The recently released World Health Report on PHC (WHO Oct 2008) is an attempt to bring PHC again to the forefront of our priorities in global health. But to go beyond well-meaning pronouncements, this will clearly need some internal reorganisation in this UN agency. The question is whether its leadership plans such a re-orientation? PHM does not shy away from a political approach to PHC and is not really fighting its opponents; it is rather bringing the level of the discussion to a higher level. PHM challenges the concept that good health is an imperative for increased economic productivity. Instead, it insists that health is an inalienable human right. Health is not either a technical or a political issue – it is both – and pro-poor health interventions mean nothing if not concomitantly accompanied by poverty reduction actions that are pro-health.
Values, Policies and Rights
In this paper, the authors describe an economic framework, including demand- and supply-side factors, for approaching the analysis and planning of health system reform in South Africa, in order to avoid piecemeal debates. They argue that there is an urgent need to re-engineer the way health facilities are internally organised to achieve better productivity and responsiveness. They further argue that funding is not the central problem of the South African public health system but rather the enormous inefficiencies in management and low productivity; and that separating the purchase from the supply side is a critical component of making significant efficiency gains. Finally, they suggest that income inequalities and a divided health system in South Africa are departure points for reform initiatives. The government must build on the strengths of the South African health system in preparation for the eventual achievement of a more homogeneous health-care system across the public and private sectors.
Since 2001, Africa’s leaders have committed the African Union and their Governments to promote and protect the right to health in a series of international and continental legal protocols and declarations. Thes commitments provide a comprehensive package for addressing the challenges of maternal mortality, HIV/AIDS, violence and disease. However, the urgent action needed to address what African Governments have described as a 'continental state of emergency' can only be achieved by ensuring firm policy and programme linkages between Sexual and Reproductive Health, HIV/AIDS and Gender Based Violence.
Since 2001, Africa’s leaders have committed the African Union and their Governments to promote and protect the right to health in a series of international and continental legal protocols and declarations. These commitments provide a comprehensive package for addressing the challenges of maternal mortality, HIV/AIDS, violence and disease. However, the urgent action needed to address what African Governments have described as a “continental state of emergency” can only be achieved by ensuring firm policy and programme linkages between Sexual and Reproductive Health, HIV/AIDS and Gender Based Violence. The article encourages African Health Experts and Ministers of Health meeting in Maputo to ensure that the draft Action Plan contains targets and indicators that enshrine on key components of the Abuja Declaration.
Benchmarking exercises have become increasingly popular within the sphere of regional policy-making. This paper analyses the concept of regional benchmarking and its links with regional policy-making processes. It develops a typology of regional benchmarking exercises and benchmarkers, and critically reviews the literature. It is argued that critics of regional benchmarking fail to take account of the variety and development of regional benchmarking systems. It is suggested that while benchmarking exercises are informing policy adaptation and innovation, they have been constrained by political and financial factors. It is concluded that regional benchmarking is facilitating the heightened regional interaction necessitated by globalisation.
In the era of the persisting global north-south health divide, regional integration organisations have emerged as significant legal and diplomatic spaces to advance health goals. In this context, African regionalism is evolving as important frameworks for promoting health diplomacy. This evolving regional health diplomacy is contributing to the reinforcement of social goals of new regionalism in Africa and shaping the drivers of health policy at the global, regional and domestic levels. With reference to case studies of African regional and sub-regional integration organisations, the author of this paper examines the drivers, nature and limits of their practice of health diplomacy. He also analyses the nature of engagement of African regional groupings with select international health regimes. The author identifies the strengths and limits of regionalism for health diplomacy that also advances the protection of public health. The paper concludes with options to foster health diplomacy and its implications for the advancement of health at the domestic, regional and global levels.
This presentation given at the second regional meeting of the African Civil Society Coalition on the Intergovernmental Working Group (IGWG) on Public Health, Innovation and Intellectual Property in Arusha, Tanzania, 3-4 April 2008 provides an introduction to the workings of the IGWG and gives international context for its operations. Drug development and application processes are explained and much of the report is devoted to an evaluation of the IGWG's fixed-dose artsunate-based combination therapy (FACT) project for the treatment of malaria.
In a speech to a plenary session of the 2011 International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) in Ethiopia in December 2011, Stephen Lewis, Co-Director of AIDS-Free World, pointed to the failure globally to apply knowledge to prevent vertical transmission, and expressed concern that the same not happen in relation to the elimination of pediatric AIDS. He pointed to the profound influence of gender inequality on the spread of HIV and in the burden placed on women to manage the epidemic. He noted the cancellation of the Global Fund's Round Eleven as a "punch below the belt" that will cost Africa lives, and not acceptable at a time when funds are available to finance wars or bail out banks. He called for a high-level crisis meeting on the funding situation for HIV and AIDS, to challenge any 'right to withdraw' in those funding the Global Fund. He argued that "If the MDGs are as important as everyone says, then AIDS must be subdued".
The WHO Director General, Mr Chan, said in taking WHO forward in the next two years, it was extremely important to pay particular attention to the rights and needs of especially women and the people of Africa, who faced multiple threats in their access to health care. He reiterated the importance of the Millenium Development Goals, and made a strong link between poverty and health: "Poor health anchors large populations in poverty."
The Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health considers in this report occupational health as an integral component of the right to health. The report outlines international human rights and other instruments related to occupational health, and it addresses occupational health in the informal economy, focusing on the needs of vulnerable and marginalized groups. It also addresses the obligation of States to formulate, implement, monitor and evaluate occupational health laws and policies, as well as the requirement for the participation of workers at all stages of those activities. The discussion of State obligations is followed by the analysis of such occupational health issues as environmental and industrial hygiene; prevention and reduction of the working population's exposure to harmful substances; challenges posed by emerging technologies; minimization of hazards in the workplace; and availability and accessibility of occupational health services. The Special Rapporteur then elaborates on the prospective and retrospective components of accountability, as well as remedies for violations related to occupational health. The Special Rapporteur concludes his report with a number of recommendations aimed at strengthening occupational health, as a component of the right to health.