Editorial: Well-being for everyone. From selective development to an inclusive post-2015 agenda
Dear reader,
The Millennium Development Goals have galvanised the efforts of the global community to work towards a more dignified life for all, with some significant successes. Attention was brought to the plight of the poor, more financial resources were raised and clear targets set for governments to work towards. This has meant considerable improvements for people’s lives: On average, the targets on reducing poverty, better access to water and equal enrolment of boys and girls in primary school have been achieved.
But the MDGs have also left much to desire for.
For one, UN Member States accepted right from the start that only part of those in need would have their human rights to education, health or water fulfilled. Whether an expectant mother in Sierra Leone survives childbirth is thus not a matter of her right to life and health. Rather, in the context of Goal 5 to improve maternal health, a mere three quarter reduction of the maternal mortality ratio is sufficient to have achieved the goal. That we are still far off-track to achieve this cannot be emphasised enough to maintain momentum but it should not distract from the limitations of the MDGs’ approach.
The injustice is exacerbated by the way the MDGs are reported upon. The MDGs’ aggregate targets for reducing poverty and improving health have led to a concentration on reaching the largest numbers of people, and therefore often the easiest to reach. This carries the danger of actually reducing resources for the most marginalised, as they are diverted towards meeting the targets in the easiest way.
In health, separating different health issues, such as specific diseases, maternal, and child health, into sectoral silos has worsened the non-integration, inefficiency and unsustainability of vertical health programmes. In particular, the necessary foundation of strong health systems has been neglected. Achieving further progress on health requires the provision of comprehensive primary care, addressing the huge health worker and drug shortages, tackling weak data systems and inadequate funding.
A new development framework must aim towards the well-being of everyone and place equity and human rights at its heart. For inequities to become more visible, monitoring mechanisms must report data that is disaggregated along the major fault lines of social disparities. It is essential that targets be set nationally and they should have a dimension of reducing the gaps in health between different groups so that resources may be allocated to the most marginalised.
Health is a prerequisite and an outcome of development and, as such, cannot be missing from the post-2015 development framework. It should also be seen as a cross-cutting issue across a range of sectors which are determinants of health, such as water and sanitation, nutrition or intellectual property rules. An overall health goal could be a reduction in the number of years lost due to ill-health, disability or early death or could revolve around gains in life-expectancy. But one important means towards achieving well-being and longer life-expectancy is universal health coverage which would not only extend health services in their range and reach but would also prevent people from plunging into poverty because they are protected against the financial risks of health care.
Last not least, the responsibility for achieving human well-being and global equity lies with everyone, not just with developing country governments as a response to overseas aid. While aid remains important, there must be much more emphasis on building the capacity of developing countries to raise domestic revenues to fulfil the rights of their citizens in the longer term. There also need to be specific goals addressing the root causes of poverty and inequity such as unfair trade rules or environmental exploitation. Changes in these areas could do much more for tackling poverty sustainably than overseas aid can ever achieve.
Corinna Heineke, Senior Policy Advisor
Health Poverty Action, www.healthpovertyaction.org
c.heineke@healthpovertyaction.org
Shortened version of a blog posted in the Huffington Post
and on the Health Poverty Action website on 1 November 2012
www.healthpovertyaction.org/news/well-being-for-everyone/
MMI Network: News and events
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Network campaign: Medicus Mundi International
Health in the post-2015 UN development agenda.
Civil society input in UN thematic consultation
What will be the role of health in the development agenda beyond 2015? Beyond 2015, a global civil society campaign pushing for a strong and legitimate successor framework to the Millennium Development Goals, appointed the Medicus Mundi International Network to coordinate campaign input in the thematic consultation on health in the post-2015 development agenda led by WHO and UNICEF.
During the month of October, the secretariat of the MMI Network collected initial civil society input and published it in an “inbox” on the MMI ePlatform. Thanks to everybody who contributed to this great resource! Since 5 November, the drafting process takes its course, based on a first draft provided by Mariska Meurs and Remco van de Pas, Wemos, who accepted to act as lead authors.
UN thematic consultation website: www.worldwewant2015.org/health
MMI Network, “inbox”: www.bit.ly/mmi-beyond2015call
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Network event: DWA Cuamm
Is health really for everyone?
