HIV prevalence is significantly associated with poor governance. International public health programs need to address societal structures in order to create strong foundations upon which effective healthcare interventions can be implemented, according to a recent study in the journal International Health and Human Rights. Only governments sensitive to the demands of their citizens appropriately respond to needs of their nation. Based on Professor Amartya Sen's analysis of the link between famine and democracy, the study tested the null hypothesis: "Human Immunodeficiency Virus (HIV) prevalence is not associated with governance".
Values, Policies and Rights
The link between good governance and good health
The need for a national cancer policy in Malawi
Mlombe Y, Othieno-Abinya N, Dzamalala C and Chrisi J: Malawi Medical Journal 20(4):124-127, 2008
Cancer is causing a lot of suffering and death in Africa but is not considered a major health problem in Africa. This needs to change. Cancer should be given equal emphasis to HIV/AIDS, tuberculosis (TB) and malaria. A national cancer policy is required in Malawi to develop and improve evidence-based cancer prevention, early diagnosis, curative and palliative therapy. A national cancer policy is crucial to ensure a priotised, clear, coordinated and sustained fight against cancer. When no policy exists, events are likely to be random, stakeholders and practitioners in the fight against cancer may not agree on how to proceed, may duplicate efforts or may neglect areas that would have greater nationwide impact resulting in poor quality activities and haphazard development.
The need for an ethical and political de-colonization of human rights
Baraka A: Pambazuka News 659, 18 December 2013
There is growing dissatisfaction and even mistrust of human rights as an instrument for radical social change. The author argues that what is needed is a revolutionary approach to human rights informed by an analysis of the oppressive, anti-human social/historical context of national and global social relationships. For many social justice activists, moral contradictions in thye use of rights frameworks by both Western and non-Western states has created dissatisfaction and even mistrust of human rights as an instrument for radical social change. A “people-centered human rights” concept and approach has been developing, based on the communitarian principles of social solidarity, cooperation, non-discrimination in all social relationships, collective public ownership of the earth’s resources, respect for difference, self-determination of all peoples’ and the recognition and respect for the inherent dignity of all individuals and people’s.
The Next WHO Director-General’s Highest Priority: A Global Treaty on the Human Right to Health
Gostin L; Friedman E; Buss P; et al.,: Lancet Global Health, October 2016
Amidst the many challenges facing the next WHO Director-General, the authors argue that the new WHO head should prioritise the right to health. They call for leadership on a Framework Convention on Global Health (FCGH), based in the right to health and aimed at national and global health equity. The treaty would, they argue, enhance accountability, transparency, and civil society participation and protect the right to health in trade, investment, climate change, and other international regimes, while catalysing governments to institutionalise the right to health at community through to national levels. With the Framework Convention on Tobacco Control having served as a proof of concept, the FCGH would be an innovative treaty finding solutions to overcome global health failings in accountability, equality, financing, and inter-sectoral coherence, with a national and global health financing framework. They raise options for reaching beyond the health sector with right to health assessments, public health participation in developing international agreements, and responsibility for all sectors for improving health outcomes. Finally they propose that the FCGH would reinvigorate WHO’s global health leadership, breathing new life into its founding principles and bringing badly-needed reforms to the institution, such as community participation, new priorities favouring social determinants of health, and a culture of transparency and accountability.
The occupational safety and health of workers in coal mines: filling in the lacuna in Kenyan legislation
Muhindi I: Strathmore Law School, Dissertation, 2016
This research assessed the extent to which the occupational safety and health act in Kenya safeguards the safety and health of workers in its coal mines. From a comparison with law in other countries, the author identifies gaps and recommends that Kenya should enact more comprehensive clauses for occupational safety and health of coal mine workers, should revise the compensation amounts provided for by the Work Injury Benefits Act; set guidelines and directions encompassing duties of employers and employees in mining and provide for medical services in coal mines.
