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:
- www.alames.org/?page_id=436
- www.alames.org
- www.healthp.org
- 1st World Conference on the Development of Universal Social Security Systems, www.conselho.saude.gov.br/cm/index_eng.html
- 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
- Progress and changes in the South African health sector. Aaron Motsoaledi, Minister of Health
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961997-7/fulltext - Mapping of multiple criteria for priority setting of health interventions: aid for decision makers. Tromp / Baltussen
http://www.biomedcentral.com/1472-6963/12/454/abstract - Health financing in the context of the right to health. Report by UN Special Rapporteur on the Right to Health to the UN General Assembly
http://www.ohchr.org/EN/Issues/Health/Pages/AnnualReports.aspx - Performance based funding for African health systems: who is setting the agenda? Garrett Wallace Brown
http://equinetafrica.org/newsletter/
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Universal health coverage
- Universal health coverage: Reason to maintain AIDS exceptionality or way to move towards “AIDS exemplarity”? Gorik Ooms
http://e.itg.be/ihp/archives/universal-health-coverage-reason-maintain-aids-exceptionality-move-aids-exemplarity - UHC and green growth are acceptable aims for almost everybody – but not ambitious enough for 21st century. K. Decoster
http://e.itg.be/ihp/archives/universal-health-coverage-green-growth-acceptable-aims-ambitious-21st-century - UN General Assembly: Global health and foreign policy resolution on Social Protection and Universal Health Coverage (A/67/L.36)
http://www.un.org/ga/search/view_doc.asp?symbol=A/67/L.36 - UN adopts ‘momentous’ resolution on universal healthcare. Mark Tran
http://www.guardian.co.uk/global-development/2012/dec/13/un-momentous-resolution-universal-healthcare - Roundup of last week’s blogs on UN General Assembly Universal Health Coverage resolution
http://uhcforward.org/blog/2012/dec/16/week-headlines - Moving towards universal coverage: How to improve global health security and access to healthcare. Workshop summary
http://www.chathamhouse.org/publications/papers/view/187357
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Human resources for health
Migration of health professionals
- Optimizing health worker roles for maternal and newborn health. @WHO recommendations
http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/978924504843/en/index.html - Call for European universities to respond to shortages of health professionals. Jan Petter Myklebust
http://www.universityworldnews.com/article.php?story=20121206111338460 - Strengthening the health worker pipeline through gender-transformative strategies. CapacityPlus technical brief
http://www.capacityplus.org/new-publication-spotlight-strengthening-health-worker-pipeline-gender-transformative-strategies - Physician migration at its roots: factors contributing towards career choice abroad among Pakistan students. Sheikh et al.
http://www.globalizationandhealth.com/content/8/1/43/abstract - The impossible dream? Codes of Practice and the international migration of skilled health workers. J Connell & J Buchan
http://onlinelibrary.wiley.com/doi/10.2202/1948-4682.1175/pdf
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Access to medicines and vaccination
Medical research and development
Neglected diseases
- Access to medicines from a health system perspective. Maryam Bigdeli et al.
http://heapol.oxfordjournals.org/content/early/2012/11/21/heapol.czs108.full - Medical innovations for neglected patients. MSF/DNDi conference background report
http://bit.ly/VNQ5s2 - Fatal neglect: The global health revolution’s forgotten patients. MSF six-part documentary film project
http://www.doctorswithoutborders.org/events/symposiums/2012-lives-in-the-balance/?id=6394&cat=lives-in-the-balance - Access to Medicine Index 2012: what are the top 20 pharmaceutical companies doing to improve access to medicine?
