This strategy is a detailed and comprehensive guide to how health sectors can most effectively tackle the HIV and AIDS epidemic. Data shows that the epidemic has been halted and that the spread of HIV is beginning to be reversed. New infections have fallen by almost 20% in the last ten years and between 2003 and 2009 there was a 13-fold increase in treatment coverage. However, in 2009 only a third of people in need of treatment received it and the demand for resources is still outstripping supply. The Strategy is intended to optimise progress towards universal access and the attainment of the Millennium Development Goals. It aims to promote tailored responses to national and regional epidemics and analyses the underlying socio-economic and cultural determinants contributing to the spread of the virus. The strategy seeks to reduce vulnerability and structural barriers to accessing good quality services. It also demonstrates how HIV programmes can play a role in broader health outcomes and recognises the importance of strong health and community systems to guarantee a sustainable response. WHO will make five key contributions to the Global Health Sector Strategy: scale up innovation in prevention; optimise treatment and care; support health for women and children; promote strategic health-sector information and planning; and provide leadership in addressing health equity and HIV (examining inequities in access to HIV services).
Values, Policies and Rights
The global agenda for malaria has, once again, embraced the possibility of eradication. The author argues that as history has shown, there will be no single magic bullet that can be applied to every epidemiological setting. Africa has a diverse malaria ecology, lending itself to some of the highest disease burden areas of the world and a wide range of clinical epidemiological patterns making control with our current tools challenging. This commentary highlights why the epidemiology of Plasmodium falciparum malaria in Africa should not be forgotten when planning an eradication strategy, and why forgetting Africa will, according to the author, once again, be the single largest threat to any hope for global eradication.
The People's Health Movement, an international organisation of health activists, launched a new global campaign on the right to health at its second assembly in Cuenca, Ecuador, held from 18 to 23 July. Assembly delegates from many countries attested to the campaign's importance. Increasing erosion in access to universal health care, growth of unregulated private providers, and declines in public funding are leaving millions of people without insured services.
The People’s Health Movement (PHM) has initiated a Global Right to Health Care (RTHC) Campaign to be developed in collaboration with various networks, coalitions and organisations sharing a similar perspective. This campaign will document violations of health rights, present country level assessments of the right to health care and advocate for fulfillment of commitments to the right to health care at the national, regional and global levels. The campaign has three phases of action: Phase 1 is concerned with the production of diagnostic assessment reports on the RTHC in more than 20 countries; Phase 2 is concerned with the development and interactions of regional assemblies to share results and enable a dialogue between PHM and partners; and Phase 3 looks to the issue of global expansion by implementing Phase 2 conclusions and recommendations and drafting and submitting time-bound resolutions on health rights. To get involved, contact Claudio Schuftan at the email address provided.
For 650 million people with disabilities - roughly 10 percent of the world’s population - a new UN treaty which would extend international human rights to this traditionally marginalised sector of society is finally within reach. After four years and eight sessions of negotiations, the United Nations‘ Convention to Protect the Rights of Persons with Disabilities was recently finalised by the UN General Assembly’s Ad Hoc Committee. The UN disability convention guarantees persons with disabilities non-discrimination and equal recognition before the law; security, mobility and accessibility; the right to health, work and education; and participation in political and cultural life.
This joint UNDP-UNRISD report reviews recent trends in six areas that are fundamentally important to achieving the 2030 Agenda. These six “mega-trends” relate to (i) poverty and inequalities, (ii) demography, (iii) environmental degradation and climate change, (iv) shocks and crises, (v) development cooperation and financing for development, and (vi) technological innovation. The report explores whether these trends are having positive or negative effects on development and discusses policy implications for the implementation of the 2030 Agenda. The report raises that some of the trends displayed currently are positive and supportive, including in the reduction of absolute poverty and technological innovation. Yet negative trends in several of the other target areas pose a significant risk to the realisation of the SDGs. They suggest that evidence-generating processes should be designed so as to take interactions between areas into account, whether that be through the use of interdisciplinary teams who can bring different insights to research, or through modelling and simulations of complex interactions. The potential for policy coherence manifests itself in two ways in the 2030 Agenda. First, there is a need to pursue progress across goals at the same time (e.g. employment guarantee programmes that focus on the provision of the safeguarding of environmental goods and services), while recognising and minimising the negative interactions. Second, there is the issue of coherence at different levels of decision-making and implementation, primarily local, national, regional and global—for example, whether local policies on education service provision are supported by fiscal policies at the national level, especially the decentralisation of tax policy. All of the issues discussed in the report are argued to point to the need for collective action so as to maximise the positive dynamics in these areas and minimise risk, and for processes that build trust and inclusiveness of participation.
