Leading aid models focus on economic growth and poverty reduction, but the well-being approach aims for more comprehensive change, said a new group studying the problem. Well-being requires us to go beyond the macro statistics on growth, poverty and inequality and get a more fine-grained understanding of the distributions of resources and relationships that constitute the barriers to successful development in particular contexts. This is what development policy must engage in. The work of the group brought together four major bodies of thinking about development, each of which has been adopted with some success by developing countries and development agencies: theories of human need, Nobel laureate Amartya Sen’s ‘development as freedom’, the ‘participation’ and ‘livelihoods’ frameworks, and the work of social psychology on subjective well-being.
Equity in Health
African nations need a "massive infusion of funds" to save 38 million people from starvation, World Food Programme Director James Morris told a public meeting of the United Nations Security Council last month, adding that food aid was "crucial" in the fight against AIDS, Agence France-Presse reports.
The World Health Assembly (WHA), the supreme decision-making body of the World Health Organization (WHO), wrapped-up its sixtieth session today, reaching last-minute agreement on two key resolutions on Pandemic influenza preparedness and Public health, innovation and intellectual property. More than 2400 people from WHO's 193 Member States, nongovernmental organizations and other observers attended the meeting which took place from 14-23 May.
The 62nd World Health Assembly in May 2009 adopted a resolution strongly reaffirming the values and principles of primary health care, including equity, solidarity, social justice, universal access to services, multisectoral action and community participation as the basis for strengthening health systems. It calls on WHO to reflect the values and principles of the Declaration of Alma-Ata in its work and that the overall organizational efforts across all levels contribute to the renewal of primary health care and to strengthen the Secretariat’s capacities to support this. Full text is found at the website provided.
The author reports on efforts in the last 21 years tracking down malaria survey reports done across Africa. The greatest challenge was that they were mostly hidden in old government archives or curated by the World Health Organisation. Their final report covers over 50,000 surveys dating back 115 years. This is the largest repository containing information on over 7.8 million blood tests for malaria. They analysed malaria infection prevalence for each of 520 administrative units across countries south of the Sahara and Madagascar for 16 time periods. The study suggests that the prevalence of malaria infection in sub-Saharan Africa today is at the lowest point since 1900. The biggest historical reduction in malaria coincided with the introduction of new tools to fight malaria. After the Second World War, the discovery of DDT for indoor spraying and chloroquine drugs made a difference in treating malaria. In 2005 the rolling out of insecticide treated bed nets and new antimalarial drugs, led to a further drop of malaria cases. The lowest periods of malaria prevalence were evident when the international community abandoned specific malaria control investment in Africa, during the late 1960s, through the 1970s and early 1980s. The gains made after 2005 are also reported to have stalled since 2010. Declining malaria funding, insecticide and drug resistance are the obvious threats to the elimination of malaria in Africa. The authors observe from the evidence that the malaria map in Africa might shrink a bit at the margins but that middle belt isn’t going anywhere in our lifetimes with what we have at our disposal now – bed nets and drugs. When insecticide and drug resistance becomes established, they argue that unless we have new classes of both drugs and insecticides or a natural period of drought, malaria will revert in large parts of Africa to what it was in the 1990s, another perfect storm.
Whether or not health inequalities are unjust, as well as how to address them, depends on how they are caused, the author of this paper argues. He reviews a range of health inequalities in different countries and internationally, between genders, class, income and racial groups and between countries, tentatively identifying pathways of causality in each case, and making judgments about whether or not each inequality is unjust. He asserts that health inequalities that arise due to medical innovation are among the most benign, while those that arise due to inequalities in early life are more significant, pointing to the importance of parental and child circumstances. Society judges racial inequalities in health as unjust, adding to injustices in other domains. While the inequalities in health between rich and poor countries are wide, the author asserts that they are not perceived as just nor unjust, nor are they easily addressed.
In this study, the author reviews a range of health inequalities, across social class, gender, wealth and within and between countries. He tentatively identifies pathways of causality in each case, and makes judgments about whether or not each inequality is unjust. Health inequalities that come from medical innovation are among the most benign, he argues. The author emphasises the importance of early life inequalities, and of trying to moderate the link between parental and child circumstances. He argues that racial inequalities in health are unjust and add to injustices in other domains. The vast inequalities in health between rich and poor countries are neither just nor unjust, nor are they easily addressable. The author concludes that there are grounds to be concerned about the rapid expansion in inequality at the very top of the income distribution: this is not only an injustice in itself, but it poses a risk of spawning other injustices, in education, in health, and in governance.
In the last two decades, powerful international trends in health care reform have been observed around the world. Although health care reform is a global phenomenon driven by common financial and political actors, adopted reforms vary by country and region. Albeit from a European perspective, this article discusses how, regardless of the national and regional contexts in which health care reforms are implemented, the changes have fundamental consequences for many people's day-to-day lives and well-being.
Drawing on evidence of what has worked in 50 countries, this report provides an eight-point MDG action agenda to accelerate and sustain development progress over the next five years. The eight points focus on supporting nationally-owned and participatory development; pro-poor, job-rich inclusive growth including the private sector; government investments in social services like health and education; expanding opportunities for women and girls; access to low carbon energy; domestic resource mobilisation; and delivery on Official Development Assistance commitments. From the abolition of primary school fees leading to a surge in enrolment in Ethiopia to innovative health servicing options in Afghanistan reducing under-five child mortality, the report brings forward concrete examples that have worked and can be replicated, even in the poorest countries, to make real progress across the Millennium Development Goals. Rapid improvements in both education and health, the report illustrates, have occurred in countries where there were adequate public expenditures and strong new partnerships, where economic growth is job-rich and boosts agricultural production, where robust social protection and employment programmes are in place, and where development is country led, with an effective government in place.
Equity and universality are implicit in universal health coverage (UHC), although ambiguity has led to differing interpretations and policy emphases that limit their achievement. Diverse country experiences indicate a policy focus on differences in service availability and costs of care, and neoliberal policies that have focused UHC on segmented financing and disease-focused benefit packages, ignoring evidence on financing, service, rights-based and social features that enable equity, continuity of care and improved population health. Public policies that do not confront these neoliberal pressures limit equity-promoting features in UHC. In raising the impetus for UHC and widening public awareness of the need for public health systems, COVID-19 presents an opportunity for challenging market driven approaches to UHC, but also a need to make clear the features that are essential for ensuring equity in the progression towards universal health systems.