Florence, 24 November 2012
“Is health really for everyone? How is social crisis affecting Italy and Europe? What kind of healthcare models are we tending towards? In an open meeting, experts in public health from four different Countries will exchange ideas and outline a scenario of the current situation, highlighting possible prospects for the years to come.” Event and roundtable co-organized by Doctors with Africa Cuamm.
www.educationglobalhealth.eu/en/news/250-is-health-really-for-everyone
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Network event: MM Switzerland
A generation at risk: psychosocial support for Africa’s children
Basel, 4 December 2012
“Over 16 million children worldwide have lost one or both parents to HIV and AIDS, and most of them live in sub-Saharan Africa. In addition to those affected by chronic illness and death, many other children are confronted by the challenges of poverty and conflict. This year’s Novartis Foundation Symposium invites esteemed speakers and experts to assess psychosocial approaches and discuss various interventions that strive to ensure mental health and wellbeing for Africa’s children.” Annual symposium of the Novartis Foundation for Sustainable Development, a member of the Network Medicus Mundi Switzerland.
www.novartisfoundation.org/page/content/index.asp?MenuID=708&ID=2298&Menu=3&Item=45.16
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Network event: MM Switzerland
The Global Fund and Civil Society
Bern, 12 December 2012
“The Global Fund and Civil Society will be in the focus of the thematic part of the Annual Meeting 2012 of aidsfocus.ch, the Swiss platform HIV/AIDS and international cooperation. Christoph Benn, Director, Resource Mobilization and Donor Relation Division, and Linda Mafu, Head Advocacy and Civil Society, both from the Global Fund, accepted the invitation to share with us recent information on the Global Fund to Fight AIDS, TB and Malaria. They will join in the discussion on the roles, opportunities and challenges of Civil Society in shaping the Global Fund.” aidsfocus.ch is coordinated by the Network Medicus Mundi Switzerland.
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MMI Network event: DWA Cuamm
Mothers and children first: initial steps
Rome, 15 December 2012
“We will discuss about innovation and research on Maternal, Neonatal and Child Care and present the results of CUAMM’s five year project Mothers and children first started a year ago. Will be showing the activities implemented and the improvement of four hospitals (in Ethiopia, Uganda, Angola and Tanzania), underlining the outcomes and the use of innovative methodologies and tools.”
www.medicusmundi.org/en/contributions/events/2012/mothers-and-children-first-initial-steps
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Network resource: MM Switzerland
Executive Course on Intellectual Property,
Diplomacy and Global Public Health
Geneva, 13-15 February 2013. “Intellectual property (IP) issues play a very important role in discussions of national and global health problems. Yet, individuals whose primary expertise is health or diplomacy may find these discussions inaccessible because they lack a sufficient understanding of basic intellectual property concepts and their relationship to global public health. This course is designed to help fill this gap by exploring current debates about health-related aspects of IP through a multi-disciplinary learning process.” Course co-organized by the Global Health Programme of the Graduate Institute of International and Development Studies, a member of Medicus Mundi Switzerland.
www.graduateinstitute.ch/corporate/executive/training-workshops/ghd-ip_en.html
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Network event: ACHAP
Increasing burden of non-communicable diseases (NCDs) in Africa:
the challenge of sustainability in scaling up FBOs response
Lusaka, 25-28 February 2013
The Africa Christian Health Associations’ Platform (ACHAP) will hold their 6th Biennial Christian Health Associations Conference on February 25-28, 2013 in Lusaka, Zambia. The conference will be hosted by the Churches Health Association of Zambia (CHAZ) in collaboration with ACHAP Secretariat. The conference will create an opportunity for Christian Health Associations to take stock of their contribution to the non-communicable diseases prevention and management in various countries and discuss opportunities for strengthening capacity, partnerships and health systems for quality, accessible, integrated and sustainable services for NCD prevention and control through the faith based health networks in Africa.
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Network event: FAMME and MMI
50 years of Medicus Mundi Spain, 50 years of MMI
Barcelona, 7-8 June 2013
Medicus Mundi International Jubilee Assembly as side event to the jubilee event “50 years of Medicus Mundi Spain”, including a public conference on primary health care. Save the date! A proper announcement will be published later.
www.bit.ly/mmi50
www.medicusmundi.es/famme/50_aniversario__2
International Health Policy: MMI updates
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Health systems strengthening
Health services, health financing
Universal health coverage
- Social protection and basic services in conflict-affected situations: what do we know? Rachel Slater et al., ODI 2012
http://www.odi.org.uk/sites/odi.org.uk/files/odi-assets/publications-opinion-files/7860.pdf - Health systems strengthening & conflict transformation in fragile states: catching two birds with one stone? Bruno Meessen
http://e.itg.be/ihp/archives/health-systems-strengthening-conflict-transformation-fragile-states-catching-birds-stone
- Performance-based financing for health systems in Sub-Saharan Africa: What have we learnt so far? Adanna Chukwuma
Part 1 http://bit.ly/SYfdfm
Part 2 http://bit.ly/SYcRwW - Economic downturn and health systems: Assess, track, and mitigate! Edit Velényi
http://blogs.worldbank.org/health/economic-downturn-and-health-systems-assess-track-and-mitigate - What is so innovative about Innovative Financing for Health? IHP Newsletter
http://ow.ly/eNozd - Impact of national health insurance for poor and informal sector in low- and middle-income countries. A. Acharya et al.