While neoliberal globalisation is associated with increasing inequalities, global integration has simultaneously strengthened the dissemination of human rights discourse across the world. This paper explores the seeming contradiction that globalisation is conceived as disempowering nations states’ ability to act in their population’s interests, yet implementation of human rights obligations requires effective states to deliver socio-economic entitlements, such as health. Central to the actions required of the state to build a health system based on a human rights approach is the notion of accountability. Two case studies are used to explore the constraints on states meeting their human rights obligations regarding health, the first drawing on data from interviews with parliamentarians responsible for health in East and Southern Africa, and the second reflecting on the response to the HIV/AIDS epidemic in South Africa. The case studies illustrate the importance of a human rights paradigm in strengthening parliamentary oversight over the executive in ways that prioritise pro-poor protections and in increasing leverage for resources for the health sector within parliamentary processes. Further, a rights framework creates the space for civil society action to engage with the legislature to hold public officials accountable and confirms the importance of rights as enabling civil society mobilization, reinforcing community agency to advance health rights for poor communities. In this context, critical assessment of state incapacity to meet claims to health rights raises questions as to the diffusion of accountability rife under modern international aid systems. Such diffusion of accountability opens the door to ‘cunning’ states to deflect rights claims of their populations. We argue that human rights, as both a normative framework for legal challenges and as a means to create room for active civil society engagement provide a means to contest both the real and the purported constraints imposed by globalisation.
The World Health Organisation should be faithful to its Constitution, making health care and access to health care a human right, confronting powerful governments including the US government, which is in clear violation of the WHO Charter's instruction that member countries should ensure their citizens' access to health care in time of need. WHO should regain its credibility and moral standing, and could include growing movements of protest such as the anti-globalisation movement that are providing pointers to another possible world. Membership of WHO should be conditional on governments' acceptance of a whole set of principles and practices, including the promotion of health as a human right and the obligations deriving from this right. This is according to an article "The world situation and WHO", published in the Lancet.
In this press statement, human rights organisation Release Political Prisoners (RPP) Trust registers its support for the position taken by the Kenya National Commission on Human Rights to promote the rights of lesbians, gays, bi-sexual and transgender people as well as commercial sex workers. RPP notes that the constitution protects all Kenyans against any form of discrimination and that the bill of rights guarantees all persons, non-heterosexuals included, all rights and entitlements under that Chapter, including the right to health and education. Statistics indicate that up to 15% of new HIV infections in Kenya are attributable to gay men and 6 out every 10 gay men are in heterosexual relationships. Yet discrimination hampers access to health services for these marginalised groups. Even when they get infected, they rarely have access to treatment and are reportedly often discriminated against by health workers. RPP notes several incidences in the recent past where gay men and women have been threatened and attacked at health facilities while seeking treatment for HIV. It argues that these attacks can be directly attributed to the preaching of hatred against gays and lesbians by religious leaders, and calls on the National Cohesion and Integration Commission (NCIC) to consider investigating these religious groups for hate speech and for promoting discrimination against non-heterosexuals and commercial sex workers.
These guidelines recognise that all types of work are hazardous and persons at work are exposed to situations that may result into injury, disease or even death. In Uganda, the authors argue that the health sector is loaded with a wide variety of situations where health and safety issues are crucial. Additionally, while the economic cost of occupational risks is high, public awareness of safety and health tends to be quite low. The Ugandan health sector requires a standardised framework for workplace safety and health, including responding specifically to HIV as a workplace hazard. The first chapter gives background information on occupational health and safety (OHS). The second addresses the basic OHS principles and interventions. The third deals with management of HIV and AIDS as a specific workplace hazard, while the fourth covers management of the other common hazards that exist at the health workplace. The final chapter deals with implementation of a workplace safety and health programme, including aspects of monitoring.