This paper reports the results of an assessment of the mental health policies of Ghana, South Africa, Uganda and Zambia. The WHO Mental Health Policy Checklist was used to evaluate the most current mental health policy in each country. All four national policies addressed community-based services, the integration of mental health into general health care, promotion of mental health and rehabilitation. Only the Zambian policy presented a clear vision, with the other three countries spelling out values and principles, the need to establish a coordinating body for mental health, and to protect the human rights of people with mental health problems. None included all the basic elements of a policy, nor specified sources and levels of funding for implementation. Only Uganda sufficiently outlined a mental health information system, research and evaluation, while only Ghana comprehensively addressed human resources and training requirements. No country had an accompanying strategic mental health plan to allow the development and implementation of concrete strategies and activities. The authors recommend strengthening capacity of key stakeholders in public (mental) health and policy development, the creation of a culture of inclusive and dynamic policy development, and coordinated action to optimise use of available resources.
Values, Policies and Rights
Universal Health Coverage UHC is a critical component of the new Sustainable Development Goals (SDGs) which include a specific health goal: “Ensure healthy lives and promote wellbeing for all at all ages”. Within this health goal, a specific target for UHC has been proposed: “Achieve UHC, including financial risk protection, access to quality essential health care services and access to safe, effective, quality and affordable essential medicines and vaccines for all”. In this context, the opportunity exists to unite global health and the fight against poverty through action that is focussed on clear goals. For WHO, “UHC is, by definition, a practical expression of the concern for health equity and the right to health”; thus promoting UHC advances the overall objective of WHO, namely the attainment by all peoples of the highest possible standard of health as a fundamental right, and signal a return to the ideals of the Declaration of Alma Ata and the WHO Global Strategy for Health for All by the Year 2000. Yet some argue that the “current discourse on UHC is in sharp contrast with the vision of Primary Health Care envisaged in the Alma Ata declaration of 1978”. The underlying assumption of this paper is that efforts towards achieving UHC do promote some, but not necessarily all, of the efforts required from governments for the realisation of the right to health. While this publication explores how efforts to advance towards UHC overlap with efforts to realise the right to health, its main focus is the gaps that exist between UHC efforts and right to health efforts.
Proposed reforms to Angola's Penal Code have divided opinion in the country about whether HIV-positive people who intentionally infect others with the virus should be punished. The law under discussion calls for a sentence of between three and 10 years in prison for those who knowingly pass on infectious diseases, including HIV. Some argue that the law will act as a deterrent; others say it will bring more problems than benefits.
After a long nine years of waiting, the Centre for Human Rights and Development (CEHURD) finally received the judgment in the famous Petition 16 maternal health case on 19th August, 2020. The Constitutional Court agreed with CEHURD submissions and all judges accepted all the grounds of the petition. Through this judgment, the right to maternal health care (and the right to health broadly) has been granted a place in Uganda’s Constitution. This judgment recognizes provision of basic maternal health care services and emergency obstetric care as an obligation by the government. It’s through unremitting advocacy, litigation and activism that CEHURD achieved this landmark decision. It took a whole movement/coalition on maternal health to realize what a few thought would be possible. CEHURD now turn their efforts to the implementation. Investing in maternal health is a political and social imperative, as well as a cost effective investment in strong health systems overall. The #Petition16 judgment entails some very powerful declarations and orders on health financing. This case creates positive jurisprudence and makes it possible for people to sustain a cause of action in the right to health against the state for failing to provide the basic minimum health care package.
Clinicians have long known that microbes such as bacteria, viruses and fungi are becoming alarmingly resistant to the medicines used to treat them. But a global response to this complex health threat — commonly termed 'antimicrobial resistance' — requires engagement from a much broader array of players, from governments, regulators and the public, to experts in health, food, the environment, economics, trade and industry. The authors argue that people from these disparate domains are talking past each other. Many of the terms routinely used to describe the problem are misunderstood, interpreted differently or loaded with unhelpful connotations. In 2017, the United Nations formed an interagency group to coordinate the fight against drug resistance urging that, as one of its first steps, the group coordinate a review of the terminology used by key actors. They proposed that drug-resistant infection be the overarching term used (in English) to describe infections caused by organisms that are resistant to treatment, including those caused by bacteria that do not respond to antibiotics. They also noted that a blame narrative is unhelpful, failing to acknowledge symbiotic relationships with bacteria. Because terminology has geographic, disciplinary and societal variations that affect understanding and interpretation, research is argued to be needed to optimize the lexicon across different countries and languages.
A landmark court case, alleging that HIV-positive women were forcibly sterilised in Namibian state hospitals is taking place in Windhoek, Namibia. Human rights groups claim the practice has continued long after the authorities were notified. Three women's cases will be heard initially. Each woman is demanding the equivalent of US$132,000 in damages. 'The first cases emerged during community meetings in early 2008. In the months that followed we interviewed 230 women, 40 of whom were sterilised against their will,' says Veronica Kalambi of the International Community of Women living with HIV (ICW). 'In August 2008 we formally alerted the Ministry during a meeting with the deputy Minister.' The State will argue that consent forms were signed in all three cases. However, the women’s lawyers maintain the process necessary for 'informed consent' was not followed and the women were coerced, or did not understand the procedure.
The authors interrogate the relationship between gender based violence (GBV) and COVID-19 in Uganda through documentary reviews and in-depth interviews from selected key informants. The authors find an increase in cases of GBV that calls for government ministries and agencies to prioritize measures to address the issue. They recommend gender sensitization of communities on GBV and its effects especially in situations of health related emergencies. The authors find that the majority of the fights are heightened by men having limited funds to fulfil their provisioning roles, and recommend that vulnerable households should be identified and provided with food. They also argue that is important to provide women with a platform where they can air their views and concerns about COVID-19 and GBV.
In January 2015, a few days before he would feature as Applicant No 1 in a groundbreaking High Court application for the right to an assisted death, Avron Moss ended his life using medication he had smuggled into South Africa from Mexico. Diagnosed with melanoma, Moss knew when he offered to act as the applicant that it would be a race against time. This article discusses the history and legal and social implications of assisted dying for the terminally ill in South Africa.
Two hundred-and-five African and global organisations and networks have called on the Assembly of Heads of State of the African Union to ensure the Implementation Plan of the AU Africa Health Strategy is urgently and adequately funded, and for the AU Abuja 15% Commitment to health to be implemented by all member states. The Implementation Plan was adopted by African Ministers of Health on the 17 May 2008 following presentation of the Health Strategy last year by the AU Commission Social Affairs Division. It provides guidelines for implementing various African health frameworks, health MDGs and global universal access targets including on TB, HIV and AIDS, malaria, child and maternal health.
The population of older people throughout the world is increasing rapidly, with Africa projected to have about 210 million older people by 2050. In addition to the usual physical, mental and physiological changes associated with ageing, old people in Africa are argued to be particularly disadvantaged due to lack of social security for everyday social and economic needs. This policy framework binds all AU member countries to develop policies on ageing and is being used as a guide in the formulation of national policies to improve the lives of the continent’s older people. The authors argue that advocacy efforts need improve the adaptation and domestication of the policy and encourage appropriate consultations with older people in these processes, including to ensure the allocation of resources for the implementation of commitments. Notably, the International Plan of Action on Ageing agreed upon in Madrid during the Second World Assembly on Ageing in April 2002, borrowed significantly from the AU Policy Framework.