In August ZMAPP, an untested serum-based therapy in humans, was successfully administered to two American health workers infected with the Ebola virus, who were later declared free from the virus. The public announcement raised hopes for a new front in the fight against the ravaging epidemic. Besides the ethical and equity challenges present in distributing the limited quantity of the experimental therapies, the remarkable survival and first-rate quality of treatments provided to the American patients, as well as the water-tight public health containment measures employed, paint in a very stark manner the contours of divisions in global health, which were already widening before Ebola and have been worsen by the outbreak. The authors argue that an emergency-only response by African countries and the international community would fail to bridge those divisions that will continue in future to manufacture new and remerging epidemics like Ebola at an alarming rate as well as with frightening impact on a global scale. Africa’s endemic diseases like Ebola affect mostly its bottom millions. As such, the patients do not form a viable consumer base enough to motivate pharmaceutical industry to invest in innovative drugs and treatments for them. The WHO has put together a list of 17 neglected poverty-related diseases (NTDs). According to one study, of the about 1,393 new chemical entities introduced between 1975 and 1999, only 16 targeted NTDs.
Equity in Health
Nearly two decades after the United Nations Conference on Environment and Development (the Rio Summit), the world still needs to alleviate poverty and improve human lives through more equitable access and use of resources and healthier environments. Understanding that human health depends on ecosystems, researchers are cutting a new path toward a more sustainable future. An ecosystem approach to health, integrating research and practice from such fields as environmental management, public health, biodiversity, and economic development, is based on an understanding that people are part of complex socio-ecological systems. Featuring case studies from around the world, Ecohealth Research in Practice demonstrates innovative practices in agriculture, natural resource management, community building, and disease prevention, reflecting the state of the art in research, application, and policymaking in the field. The book demonstrates how ecohealth research works and how it has led to lasting changes for the betterment of peoples’ lives and the ecosystems that support them.
The Economic and Social Council (ECOSOC) has adopted a number of resolutions, including a resolution urging the Joint United Nations Programme on HIV/AIDS (UNAIDS) and other relevant organisations and bodies of the United Nations system to intensify their support to governments in dealing with HIV and AIDS. It also reaffirmed its commitment to the implementation of the Programme of Action for the Least Developed Countries for the Decade 2001–2010, which calls on the UN Secretary-General to step up appropriate measures for effective and timely implementation of the Programme in coordination with all relevant stakeholders, and submit an analytical and results-oriented annual progress report on the further implementation. The Council also recommended mainstreaming information and communication technologies in the economy as a driver of growth and sustainable development and encouraged all stakeholders to continue engaging in people-centred partnerships as an effective way forward.
A United Nations Economic and Social Council (ECOSOC) panel discussion on universal health coverage (UHC) on 3 July 2013 highlighted the importance of science, technology and innovation for achieving UHC, especially in the context of the post-2015 development agenda. Speakers discussed the meaning and scope of UHC as well as the financing and promotion of UHC in various country contexts. World Health Organisation Director General Margaret Chan pointed to political commitment, investment, clear policy goals and tracking mechanisms as necessary conditions for UHC, but also emphasised state ownership in developing and implementing UHC. She argued that each state should develop its own healthcare system according to the needs of its population. She said that no major breakthrough, such as the introduction of vaccines, is possible without innovation; however, innovation has become expensive, at the cost of access for most people. On the matter of social innovation Chan remarked that often innovation is thought of as sophisticated science, but looking forward, the future of healthcare should be people-centred, integrated and based on primary healthcare and prevention.
Of 585 000 maternal deaths worldwide each year, 99% are in developing countries. What factors underlie this striking imbalance? Research involving the Malawi College of Medicine and the Liverpool School of Tropical Medicine studied this issue in a rural community in southern Malawi. Maternal education and access to healthcare facilities influence pregnancy outcomes, it showed.
In this study, researchers investigated whether maternal obesity is a risk factor for neonatal death in sub-Saharan Africa and the effect on the detailed timing of death within the neonatal period. Cross-sectional Demographic and Health Surveys from 27 sub-Saharan countries (2003-09) were pooled, comprising a total of 81,126 women. Of these women, 15,518 were overweight, 4,266 were obese, 52,006 had an optimum body mass index (BMI) and 13,602 were underweight. Maternal obesity was associated with an increased odds of neonatal death after adjustment for confounding factors, and it was a significant risk factor for neonatal deaths occurring during the first two days of life. Strategies to prevent and reduce obesity need to be considered, the authors argue, and obese women should be advised to deliver in a health-care facility that can provide emergency obstetric and neonatal care.
Brazil is the country with the third worst income distribution in the world and, as a consequence of the unequal distribution of its main determining factors (income, education, living conditions, sanitation, and health service), the health indicators also present broad inequalities by regions and social classes. The expansion of primary health care in Brazil has been thought to be shaping the agenda for health care policy in the Latin American region. This editorial discusses the importance of a study which performed a longitudinal evaluation, at a national level, of a broad primary health care strategy.
In order to "save Africa from two catastrophes" - the HIV/AIDS epidemic and famine - "we would do well to focus on saving Africa's women," U.N. Secretary-General Kofi Annan writes in a New York Times opinion piece. Women account for 50% of the individuals infected with HIV worldwide and 58% of the HIV-positive people in Africa. According to Annan, AIDS is "attacking the capacity of these countries to resist famine by eroding those mechanisms that enable populations to fight back - the coping abilities provided by women."
As the UN's specialist health agency, the World Health Organization remains the most important international public health institute. The People's Health Movement is therefore monitoring the election of the organization's new Director General. All candidates have been sent a set of questions on key health issues and their answers will be posted on the website to complement their background profiles.
This latest edition of Roll Back Malaria’s (RBM) global progress report indicates that all but four of the 46 African region countries still have ongoing malaria transmission. Four countries in southern Africa (Botswana, Namibia, South Africa and Swaziland) share a common goal of eliminating malaria by 2015. They were joined by their four northern neighbours (Angola, Mozambique, Zambia and Zimbabwe) in 2009, to form the sub-regional malaria elimination initiative known as the Elimination Eight (E8). Another four countries in Africa (Gambia, Rwanda, São Tomé and Principe, and Madagascar) have secured Global Fund grants to prepare for elimination. The long-term cost benefit of elimination still needs to be sufficiently documented, RMB notes, in order to facilitate the required policy and financing commitments. Success is accumulating, however, and the evidence base guiding local, national, regional and global action is growing quickly. Future investment in new malaria control tools and in socio-economic development that will support malaria control and communities broadly will be essential, RBM argues. With strong human capacity, continued investment, evidence-based programming and continued partnership, achieving the ambitious Roll Back Malaria 2015 targets, including elimination in at least eight to ten countries is still possible, the report concludes.