In October 2018, United Nations Member States unanimously agreed to the Declaration of Astana, vowing to strengthen their primary health care systems as an essential step toward achieving universal health coverage. The Declaration of Astana reaffirms the historic 1978 Declaration of Alma-Ata, the first time world leaders committed to primary health care. The Declaration of Astana comes amid a growing global movement for greater investment in primary health care to achieve universal health coverage. Health resources have been overwhelmingly focused on single disease interventions rather than strong, comprehensive health systems – a gap highlighted by several health emergencies in recent years. The author reports that UNICEF and WHO will help governments and civil society to act on the Declaration of Astana and encourage them to back the movement and will support countries in reviewing the implementation of this Declaration, in cooperation with other partners.
Values, Policies and Rights
This new report by the Center for Health, Human Rights and Development (CEHURD). “Facing Uganda’s Law on Abortion: Experiences from Women and Service Providers” raises that an unclear abortion law in Uganda means that women and adolescents seek unsafe abortions and are vilified by their families and communities, with doctors and health workers who provide legal post-abortion care being arrested. This report highlights experiences and perspectives of individuals who have been affected by or have dealt with abortion. It includes interviews with women and girls who ended pregnancies, as well as doctors, nurses, health worker, lawyers, police and community members. Abortion in Uganda is legal in limited circumstances, yet approximately 85,000 women each year receive treatment for complications from unsafe abortion and an additional 65,000 women experience complications but do not seek medical treatment. The CEHURD report also draws on a research report by the Center for Reproductive Rights in 2012 on Uganda’s laws and policies on termination of pregnancy that found that the laws and policies are more expansive than most believe, and that Uganda has ample opportunity to increase access to safe abortion services.
Expanded mobility and cross-border trading across the road transport sector in Southern Africa have contributed to increased HIV prevalence rates among key populations and communities living in the region. To support a strengthened and co-ordinated response to the unique public health challenges this presents, the Southern African Development Community (SADC) approved the Regional Minimum Standards and Brand for HIV and other Health Services Along Road Transport Corridors in the SADC Region (RMSB) in November 2015. It includes guiding principles on the right to health; health-promoting workplaces; gender mainstreaming; empowerment of commercial sex workers and effective partnership. It sets minimum standards on service delivery and a minimum package of services for those involved in road transport corridors.
Human Rights Watch argues that migrants are also especially vulnerable to communicable disease because of substandard living environments, limited sanitation, and cultural and social dislocation, making them vital targets for public health surveillance and intervention. According to Department of Health policies, everyone in South Africa should have access to treatment for communicable disease without cost. Any barrier to prevention and treatment of communicable disease for vulnerable mobile and migrant populations is unwise from a public health perspective, but also a violation of South African and international law. South Africa has recognised the importance of access to health care for vulnerable and migrant populations in its laws and policy documents, yet continues to allow unlawful discrimination by health care staff, undermining efforts to contain disease and improve treatment outcomes. In over 100 interviews with migrants, advocates, health care and other service providers in both urban and border communities, Human Rights Watch found that South Africa’s failure to protect asylum seekers and refugees from deportation and violence leads both to increased disease and injury, and increased barriers to treatment for those conditions.
In the run up to the UN summit on non-communicable diseases, there are fears that industry interests might be trumping evidence based public health interventions. Will anything valuable be agreed? With only weeks to go before the summit, years of negotiations seem to be stalling. Discussions have stopped on the document that forms the spine of the summit, and charities are concerned that governments are trying to wriggle out of commitments. For example food is proving to be a sticking point again. Changes to language in the latest version of the draft document are subtle but clearly important. While the so called G77 group of lower income states—including India, China, Kenya, and Brazil—argue that saturated fat should be reduced in processed products, as well as sugar and salt, that recommendation is being resisted by the US, Canada, Australia, and the EU. Other areas of industry interest are proving contentious.
This report focuses on the specific needs and challenges of girls and women at risk of, or living with non-communicable diseases (NCDs). The authors contend that NCDs impact on women’s health and development across the lifecycle, causing morbidity and mortality, and compromising their socio-cultural status in communities. In light of this, the authors argue that failure to act now on NCDs will undermine development gains made to date, including progress made on women’s empowerment. They argue that recognition of the importance of women’s contribution to society in their productive and reproductive roles as well as consumers and providers of healthcare will enable real progress in turning back the global epidemic of NCDs. In conclusion, the authors note that there is lack of awareness around this critical issue for women's health and thus call for attention to NCDs as a priority for women’s health and development, policy dialogue on the particular issues related to girls and women and evidence-informed actions by all partners to improve the health and lives of girls and women worldwide.
