A Ugandan health lobby group, the Centre for Health Human Rights and Development, has petitioned the Constitutional Court over the alarming number of maternal deaths in government health facilities - currently, Uganda has one of the highest maternal mortality rates in the world. The group is arguing that government neglect is responsible, manifested in the ‘careless manner’ in which government hospital staff handle expectant mothers before, during and after birth. They are hoping the Constitutional Court will declare that it is a violation of the right to health when health workers and government fail to take required essential care during pre- and post-natal stages. The petitioners also want financial compensation from government for the affected families.
Values, Policies and Rights
The Independent Panel for Pandemic Preparedness and Response was set up by WHO to review the state of pandemic preparedness before COVID-19, the circumstances of the identification of SARS-CoV-2 and responses globally, regionally, and nationally, particularly in the early months of the pandemic, and its health system, social and economic consequences. This report of the panel indicates that preparedness was limited and disjointed, leaving health systems overwhelmed when actually confronted by a fast-moving and exponentially spreading virus. The panel concluded addressing this gap not requires sustained investment, and new approaches to peer review of country preparedness, and to the international alert system. The panel suggests that the legally binding International Health Regulations (IHR) (2005) did not facilitate rapid action, and that the consequence of delays in response impacted most on already disadvantaged people.
As the state and non-state actors take steps in dealing with COVID-19, the author argues for an awareness of the need to urgently strike a balance between prevention approaches and rights with collective responsibilities. From a right to health perspective, it is important for the government of Uganda to ensure that prevention and treatment measures and commodities are available, accessible, and affordable for the most vulnerable communities including: the older persons, those under incarceration, refugees and very poor people. Community participation and solidarity are pillars that have historically been critical in controlling and managing similar outbreaks in Uganda. The author argues for an attentiveness to ensure that research and clinical trials comply with key ethical and human rights principles and that government makes full use of the policy space Uganda has in intellectual property as an LDC to enable it utilise new innovations. The paper points to the need to review and ensure provisions under the Public Health Act enable an effective and equitable response to pandemics like COVID-19, to ensure regulatory approval for new medicines and attention to developing new formulations for the prevention and treatment of COVID-19.
The authors raise that the impacts of the COVID-19 pandemic have gone far beyond the disease itself. In addition to the increasing number of COVID-19 deaths, the pandemic has deepened social and economic inequalities. These indirect impacts have been compounded by pervasive gender inequalities, with profound consequences, especially for women, girls, and people of diverse gender identities. There has been an escalation in gender-based violence within households, increasing numbers of child marriages and female genital mutilation, and an increased burden of unpaid care work, with impacts on mental health. Communities of people affected by HIV are, again, at the crossroads of injustice and targeted discrimination. Measures to control the pandemic have reduced access to essential health and social welfare services, including sexual and reproductive health services, reduced employment and labour force participation, and decimated many household incomes. Here again, women have borne the brunt of marginalisation, particularly those working in the informal sector.
The authors note a proposal for the World Health Organization (WHO) to provide capacity-building for drafting health laws in Member States. They highlight that WHO has the authority and credibility to work with countries to make their national laws easier to access and understand, and to monitor and evaluate their implementation. WHO’s new technical support work related to universal health coverage (UHC) laws is observed as one example of its support for Member States in this important area. Strengthening countries’ legal and regulatory frameworks and engaging in universal health coverage-compliant law reforms has been missing from the universal health coverage agenda. WHO calls on Member States to align their health system policies with universal health coverage goals such as equity, efficiency, health service quality and financial risk protection. Strengthening health systems using health laws and legal frameworks is a pivotal means for attaining these goals and achieving sustainable results in health security and resilience.
In this statement civil society organisations call for a change to the business-as-usual approach to achieving UHC and raise following principles that need greater emphasis in national and global efforts: Health is a human right and the achievement of UHC should ensure that no one is left behind; Out-of-pocket payments should be progressively abolished and public financing for health should be significantly increased; and good governance, robust transparency, and sound accountability must be ensured.
As part of the 11th edition of the World Social Forum (WSF) in Dakar, African civil society presented the draft of an African Consensus, to spur endogenous development of the continent. The WSF is an initiative of civil society and a democratic meeting place that aims to stimulate debate and deepen the collective thinking. This is a space where all types of social movements come to discuss world problems in a democratic way. Members of the International Committee of the Forum discussed the prospects for social movements to make proposals and alternatives to "a neoliberal system that is currently going through deep crisis". Inspired by that of the Himalayas, an innovative approach to development, the "African Consensus" refers to the implementation of economic platforms and autonomous enterprises programmes based on local realities, through skills transfer that give a sense of responsibility. Unlike the "Washington Consensus", which enhances the immediate liberalization of markets, privatization of enterprises, the elimination of subsidies, the "African Consensus" is based on the fact that Africa is not poor, but that it enjoys great wealth and the mosaic of cultures and ethnicity.
South Africa’s GDP is reported to have risen from US $3445 in 1994 to US $5284 in 2016, but far from ushering in overall improvement in health or well-being, the author notes that rising white collar crime, violence, small business failure , un- and underemployment and the flight of skills signpost an unhappy place. He notes that South Africa “… had the highest number of drunk driving incidents at 58 percent” in the world …”. Alcohol is said to account for 40 percent of violent crime. The author calls more regulations to ensure that alcohol companies pays for the consequences that come with heavy drinking in the country.
According to this statement by Latin American social medicine and civil society organisations at the World Conference on Social Determinants of Health, the fundamental cause of the inequalities within and between nations is the neoliberal economy, infused with an exclusively speculative desire for unlimited profit. Capitalism grabs profits and socialises losses, they argue, resorting to new and crueler neoliberal measures that further reduce the fundamental social rights of people. There are abundant resources for all of us on the earth, but the ‘logic’ of the market prevents people from obtaining what they need. In the area of public health, neoliberalism translates into the commercialisation of life, legal protections for intellectual property for the benefit of the medical industrial complex, control of the media in order to create ‘need’ through shock, damage to public health systems, manipulation of civil society, multiple forms of violence and other strategies to colonise the ‘collective thought’. The current dominant societal model, using the lifestyle of affluent Americans as a basis, they argue is not sustainable. The statement concludes with a call for the establishment of global alliances between progressive governments and social movements, and meaningful social participation, as well as support for the creation and consolidation of health systems and social security systems that are universal, free, integral, and public, with coverage for all people for all services.
This document presents the decisions and declarations of Extraordinary Session of the Assembly of the African Union 12 October 2013 Addis Ababa, Ethiopia.