http://www.dfid.gov.uk/r4d/Output/190461/Default.aspx - Measuring progress towards universal health coverage. Presentation by Melitta Jakab, WHO (ppt as pdf)
http://www.actionforglobalhealth.eu/fileadmin/AfGH_Intranet/Espana/seminario_2012/Presentacion_Melitta_Jakab.pdf - Inclusion and innovation towards Universal Health Coverage: Plenary session webcasts & presentations of HSR Symposium
http://www.hsr-symposium.org/index.php/programme-/plenary-webcasts - On the road to universal health coverage. The vital role of the essential package for health impact. Jonathan Quick
http://uhcforward.org/blog/2012/nov/1/road-universal-health-coverage - Universal health coverage: A quest for all countries but under threat in some. Martin McKee et al.
http://people.ds.cam.ac.uk/ds450/details/P630%20Universal%20health%20coverage.pdf - Universal Health Coverage on the international agenda. Trinidad García and Vanessa López
http://bit.ly/Tb8D8J
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Human resources for health
- The promise of competency-based education in the health professions for improving global health. Larry D Gruppen et al.
http://www.human-resources-health.com/content/10/1/43/abstract - Road map for scaling up human resources for improved health services delivery in Africa (document for WHO AFRO meeting)
http://www.afro.who.int/index.php?option=com_docman&task=doc_download&gid=7970&Itemid=2593 - A descriptive study on health workforce performance after decentralisation of health services in Uganda. Lutwama et al.
http://www.human-resources-health.com/content/10/1/41/abstract - Experiences, opportunities, challenges of implementing task shifting in underserved remote settings (TZ). Munga et al.
http://www.biomedcentral.com/1472-698X/12/27/abstract - Models for increasing the health workforce. S Y Essack (focus on South Africa)
http://www.samj.org.za/index.php/samj/article/download/5779/4546 - Our Side of the Story: Policy report on the lived experience and opinions of Ugandan health workers. P. Thornton et al.
http://de.scribd.com/doc/110291198/VSO-Our-Side-of-the-Story-Uganda-Full-Report - Sharing health workforce findings and strengthening the field of health systems research. Series of CapacityPlus papers
http://www.capacityplus.org/sharing-health-workforce-findings-strengthening-field-health-systems-research
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Health systems research
- Global Symposium on Health Systems Research: Beijing Statement
http://www.hsr-symposium.org/images/stories/downloads/beijing%20_statement.pdf - Health Systems Research and the particular challenge of Fragile States. Luc Van Leemput et al.
http://e.itg.be/ihp/archives/health-systems-research-challenge-fragile-states - Putting health policy and systems research on the map. Abdul Ghaffar et al., WHO Bulletin
http://www.who.int/entity/bulletin/volumes/90/11/12-113118/en/index.html - Changing Mindsets. WHO launched first-ever strategy on health policy and systems research
http://www.who.int/alliance-hpsr/whostrategyhpsr/en/index.html
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Access to medicines and vaccination
Medical research and development
- WHO Convention on Research and Development Financing and Coordination: Bumpy road ahead for Africa. R Machemedze (p.10)
http://www.ghd-net.org/sites/default/files/Health%20Diplomacy%20Monitor%20Volume%203%20Issue%206.pdf - Lives in the balance: Delivering medical innovations for neglected patients and populations. New York, 13-14 Dec. 2012
http://www.doctorswithoutborders.org/events/symposiums/2012-lives-in-the-balance/ - South Africa: Easy patents cost patients
http://bit.ly/R9TzFX - Assessing implementation mechanisms for an international agreement on R&D for health products. Hoffman/Røttingen
http://www.who.int/entity/bulletin/volumes/90/11/12-109827/en/index.html - Balancing options for health research and development. James Love
http://www.who.int/bulletin/volumes/90/11/12-113886/en/index.html - Towards a new model for pharmaceutical research. Carlos M Correa
http://www.who.int/entity/bulletin/volumes/90/11/12-113712/en/index.html
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Women’s and children’s health
Sexual and reproductive rights and health
- BORN equal. How reducing inequality could give our children a better future. Save the Children UK, November 2012
http://www.savethechildren.org.uk/news-and-comment/news/2012-10/gap-between-rich-and-poorest-widest-nineties - By choice, not by chance: Family planning, human rights and development. UNFPA State of World Population report 2012
http://www.unfpa.org/swp/ - Born Too Soon: The global action report on preterm birth. WHO 2012
http://bit.ly/SSepIN
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Equity and human right to health
Social determinants of health
Poverty and social protection
- Social protection and social exclusion: an analytical framework to assess the links. Babajanian and Hagen-Zanker, ODI
http://www.odi.org.uk/publications/6889-social-protection-social-exclusion-design-analytical-framework - Bad medicine. Inequality squeezes both how healthy we are and the healthcare we get. Time to get past it. Dinyar Godrej
http://www.newint.org/features/2012/11/01/healthcare-keynote/ - Bringing clarity to the reporting of health equity. PLOS Medicine editorial
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001334 - NGOs to ask themselves: what is the added value of Human Rights to us? Is it another tool or the key tool? C. Schuftan
http://bit.ly/U9UN6h
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Global health governance and policy
WHO reform
- A public sector for the whole world could end aid as we know it. Jonathan Glennie
http://www.guardian.co.uk/global-development/poverty-matters/2012/nov/06/public-sector-world-end-aid - Conceptualising global health: theoretical issues and their relevance for teaching. Mike Rowson et al.
