By May 2016, tests conducted at Brazil’s national reference laboratory conclusively identified that a new mosquito-borne disease - Zika- had indeed arrived in the Americas, though no one knew what that might mean. Although the re-profiling of Zika from a benign disease to a global health emergency stimulated a flurry of research, the disease remains poorly understood at levels ranging from its virology and epidemiology to the clinical spectrum of complications it can cause. No one can answer questions about further international spread with certainty, though theories abound. As the virus has been detected in parts of Asia and Africa for several decades, some level of endemicity is assumed, though no one knows whether presence of the virus over time has resulted in widespread or low-level immune protection or possibly no protection at all. In April 2016, researchers in Ecuador and the northeastern part of Brazil reported the detection of Zika in monkeys, suggesting a new transmission cycle that could allow the virus to persist. In Brazil, the virus detected in monkeys was identical to the one circulating in humans. Researchers at a government laboratory in Mexico reported detection of the Zika virus in female Aedes albopictus mosquitoes collected in the wild, as opposed to experimentally infected – a first for the western hemisphere. As the mosquito can survive the winter in temperate climates, its ability to carry the Zika virus could expand the map of areas at risk of Zika virus transmission.
Equity in Health
At a roundtable hosted by the UNDP at the 13th ICASA, Nairobi, Kenya, it was reported that of the US$50 million allocated to 53 countries in the first Round by the Global Fund for Aids, TB and Malaria, only 23% has been distributed. Jerry van Nortick from the Fund reported that the money was being distributed based on results and progress in individual countries.
In this open letter, participants of the Conference on the Social Determinants of Health have called on the British Prime Minister to ensure that consideration at the forthcoming G20 meeting onthe financial crisis is not limited to the immediate problems of the banking and financial system. Leaders should extend their review to the key global challenges of ill-health, poverty and climate change, and the anachronistic and undemocratic structure of global governance which underlies the failure of the global community to deal with these issues effectively. The letter calls for reform of the ‘Bretton Woods’ institutions to be fully inclusive of all countries, on an equal basis, and for the institurtions to reflect contemporary standards of democracy, transparency and accountability. It is only through such a system of global governance, placing fairness in health at the heart of the development agenda and genuine equality of influence at the heart of its decision-making, that coherent attention to global health equity is possible.
The current economic downturn will diminish wealth and health, but the impact will be greatest in the developing world. The world can be grateful that health officials are recommitting themselves to primary health care, the surest route to greater equity in access to health care. Much of the blame for the essentially unfair way our world works rests at the policy level. Time and time again, health is a peripheral issue when the policies that shape this world are set. When health policies clash with prospects for economic gain, economic interests trump health concerns. Time and time again, health bears the brunt of short-sighted, narrowly focused policies made in other sectors. Equity in health matters. It matters in life-and-death ways. The HIV/AIDS epidemic taught us this, in a most visible and measurable way. We see just how much equity matters when crises arise.
For many years it has been known that unprotected oral sex carries a risk, albeit relatively small, of HIV transmission. Recent work in the USA and in the UK has suggested that this risk may contribute to 3-8% of HIV infections among men who have sex with men.
The International Conference on Primary Health Care and Health Systems in Africa, meeting in Ouagadougou, Burkina Faso, from 28 to 30 April 2008, reaffirms the principles of the Declaration of Alma-Ata of September 1978, particularly in regard to health as a fundamental human right and the responsibility that governments have for the health of their people. Having analysed the experience of Primary Health Care implementation in the countries of Africa in the last 30 years, the Conference expresses the need for accelerated action by African governments, partners and communities to improve health. The Conference also reaffirmed the importance of the involvement, participation and empowerment of communities in health development in order to improve their well-being, as well as the importance of a concerted partnership, in particular, between civil society, private sector and development partners, to translate commitments into action.
Decades of neglect and chronic underinvestment have had serious detrimental effects on the health and wellbeing of adolescents aged 10–24 years, according to a major new Lancet Commission on adolescent health and wellbeing. Two-thirds of young people are growing up in countries where preventable and treatable health problems like HIV, early pregnancy, unsafe sex, depression, injury, and violence remain a daily threat to their health, wellbeing, and life chances. Evidence shows that behaviours that start in adolescence can determine health and wellbeing for a lifetime. Adolescents today also face new challenges, including rising levels of obesity and mental health disorders, high unemployment, and the risk of radicalisation. Adolescent health and wellbeing is also a key driver of a wide range of the Sustainable Development Goals on health, nutrition, education, gender, equality and food security, and the costs of inaction are enormous, warn the authors. While efforts to improve the health of children under 5 have led to major improvements in younger ages, the leading causes of death for young people aged 10-24 years have changed remarkably little from 1990 to 2013, with road injuries, self-harm, violence, and tuberculosis remaining in the top five. Maternal disorders were the leading cause of death in young women in 2013, responsible for 17% of deaths in women aged 20–24 years and 11.5% in girls aged 15–19 years. The leading risk factors for death in young people aged 10–14 years have not changed in the past 23 years, with unsafe water, unsafe sanitation, and handwashing remaining in the top three. Diarrheal and intestinal diseases are still responsible for 12% of deaths in 10–14 year old girls. Injuries, mental health conditions, common infectious diseases, and sexual and reproductive health problems are the dominant health problems in young people. The two main contributors to health loss worldwide for both sexes are mental health disorders and road injuries.
This outcome statement summarises views from stakeholders from a total of 53 African countries, represented by governments, Regional Economic Communities, civil society organisations including youth and women’s organisations, parliamentarians, academic institutions and the private sector. Noting the relatively slow progress made by African countries towards the Millennium Development Goals (MDGs) and recognising the capacity deficits and disabling initial conditions prevailing in a number of countries, participants unanimously agreed that the post-2015 development agenda should: 1. Emphasise inclusive economic growth and structural transformation. 2. Re-orient the development paradigm away from externally-driven initiatives toward domestically- inspired and funded initiatives that are grounded in national ownership. 3. Prioritise equity and social inclusion and measure progress in terms of both the availability and quality of service delivery. 4. Pay greater attention to vulnerable groups such as women, children, youth, the elderly, people with disabilities, displaced persons 5. Take into account the initial conditions of nation states and recognise the efforts countries have made towards achieving the goals as opposed to exclusively measuring how far they fall short of global targets. 6. Incorporate the Rio+20 outcomes and the outcomes of Africa-wide initiatives, national and regional consultations as well as UN forums such as ICPD +20. 7. Focus on development enablers as well as development outcomes.
After the United Nations announced the members of its new High-level Panel to advise on the global development agenda beyond 2015, Oxfam responded by calling on the Panel to accelerate delivery on the Millennium Development Goals (MDGs) first. There are still three years left before the MDGs expire, and with declining contributions from external funders, Oxfam argues that one way to finance the MDGs is to introduce a financial transaction tax in Europe, with at least 50% of the revenues committed to development and climate change.
A programme being run in Paarl in the Western Cape to reduce the risk of babies contr!acting HIV from their mothers during birth is setting standards not only for the rest of South Africa, but for the world. The programme is offered at the provincial administration's TC Newman health care centre, one of 18 sites countrywide designated by the national health ministry as pilots for testing "operational issues" around the use of the anti-retroviral Nevirapine.