Violence against women has become as much a pandemic as HIV/AIDS or malaria. But it is still generally downplayed by the public at large and by policymakers who fail to create and fund programmes to eradicate it. However, the achievements over the last few decades of women and men around the world who have worked to combat violence against women and promote women's empowerment are monumental. This report from Unifem also includes a focus on the problem of violence against women as a violation of human rights as well as a public health issue. "In the last decade, gender-based violence moved from the shadows to the foreground. It is increasingly recognized as a violation of human rights, as a public health problem and as a crime against women and society," says the report.
The Angola National Nurses Association in Lubango, southern Huila Province, created an Ethics Commission with a view to making the services rendered in this sector more humanised. The spokesman of ANEA, Rufino Kulamba, who was speaking at the International Nurses Day commemorations, said that the commission will be tasked with supervising the nursing activity. He stressed that the idea is to make professionals in this area have a better and better relationship with patients, as well as bring about professional improvements in this sector. He also explained that the commission will facilitate the filing of complaints against nurses who violate the principles of professional ethics.
More than 450,000 people have signed an online petition urging Uganda's parliament to drop a bill that would impose the death sentence when a positive person has sex with someone of the same sex who is disabled or under the age of 18. On 1 March, the petition was presented to the speaker of Uganda's Parliament, Hon Edward Ssekandi, by the country’s AIDS activists, including founder of the national non-governmental organisation, The AIDS Support Organization, Noerine Kaleeba, and Canon Gideon Byamugisha, the first religious leader to publicly declare that he was living with HIV. Responding to the petition, Hon Ssekandi said it could not be withdrawn at this stage, not even by the MP who tabled it; but he assured the activists that their concerns would be passed on to the legislature. The legislature would debate passing the bill, amending it or not passing it. Homosexuality is illegal in Uganda, but the new law would impose more stringent punishments for homosexual activity, while compelling people in authority with knowledge of such activity to report it or face criminal charges.
WHO has published a draft proposal for a set Framework and set of policies to address its engagement with Non Sate Actors (NSAs). Member States are being invited to discuss these proposals at WHO’s HQ in Geneva on 27th and 28th March. Public Interest NGOs are not invited. IBFAN has been following the process closely and reports finding serious flaws, inconsistencies and contradictions in the proposals. Despite the many statements of WHO’s Director General, Margaret Chan, that WHO’s policies, norms and standards setting processes should be protected from commercial influence, if the new proposals were to be adopted, the corporate influence would increase. IBFAN fears that this would compromise WHO’s integrity, independence and its ability to fulfil its mandate. In particular, the proposals introduce a new risky element, allowing Official Relations status, with all its related privileges, for International Business Associations. Up to now, if businesses wanted to attend governing body meetings in order to lobby Member States delegations, they could wear a public badge, or, if they wanted to speak, inveigle their way onto government delegations. Some, over the years have slipped through WHO’s admission procedures, pretending to be NGOs. The new proposals open the door wide to participation by any business member of these Associations, except tobacco or arms companies. This would, in effect, legitimize businesses lobbying role at WHO’s global policy-setting meetings - the very thing that WHO alleges that it is trying to avoid. In addition to turning WHO governing bodies meetings into multi-stakeholder public-private gatherings, the proposals would also allow businesses greater engagement at programme level, through agreed 3-year plans with WHO. Lida Lhotska, IBFAN NGO Liaison to WHO says: “If these new policy proposals are adopted, IBFAN fears that WHO will be unable to lead and support Member States in taking the bold decisions necessary to tackle global health challenges. For example, irresponsible marketing is a major underlying cause of Non Communicable Diseases (NCDs). In tackling NCDs, acknowledged to be a major threat to public health, will WHO prefer to engage in partnerships with corporations, who would prefer campaigns for promoting ‘slightly better for you products’– or will WHO help Member States bring in legally-binding controls that truly protect right to health of their citizens?”