Abahlali baseMjondolo formed in 2005 has more than 12,000 members in more than 60 shack settlements. The organisation campaigns against evictions, and for public housing: struggling for a world in which human dignity comes before private profit, and land, cities, wealth and power are shared fairly. The article by the founder of Abahlali baseMjondolo expresses people's frustration with lack of delivery on rights to free housing, free education and free healthcare in urban South Africa, and the consequent resolve to take direct action to move rights from paper to reality, from abstract to concrete. While they acknowledge that this brings risk to their members, the author raises frustration with political and civil society processes, they also argue that they no choice but to take their own place in the cities and in the political life of the country.
Governance and participation in health
The objective of this project was to achieve high, sustainable levels of net coverage in a village in rural Tanzania by combining free distribution of long-lasting insecticide-impregnated nets (LLINs) with community-tailored education. Community leaders held an educational session for two members of every household addressing these practice and attitudes, demonstrating proper LLIN use, and emphasizing behaviour modification. Attendees received one or two LLINs per household. Baseline interviews and surveys revealed incorrect practices and attitudes regarding: use of nets in dry season, need to retreat LLINs, children napping under nets, need to repair nets and net procurement as a priority, with 53- 88.6% incorrect responses. A three-week follow-up demonstrated 83-95% correct responses. Results suggest that addressing community-specific practices and attitudes prior to LLIN distribution promotes consistent and correct use, and helps change attitudes towards bed nets as a preventative health measure. Future LLIN distributions can learn from the paradigm established in this project.
Developed countries are reported to be turning against the World Health Organization’s framework of engagement with non-State actors (FENSA), by putting conditions for its adoption as negotiations on it enter into the last stage. Member States from Europe are reported to be raising three issues to block the adoption of FENSA. First, that the adoption of FENSA is possible only when there is a clear understanding on the implications of its implementation, especially financial and human resource implications. Secondly, that the Secretariat be given flexibility to suspend FENSA norms while engaging with non-State actors to respond to emergencies, and thirdly that the implementation of FENSA be at all three levels of WHO viz. headquarters, regional and national.
This review investigated international cooperation in health, particularly between developed and developing nations. Standard database and web-based searches were conducted for publications in English between 1990 and 2010, from which 65 articles were included in the final analysis. While some articles identified intangible benefits accrued by developed country partners, most pointed to developing country innovations that can potentially inform health systems in developed countries. Ten key health areas in which developing countries led the way were identified, such as rural health service delivery, skills substitution, decentralisation of management, creative problem-solving and innovation in mobile phone use, and health financing. The authors argue that combined developed-developing country learning processes can potentially generate effective solutions for global health systems. However, the global pool of knowledge in this area is still basic and further work needs to be undertaken to advance understanding of health innovation diffusion. Even more urgently, a standardised method for reporting partnership benefits is needed for realising the full potential of international cooperation between developed and developing countries.
Developing countries have highlighted a number of concerns over the reform agenda of ‘The Future of Financing for WHO’, which was unveiled by the Director-General of the World Health Organization (WHO) at the 128th session of the organization's Executive Board held from 17-25 January. Several developing countries pointed out that health cannot be de-linked from socio-economic development, and voiced strong support for the WHO's role in development and its leadership on global health issues. There was also a call for a transparent process to discuss the reform. While the reform agenda was initially instigated by the need to ensure more predictable and sustainable financing for WHO, proposals for reform that are contained in Director-General Margaret Chan's report suggest a more far-reaching agenda that could lead to significant changes in the role of WHO on matters of public health at the global level. In depating the proposals representatives of several low and middle income countries pointed out that health cannot be de-linked from socio-economic development and WHO cannot be reduced to being a mere technical agency. They also expressed strong support for WHO's role in development and its leadership in global health issues. Civil society groups, including the People’s Health Movement cautioned that public health should not take a back seat to market-led initiatives. Mozambique, on behalf of the African group, stated that reform of the organisation should maintain WHO's leadership position in international health, adding that any debate on financial aspects deserves a wider discussion.
It is an ongoing challenge to share health information with resource-poor communities that is locally relevant and owned by the communities themselves. When health information from outside the community goes against deeply held beliefs and attitudes about personal and sexual matters, this challenge becomes still greater. As positive a step as open discussion is, unless poor people can access and accept the information they need, they will not be able to make informed decisions regarding their lives and future, according to this article on the website of the Public Library of Science.
