AIDS Epidemic, and Africa continues as "the worst-affected region in the world." By 2020, according to UNAIDS numbers, over 25% of the workforce may be lost to Aids in some severely affected countries. "I wish I could come up with better news," said UNAIDS Executive Director, Peter Piot, briefing reporters Tuesday. "The Aids epidemic continues its expansion. It's now clear to me that we are only at the beginning of the Aids epidemic." This conclusion was unexpected, said Piot. Epidemiological modeling used to project the expansion of Aids had predicted that the spread of the disease would have "peaked" by now.
The illegal sale of anti-AIDS drugs in Malawi was endangering the lives of many HIV-positive citizens who were desperate to access affordable treatment, a health official told PlusNews. "Our major concern is that people are selling immune boosters and multivitamins, and cheating [HIV] positive people by saying they are antiretrovirals (ARVs)," Dr Bizwick Mwale, director of Malawi's national AIDS commission, told PlusNews.
Despite the relentless efforts to reduce infant and child mortality with the introduction of the National Expanded Programmes on Immunization in 1974, major disparities still exist in immunization coverage across different population sub-groups. In Kenya, while the proportion of fully immunized children increased from 57% in 2003 to 77% in 2008–9 at national level and 73% in Nairobi, only 58% of children living in informal settlement areas are fully immunized. This study aimed to determine the degree and determinants of immunization inequality among the urban poor of Nairobi, using data from the Nairobi Cross-Sectional Slum Survey of 2012 on full immunization status among children aged 12–23 months. The wealth index was used as a measure of social economic position for inequality analysis. Immunization inequality was found to be mainly concentrated among children from poor families. Decomposition of the results suggests that 78% of this inequality is largely explained by the mother’s level of education. The author suggests that efforts to reduce this inequality should aim at targeting mothers with low levels of education during immunization campaigns.
The Treatment Action Campaign (TAC) welcomes the Cabinet's instruction to the Department of Health to develop an operational plan within one month to provide ARVs in the public sector. The Cabinet endorsed the findings of the Joint Health and Treasury Task Team Report that between 500,000 and 1.7 million lives will be saved with anti-retroviral therapy. It also reaffirmed the science of HIV/AIDS pathogenesis and treatment. The TAC National Executive will formally suspend the civil disobedience campaign and reconsider pending litigation early next week. We welcome Cabinet's bold step today but we also remember the anguish, pain and unnecessary loss of lives over the last four years.
Related Link:
* Full report of the South African ARV task force
http://www.gov.za/reports/2003/ttr010803.pdf
It is now commonly admitted that the so-called (most) neglected tropical diseases have been given little attention. According to World Health Organization, neglected diseases are hidden diseases as they affect almost exclusively extremely poor populations living in remote areas beyond the reach of health service. The European Parliament recognised that Neglected Diseases have not received the attention they deserve from EU actions or in the Millennium Development Goals. Investing in drugs for these diseases is thought to be not marketable or profitable. However, despite their low mortality, neglected diseases are causing severe and permanent disabilities and deformities affecting approximately 1 billion people in the world, yielding more than 20 millions of Disability Adjusted Life Years (56.6 million according to Lancet's revised estimates) and important socio-economic losses. Urgent pragmatic and efficient measures are needed both at international and national levels.
Argentina, Brazil, Colombia, the Dominican Republic, Indonesia, Nigeria, South Africa and the Philippines are experiencing a "minor epidemic of birth defects" because poor women are taking misoprostol in an attempt to end their pregnancies, the New Scientist reports.
Preparations for the United Nations High-level Meeting on Non-communicable Diseases in September 2011 have already begun through regional consultations in all six World Health Organisation (WHO) regions. These consultations have resulted in declarations or outcome documents that identify priorities for action against NCDs and outline the expectations of Member States. Based on the regional consultations, some of these expectations include: a greater commitment from policy-makers to NCD prevention; more effective mechanisms and monitoring of intersectoral action; greater accountability of non-health sectors; and scaling-up of WHO’s Action Plan. Despite repeated external funding commitments such as the Paris Declaration on Aid Effectiveness and the Accra Agenda for Action, NCDs receive less than 3% of development assistance for health even though they cause more than one-third of all premature deaths. Ultimately the outcomes of the high-level meeting will depend on the expressed priorities of Member States, the authors of this article argue. At the very least, they conclude, the meeting should increase awareness of NCDs among policy-makers and achieve higher levels of political commitment.
Without a major breakthrough in preventing and treating diabetes, the number of cases in sub-Saharan Africa is projected to double, reaching 24 million by 2030, according to the Brussels-based International Diabetes Federation (IDF). Jean Claude Mbanya, IDF president and the study's lead researcher, said that diabetes had been misunderstood as a rich country problem, despite medical data compiled by IDF showing that 70% of cases were reported in low- and middle-income countries. Mabanya noted that there is also the perception that when diabetes does affect people in low-income countries, it only affects those who are the wealthy elite, despite the fact that diabetes is devastating for the poor, especially when it affects breadwinners. Data is scarce in Africa and estimates are based on a limited number of studies. Mabanya called for more studies to increase confidence in the numbers. He added that most people in Africa who have diabetes are undiagnosed and, therefore, even when statistics are available from health systems, the size of the problem will always be underestimated.