http://www.accesstomedicineindex.org/ranking - Vaccines for all? Enough being done to reach all children with basic immunisation? Sarah Boseley
http://www.guardian.co.uk/society/sarah-boseley-global-health/2012/dec/04/vaccines-tanzania - WHO Members agree on “Strategic Work Plan” on medical research and development – but no convention. Rachel M. Hermann
http://www.ip-watch.org/2012/11/29/who-members-agree-on-strategic-work-plan-on-health-rd-but-no-convention/ - WHO puts off an R&D treaty which would provide sustainable funding for life saving medicine until 2016. Jamie Love
http://bit.ly/RkO36M - Gutting the research and development treaty. Sanjay Basu comments on the failure of WHO CEWG negotiations
http://epianalysis.wordpress.com/2012/12/01/treatydelay - Diseases that disproportionately affect the poor will never get a fair share of investment. WHO DG Margaret Chan at CEWG follow-up meeting
http://www.who.int/dg/speeches/2012/cewg_20121126/en/index.html
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Women’s and children’s health
Sexual and reproductive rights and health
- How Kenyan girls are using the law to fight back against rape. Liz Ford
http://www.guardian.co.uk/global-development/poverty-matters/2012/dec/04/kenyan-girls-law-fight-rape - Women’s choice is key to reduce maternal deaths. The Lancet editorial
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2962009-1/fulltext - Hospitals, health centres, maternity clinics – WHO Safe Childbirth Checklist pilot
http://goo.gl/h9UAW
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Equity and human right to health
Social determinants of health
Poverty and social protection
- Health financing in the context of the right to health. Report by UN Special Rapporteur on the Right to Health to the UN General Assembly
http://www.ohchr.org/EN/Issues/Health/Pages/AnnualReports.aspx - Methodological guide to integrate equity into health strategies, programmes and activities. Spanish Ministry of Health
http://bit.ly/WBvjkX - Interview with Prof Paul Hunt, former UN Special Rapporteur, on the right to highest attainable standard of health
http://goo.gl/SVlhb - Health: not charity, not merchandise – a human right. Claudio Schuftan
http://www.socialmedicine.org/2012/11/24/human-rights/health-not-charity-not-merchandise-a-human-right-part-1-of-2/ - Health: not charity, not merchandise, a Human Right. Claudio Schuftan (part 2)
http://www.socialmedicine.org/2012/12/09/human-rights/health-not-charity-not-merchandise-a-human-right-part-2-of-2/
- Healthy Equity – A series of invited commentaries. Australian and New Zealand Journal of Public Health, December 2012
http://onlinelibrary.wiley.com/doi/10.1111/azph.2012.36.issue-6/issuetoc - Tools for assessing & supporting public health action on social determinants of health and health equity. NCCDH/NCCHPP
http://www.ncchpp.ca/141/publications.ccnpps?id_article=849 - How can the health equity impact of universal policies be evaluated? Edited by Beth Milton et al., WHO Europe
http://bit.ly/slZJz1
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Global health governance and policy
WHO reform
- Global governance of health and the requirements of human rights. Gorik Ooms and Rachel Hammonds
http://onlinelibrary.wiley.com/doi/10.1111/j.1758-5899.2012.00201.x/full - Global health is growing in prominence – now what? Alanna Shaikh
http://www.guardian.co.uk/global-development-professionals-network/2012/dec/03/global-health-alanna-shaikh - Global health challenges and opportunities. George Alleyne
http://blogs.bmj.com/bmj/2012/12/04/george-alleyne-global-health-challenges-and-opportunities/ - The struggle for leadership (in global health). Richard Horton
http://www.lancet.com/journals/lancet/article/PIIS0140-6736%2812%2962122-9/fulltext
- A framework convention on global health: a catalyst for justice. Michel Sidibé and Kent Buse, WHO Bulletin
http://www.who.int/bulletin/volumes/90/12/12-114371/en/index.html - Conflict of interest: A tenacious ethical dilemma in public health policy. Leslie London et al.
