Editorial: Different understandings of global health

Dear reader,

If you think that among civil society organizations there is a shared understanding of the set of objectives and priorities to be aimed at for global health, you might have changed your mind after a full week’s immersion in the health policy dialogues that occurred last November in Montevideo, Uruguay. Three conferences (1) were then organized in sequence by the Latin American Social Medicine Association (ALAMES (2)), the International Association of Health Policy (IAHP (3)) and the Local Health Actors’ Network of the Americas (RedeAmericas) respectively. The ALAMES conference is one of the not-to-be-missed gatherings for the public health community of the region, and it takes place every two years.

This year’s conference provided again a space for unusually dynamic exchange, with sharing of countries’ experiences and practices, many historical retrospectives (“it is necessary to defend a militant memory”, insisted Prof. Jaime Breilh) and in-depth reflections on the tremendous impact of the world’s global crises on health rights. I was invited there to present an analysis of the weaknesses of today’s multilateralism in relation to the global governance for health and the WHO reform agenda.

The Latin American health community has its own views about trends in global health, seeded in the historical role that the health chapter has variously played as a tool and a school for democracy in Latin America, when several countries were still ruled by ruthless dictatorial regimes. The perception emerging from the Montevideo debates could be described as alerted scepticism, if not downright rejection, of most of the so called “global priorities” for health – those that happen to be widely promoted in international circles like Davos and Geneva.

Among health experts from this part of the global South, recipes prepared by the same global elite are altogether perceived as a way to institutionalize the role of the private and philanthropic sectors in health matters, at the detriment of solid, needs driven, universal public policies. This is the case of the poverty alleviation discourse and the Millennium Development Goals, regarded as a model of the displacement of the poverty debate worldwide: from a political discussion about its causes to a technical, risk management scheme.

A similarly critical view applies to the mobilizing target of universal health coverage, a new horizon of extended insurance which is attracting strong interest from a crowd of experts and NGOs in the global health arena. What does universal health coverage mean? As one prominent health activist from Brazil phrased it: “It means that everybody is invited to the same lunch, but not everybody is allowed to eat the same food”. Listening to situational analyses from countries, it appears obvious that Latin America knows the dynamic of that meal very well: it is still the reality on the ground. The implementation of the right to health, though, cannot be sliced according to different forms of response or ceilings of care. This is the on-going struggle for many, and not only in this region.

Clearly enough, the veins of Latin America continue to be open. Thirty years of corrosive application of neoliberal policies remain a heavy legacy to address, and a hard one to challenge – let alone overcome – for those governments that strive hard, in their different ways, to undo the damage and re-direct the route of past policies, particularly when they try to reshape their social programmes. In a time of crisis and transition – universal social protection is the new political and cultural horizon where health rights must be placed. If the right to health cannot live in isolation from all other economic and social rights, social protection is the fundamental measure to pursue redistribution of wealth.

By no chance did the global discussion on universal social protection start in Brazil in 2010 (4). The issue stays very high on the agenda for the next World Social Forum on Health (5), scheduled in Tunis in March 2013.

Nicoletta Dentico
Democratising Global Health Coalition on the WHO Reform (DGH)
The MMI Network is a member of the DGH Coalition

References:

  1. www.alames.org/?page_id=436
  2. www.alames.org
  3. www.healthp.org
  4. 1st World Conference on the Development of Universal Social Security Systems, www.conselho.saude.gov.br/cm/index_eng.html
  5. www.fsms.org.br/ingles/

Picture: conference logo

 

MMI Network: News and events

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Network project: Medicus Mundi International
Marketplace for NGOs “in search of research” and young researchers

After a workshop in Amsterdam in October 2012 when we received useful feedback from European research/training institutions about the feasibility of our idea to create a marketplace for NGOs “in search of research” and young researchers, we now invite interested Network members and partners to participate in the further development of this MMI Network project intended to start in early 2013.