http://www.globalizationandhealth.com/content/8/1/36/abstract - Global health diplomacy: health promotion and smart power. Manuel Manrique Gil, ISGlobal
http://bit.ly/Tb5Ewe - Results or Rhetoric: What you didn’t know about Europe’s Aid for Health. AfGH Report 2012
http://www.actionforglobalhealth.eu/index.php?id=307 - Governance of new global partnerships: Challenges, weaknesses, and lessons. KA Bezanson and P Isenman
http://www.cgdev.org/content/publications/detail/1426627/ - Angola to host 62nd Session of WHO Regional Committee for Africa, 19-23 November 2012. Press release and documentation
http://bit.ly/Q4Ex64 - Negative health system effects of Global Fund’s investments in AIDS, TB and malaria from 2002 to 2009. J. Car et al.
http://shortreports.rsmjournals.com/content/3/10/70.full - Commitment to Development Index 2012. David Roodman, CGDev October 2012
http://www.cgdev.org/content/publications/detail/1426572/ - The governance of public health: what is important (and problematic). Presentation by Gorik Ooms, October 2012
http://www.youtube.com/watch?v=Sk5AAuVRR3M&feature=youtu.be - Future of WHO hangs in the balance. David Legge
http://www.bmj.com/content/345/bmj.e6877 - Can WHO survive? Richard Horton
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961810-8
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Health beyond 2015
MDGs and SDGs
- Health Beyond 2015. Arthur Cheung
http://e.itg.be/ihp/archives/health-beyond-2015 - On-line discussion on inequalities and persons with disabilities (post-2015 consultation: addressing inequalities)
http://www.worldwewant2015.org/node/284531 - Consultation or conscription? Civil society input on content of #post2015 framework. Amy Pollard and Dominic Haslam
http://cafodpolicy.wordpress.com/2012/11/13/consultation-or-conscriptioncivil-society-input-on-the-content-of-the-post-2015-framework/ - Post-2015: the road ahead. Claire Melamed
http://www.odi.org.uk/sites/odi.org.uk/files/odi-assets/publications-opinion-files/7873.pdf - A holistic and human rights-based approach for addressing inequalities in the post-2015 development agenda. Beyond 2015
http://www.beyond2015.org/sites/default/files/Beyond%202015%20-%20Addressing%20Inequalities.pdf - The Post2015 Development Agenda explained by The Guardian
http://ow.ly/f2FQv - Global engagement for health could achieve better results now and after 2015. Gunilla Carlsson and Anders Nordström
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961809-1/fulltext - How can a post-2015 agreement drive real change? Duncan Green invites to read and comment on this draft paper
http://www.oxfamblogs.org/fp2p/?p=12299
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Other topics
- Atlas of African Health Statistics. WHO AFRO 2012
http://bit.ly/TM4lzQ - Prevention and control of NCDs: guidelines for primary health care in low-resource settings. WHO 2012
http://www.who.int/nmh/publications/phc2012/en/index.html - The draft global monitoring framework on noncommunicable diseases. WHO
http://goo.gl/jC9Dn - New international protocol adopted to combat illicit trade in tobacco products. WHO news release
http://www.who.int/mediacentre/news/releases/2012/illicit_tobacco_20121112/en/index.html - World Pneumonia Day 2012: WHO factsheet raises awareness of biggest cause of child deaths worldwide
http://www.who.int/mediacentre/factsheets/fs331/en/index.html - Cancer doctors pledge to take prevention and treatment to the poor. Sarah Boseley
http://www.guardian.co.uk/society/sarah-boseley-global-health/2012/nov/02/cancer-cancer - The geopolitics of Neglected Tropical Diseases. PLOS NTD collection to commemorate fifth anniversary of its launch
http://www.ploscollections.org/article/browseIssue.action?issue=info%3Adoi%2F10.1371%2Fissue.pcol.v08.i04 - Atlas of health and climate published jointly by WHO and the World Meteorological Organization
http://www.who.int/mediacentre/news/releases/2012/climate_atlas_20121029/en/index.html
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