http://www.sajbl.org.za/index.php/sajbl/article/view/234 - The Scaling Up Nutrition (SUN) initiative: IBFAN’s concern about the role of businesses – discussion paper
http://info.babymilkaction.org/sites/info.babymilkaction.org/files/SUN%20IBFAN%2028.11.122.pdf - They need other medicine too. Thomas Abraham on ridding the world of polio and fragmented global health programs
http://www.nytimes.com/2012/11/20/opinion/global/ridding-the-world-of-polio.html - Europe beyond aid: Assessing Europe’s commitment to development. Owen Barder et al., CGDev Working Paper
http://www.cgdev.org/content/publications/detail/1426746/ - Teeth for the Tiger. Strengthening the Role of the World Health Organisation in Global Health. AfGH Conference Report
http://www.tdh.de/fileadmin/user_upload/inhalte/04_Was_wir_tun/Themen/Gesundheit/Teeth_for_the_Tiger_2012.pdf - “Together, we are tackling an ambitious and comprehensive agenda for WHO reform.” Change@WHO Newsletter launched
http://who.int/about/who_reform/change_at_who/en/#.ULRiEPV77Sg - Dr Chan appointed Prof Thomas Zeltner as special envoy on WHO financing in June. Read his views here.
http://goo.gl/CByc1 - Proposals for harmonizing WHO’s work with hosted partnerships. Report by the Secretariat for 132nd WHO EB Session
http://apps.who.int/gb/ebwha/pdf_files/EB132/B132_5Add1-en.pdf
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Health beyond 2015
MDGs and SDGs
- Preparing for cross-sectoral action for health in the post-2015 development agenda.
AJ Thomson http://www.worldwewant2015.org/file/291897/download/316460 - Post-2015 Development Agenda: Goals, targets and indicators. Barry Carin ed al., CIGI/KDI special report, October 2012
http://www.cigionline.org/publications/2012/10/post-2015-development-agenda-goals-targets-and-indicators - A manifesto for the world we want. Lancet editorial
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2962092-3/fulltext - Healthy development in the post-2015 era. Yanzhong Huang
http://blogs.shu.edu/ghg/2012/11/27/healthy-development-in-the-post-2015-era/ - How can a post-2015 agreement drive real change? Revised edition: Political economy of global commitments. Green et al.
http://bit.ly/RBko9Y
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Global reports and annual events
- World Malaria Report 2012: Slowdown in the fight against malaria. WHO, December 2012
http://www.who.int/malaria/publications/world_malaria_report_2012/en/index.html - Malaria gains at risk, warns World Health Organisation. Sarah Boseley
http://www.guardian.co.uk/science/2012/dec/17/malaria-gains-at-risk-who - Financing Global Health 2011: Continued Growth as MDG Deadline Approaches. IHME report, December 2012
http://bit.ly/YfcgxI - Global Burden of Disease Study 2010. The Lancet, December 2012
http://www.thelancet.com/themed/global-burden-of-disease - Global Burden of Disease 2010 study. WHO comment http://www.who.int/mediacentre/news/statements/2012/global_burden_disease_20121213/en/index.html
- Global burden of disease: the key data. Nick Mead
http://www.guardian.co.uk/global-development/poverty-matters/2012/dec/13/global-burden-disease-data - December 3: International Day of Persons with Disabilities
http://www.un.org/disabilities/default.asp?id=1597 (UN) http://www.who.int/mediacentre/events/annual/day_disabilities/en/index.html (WHO) - World AIDS Day, 1 December 2012: Closing in on global HIV targets. WHO note for the media
http://www.who.int/mediacentre/news/notes/2012/aids_20121129/en/index.html - UNAIDS World AIDS Day report 2012
http://www.unaids.org/en/resources/campaigns/20121120_globalreport2012/ - World AIDS Day: The time for scaring people into action is over. Uzodinma Iweala
http://www.guardian.co.uk/global-development/poverty-matters - World AIDS Day: Without more money, it’s the end of the beginning of the end of AIDS. Tom Paulson
http://humanosphere.kplu.org/2012/11/without-more-money-its-more-like-the-end-of-the-beginning-of-the-end-of-aids/
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Other topics
- CLIMO – Climate and Mortality. Global Health Action supplement 1/2012
http://www.globalhealthaction.net/index.php/gha/article/view/20152/html - WHO updates health promotion strategy for the African Region. Sixty-second session of WHO AFRO Regional Committee
http://bit.ly/T5kXqN - Generation 2025+: The critical importance of understanding demographic trends for children of the 21st century. UNICEF
http://www.unicef.org/media/media_66404.html
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