The Ouagadougou declaration on primary health care and health systems in Africa: Achieving better health for Africa in the new millennium
Pathé S, Habib B, Joses S, Kirigia M, Nyoni J, Bessaoud K, Trapsida J, Bosco J, Edoh N, Soumbey-Alley W et al: African Health Monitor 12: 10–21, April-June 2010
The Ouagadougou Declaration on Primary Health Care and Health Systems in Africa focuses on nine major priority areas: leadership and governance for health, health services delivery, human resources for health, health financing, health information systems, health technologies, community ownership and participation, partnerships for health development and research for health. This paper describes a framework constructed for implementing the necessary activities in each of these priority areas, and proposes recommendations for consideration by World Health Organization Member States in the development of their own country frameworks. In conclusion, countries are expected to use this Framework, adapted to their own specific situations, by taking into account the progress made and the efforts needed for better and more equitable health outcomes. The Regional Committee is requested to endorse the Framework and urges Member States to put in place monitoring frameworks that feed into the national and regional observatories. Partners are expected to support countries in a harmonised and predictable manner that reduces fragmentation during the implementation of the Ouagadougou Declaration. It is expected that the implementation of the Ouagadougou Declaration by countries will contribute in accelerating progress towards the achievement of the Millennium Development Goals, and reduce the inequities and social injustices that lead to large segments of the population remaining without access to essential health services.
The Paradox of a Global Urban Agenda Led by Nations, Not Cities
Poon L: The Atlantic CityLab, 2016
The author claims that the battle for global sustainability will be won or lost in cities. Yet the UN’s Habitat III conference was argued in a 10-point manifesto that resulted from a convening of the Second World Assembly of Local and Regional Governments to miss the voices of the individuals and groups who actually run those cities. Mayors and other leaders from more than 500 cities formed a collective voice calling for “A Seat at the Global Table.” Their manifesto lays out why local governments need to be integrated into international talks traditionally reserved for national policymakers. With support from key figures such as UN Secretary General Ban Ki-moon, the assembly pushed for a “paradigm shift in global governance” that would give local leaders more say in what strategies to implement and how. sign and adopt it. The UCLG named Parks Tau, the former mayor of Johannesburg, as their new head.
The plight of LGBTI asylum seekers and refugees
IRIN News: 7 May 2013
Refugees and asylum seekers face a host of challenges when crossing borders, but the obstacles are particularly pronounced for lesbian, gay, bisexual, transgender, or intersex (LGBTI) persons, according to this article. LGBTI asylum seekers and refugees face a range of threats, risks and vulnerabilities throughout the displacement cycle, said the UN Refugee Agency (UNHCR). In situations of upheaval or conflict, sexual and gender minorities have become targets for scapegoating or “moral cleansing” campaigns, compounding the inherent vulnerability created by unrest. Activists say that security in refugee camps is complicated and contingent on numerous, unpredictable factors, which are exacerbated for LGBTI persons. Sexual abuse is common, but often goes unreported because the right questions are not being asked, and because survivors of sexual violence are reluctant to report events that will “out” them to legal authorities. This discrimination impacts negatively on LGBTI’s ability to access basic health services for fear of exposure and discrimination.
The political economy of universal health coverage
Stuckler D, Feigl AB, Basu S and McKee M: Global Symposium on Health Systems Research, November 2010
Out of 192 countries studied in this review, 75 had legislation mandating universal access to health care services independent of income. Of these, 58 met the criteria based on available measures of coverage that serve as broader proxies for access to care. The authors of the review found that most countries have adopted legal commitments to achieve universal health coverage at low- and middle-income stages of development. When they have not, healthcare has tended to expand gradually, leaving many members of the population vulnerable for extended periods of time. However, the authors caution that a legal commitment is insufficient on its own and must be translated into policies that establish a comprehensive, largely publicly financed system. An over-reliance on partial and private sector-focused care appears to disproportionately benefit richer groups, reducing both efficacy and access to coverage. It also creates groups with strong vested interests in the status quo that can block further progress, they argue. Public financing is more equitable and pro-poor, and reflects the shared value of providing care based on need rather than ability to pay.
The right to health and health workforce planning: A guide for government officials, NGOs, health workers and development partners
Physicians for Human Rights, 2008
The overriding message of this guide is that human rights are not merely add-ons or luxuries that only a few countries may be able to afford – they must be integral to developing health workforce strategies in all countries. Plans should be accountable to human rights obligations and other health goals and commitments. Broad participation in developing the plan will help ensure that it is accountable to those it serves. Planners may need to provide incentives for health workers to stay and should make sure their response to the health workforce crisis is comprehensive, covering aspects of the workforce such as numbers, distribution, quality of training, productivity, management, and information systems. Finally, health workforce strategies must be sustainable, so that countries provide their populations with ever-improving levels of health services, and maintain and enhance commitments to equality. This requires setting priorities that will ensure that essential health services, including those in underserved areas, can continue even if there are funding shortfalls beyond the country’s control.