The Fourth High Level Forum on Aid Effectiveness, held in Busan, South Korea in November 2011 again promised an opportunity for a new consensus on development cooperation to emerge. This paper reviews the recent evolution of the concept of coordination for development assistance in health as the basis from which to understand current discourses. Four distinct transitions in the understanding, orientation and application of coordination were identified: coordination within the sector, involving geographical zoning, sub-sector specialisation, external funder (donor) consortia, project co-financing, sector aid, harmonisation of procedures, ear-marked budgetary support, external funding agency reform and inter-agency intelligence gathering; sector-wide coordination, expressed particularly through the Sector-Wide Approach; coordination across sectors at national level, expressed in the evolution of Poverty Strategy Reduction Papers and the national monitoring of the Millennium Development Goals; and, most recently, global-level coordination, embodied in the Paris Principles, and the emergence of agencies such as the International Health Partnerships Plus. The transitions are largely but not strictly chronological, and each draws on earlier elements, in ways that are redefined in the new context. With the increasing complexity of both the territory of global health and its governance, and increasing stakeholders and networks, current imaginings of coordination are again being challenged. The High Level Forum in Busan may have been successful in recognising a much more complex landscape for development than previously conceived, but the challenges to coordination remain.
The Millennium Declaration of 2000 contains a comprehensive vision of development underpinned by human rights, and is the source document of the Millennium Development Goals (MDGs). However, in 2001, when the MDGs were formulated, influential voices were able to convince the international community that democratic freedoms could be relegated in favour of progress on economic indicators. But the neglect of these freedoms has come at a cost, the author argues, as evidenced by the Arab Spring, which showed that development must be about both freedom from fear and freedom from want. People need good standards of living where their basic needs are met but they also need civil and political freedoms to have a say in the decisions that affect their lives and to ensure that the benefits of development are evenly spread. The author calls on global and national decision-makers to reread the promises made by world leaders in the Millennium Declaration on freedom, equality, solidarity, tolerance, respect for nature and shared responsibility. He argues that it is time to put people at the centre of development and ditch the business as usual approach if we are to address impending and interlinked economic, social, political, environmental and humanitarian crises.
From the upheavals of recent national elections to the success of the #MyDressMyChoice feminist movement, digital platforms have already had a dramatic impact on political life in Kenya – one of the most electronically advanced countries in sub-Saharan Africa. While the impact of the Digital Age on Western politics has been extensively debated, there is still little appreciation of how it has been felt in developing countries such as Kenya, where Twitter, Facebook, WhatsApp and other online platforms are increasingly a part of everyday life. Written by a respected Kenyan activist and researcher at the forefront of political online struggles, this book presents a unique contribution to the debate on digital democracy. For traditionally marginalised groups, particularly women and the disabled, digital spaces have allowed Kenyans to build new communities which transcend old ethnic and gender divisions. But the picture is far from wholly positive. Digital Democracy, Analogue Politics explores the drastic efforts being made by elites to contain online activism, as well as how ‘fake news’, a failed digital vote-counting system and the incumbent president's recruitment of Cambridge Analytica contributed to tensions around the 2017 elections. Reframing digital democracy from the African perspective, Nyabola’s work opens up new ways of understanding our current global online era.
Maternal and child health issues have gained global political attention and resources in the past 10 years, due in part to their prominence on the Millennium Development Goal agenda and the use of evidence-based advocacy by policy networks. This paper identifies key factors for this achievement, and raises questions about prospective challenges for sustaining attention in the transition to the post-2015 Sustainable Development Goals, far broader in scope than the Millennium Development Goals. The paper uses participant observation methods and document analysis to develop a case study of the behaviours of global maternal and child health advocacy networks during 2005–2015. The development of coordinated networks of heterogeneous actors facilitated the rise in attention to maternal and child health during the past 10 years. The strategic use of epidemiological and economic evidence by these networks enabled policy attention and promoted network cohesion. The time-bound opportunity of reaching the 2015 Millennium Development Goals created a window of opportunity for joint action. As the new post-2015 goals emerge, networks seek to sustain attention by repositioning their framing of issues, network structures, and external alliances, including with networks that lay both inside and outside of the health domain. Issues rise on global policy agendas because of how ideas are constructed, portrayed and positioned by actors within given contexts. Policy networks play a critical role by uniting stakeholders to promote persuasive ideas about policy problems and solutions. The author argues that the behaviours of networks in issue-framing, member-alignment, and strategic outreach can force open windows of opportunity for political attention -- or prevent them from closing.