Project overview and background:
www.medicusmundi.org/en/network-resources/marketplace

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Network news: Community Working Group on Health
Zimbabwean government urged to unfreeze nurses’ posts

Harare, 25 November 2012. Parliamentarians, civil society members and health workers who met in Harare at the Community Working Group on Health (CWGH) annual general meeting said that all the critical vacancies in the Zimbabwean health sector needed to be filled to prevent unwarranted loss of lives. It was also stated that a government proposal to send nurses to other countries for employment was not sustainable.

www.medicusmundi.org/en/contributions/news/2012/zimbabwean-government-urged-to-unfreeze-nurses-posts

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Network event: action medeor
Local pharmaceutical production and access to medicines
Bonn, Germany, 21 February 2013

Over the past years international organizations like UNIDO and UNCTAD but also regional bodies like the East African Community or NEPAD have promoted the local manufacturing of pharmaceuticals in African countries. However, local pharmaceutical manufacturing in Africa is often debated because of its unfavorable economies of scale, lack of human capacity, unsatisfactory infrastructure and insufficient regulatory bodies questioning its contribution to the access to high-quality low-cost essential medicines in low income countries. To give more insight in this complex action medeor plans to organize a one day international conference giving the floor to experts and entrepreneurs with a special focus on African representatives to get a detailed understanding of the challenges and chances of local production and its impact on access to health. Save the date!

www.medicusmundi.org/en/contributions/events/2012/local-pharmaceutical-production-and-access-to-medicines

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Network event: Medicus Mundi Switzerland
Primary Health Care and NCDs in Eastern Europe
and Central Asia: Where do we stand and where to go?
Basel, 10 April 2013

Over the past two decades health systems in Eastern Europe and Central Asia have undergone substantial changes in relation to their financing and the way how services are delivered to the population. In many countries a shift from hospital centred to primary health care focused systems have taken place: the number of hospital beds and hospitals were reduced in an important way and family doctors sometimes embedded in family medicine teams are today the first point of contact to deliver essential services to the population. At the same time non-communicable diseases (NCDs), such as cardio-vascular disease or diabetes, have become more predominant and are today responsible for a significant share of the burden of disease in these countries. Symposium of the Swiss TPH, a member of the Network Medicus Mundi Switzerland. Save the date!

www.medicusmundi.org/en/contributions/events/2012/primary-health-care-and-ncds-in-eastern-europe-and

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Network campaign: Health Poverty Action
Once in a lifetime opportunity to ensure everyone has access to health services.

“Millions of people worldwide are forced into poverty by having to pay for health services. Sign now and urge world leaders to make universal healthcare a priority in the new global development framework.”

Health Poverty Action website: Ending Poverty after 2015
Health Poverty Action petition: sign here

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Obituary: Medicus Mundi International Network
In memoriam Hélène Besson (1932-2012)

A dedicated woman in a men’s world: Hélène Besson, President of Medicus Mundi International from 1986 to 1991, led MMI through difficult waters, moving its office from the University of Nijmegen to Brussels. Besson was much in favour of a professionalized secretariat, but serving a strongly federative MMI. Hélène Besson passed away on the 4th of November 2012, comforted by her fellow sisters, the Sœurs Auxiliatrices de Paris. Obituary by former MMI President Sake Rypkema.

www.medicusmundi.org/en/contributions/news/2012/in-memoriam-helene-besson

International Health Policy: MMI updates

Bits and pieces of news on international health policy: each “MMI update” is 140 characters or less – these are the rules of the game on twitter. Just enough for a headline, eventually an author, a date, the source – and a link to the website where you find the full information. Have a look at some of our “tweets” published during the last month. As usual, it’s a bit much, so take it or leave it.

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Health systems strengthening
Health services, health financing

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Universal health coverage

 

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Human resources for health
Migration of health professionals

 

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Access to medicines and vaccination
Medical research and development
Neglected diseases

 

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Women’s and children’s health
Sexual and reproductive rights and health

 

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Equity and human right to health
Social determinants of health
Poverty and social protection

 

 

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Global health governance and policy
WHO reform

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Health beyond 2015
MDGs and SDGs

 

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Global reports and annual events

 

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Other topics

 

Follow the MMI Updates on Twitter:
https://twitter.com/mmi_updates

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