Several misunderstandings have arisen about the Millennium Development Goals (MDGs). The biggest is that every country must achieve the same numerical targets (for example, halve poverty by 2015), which is incorrect because global performance is an average of all countries’ performance, so some countries will perform above and below average in order to achieve them. A one-size-fits-all approach will not work, as different countries have followed different approaches and strategies for achieving social and economic progress, with varying costs. Unless disparities within countries are addressed, the MDGs will not be met by 2015. To formulate a homegrown MDG-based national development strategy to address inequality and to achieve the MDGs, the author proposes four practical steps: tailor the global targets to make them context-sensitive, set intermediate targets for political accountability, translate targets into specific programmes and policies, and cost programmatic and policy interventions.
Equity in Health
Effects of climate change on health will affect most populations in the next decades and put the lives and wellbeing of billions of people at increased risk. During this century, earth's average surface temperature rises are likely to exceed the safe threshold of 2°C above preindustrial average temperature. Rises will be greater at higher latitudes, with medium-risk scenarios predicting 2–3°C rises by 2090 and 4–5°C rises in northern Canada, Greenland, and Siberia. This report outlines the major threats – both direct and indirect – to global health from climate change through changing patterns of disease, water and food insecurity, vulnerable shelter and human settlements, extreme climatic events, and population growth and migration.
Deaths of children aged under five years old have dropped by 27% globally since 1990, according to the latest World Health Organization (WHO) estimates. But, in WHO’s first progress report on the health-related Millennium Development Goals, released in the World Health Statistics 2009, other results are mixed. Areas where there has been little or no movement are notably maternal and newborn health. In many African countries – and in low-income countries generally – progress has been insufficient to reach the Millennium Development Goal target that aims for a two-thirds reduction in child mortality by the year 2015. ‘While data is patchy and incomplete, it appears that the regions with the least progress are those where levels of maternal mortality are the highest. The challenges ahead are those presented by weak health systems, those associated with noncommunicable chronic conditions and emerging health threats such as pandemics and climate change,’ said WHO.
Recent claims have been made that system-wide approaches, and primary health care for all, are universally agreed-upon goals. So why haven’t these goals been fulfilled? Certainly much of the problem has been lack of real commitment to a comprehensive approach to reducing health risks and improving primary care. The prevailing neoliberal economic model of development, the so-called 'Washington Consensus', which -emphasised liberalisation, privatisation and fiscal austerity, displaced ‘Primary Health Care for All’ with ‘Primary Health Care for Some’.
The current economic downturn will diminish wealth and health, but the impact will be greatest in the developing world. The world can be grateful that health officials are recommitting themselves to primary health care, the surest route to greater equity in access to health care. Much of the blame for the essentially unfair way our world works rests at the policy level. Time and time again, health is a peripheral issue when the policies that shape this world are set. When health policies clash with prospects for economic gain, economic interests trump health concerns. Time and time again, health bears the brunt of short-sighted, narrowly focused policies made in other sectors. Equity in health matters. It matters in life-and-death ways. The HIV/AIDS epidemic taught us this, in a most visible and measurable way. We see just how much equity matters when crises arise.
Deaths of children aged under five years have dropped by 27% globally since 1990, according to the latest WHO estimates. But in WHO’s first progress report on the health-related Millennium Development Goals (MDGs) released today in the World Health Statistics 2009, other results are mixed. An estimated nine million children aged under five years died in 2007, significantly fewer than the 12.5 million estimated to have died in 1990. However, in many African countries and in low-income countries generally, progress has been insufficient to reach the MDG target, which aims for a two-thirds reduction in child mortality by the year 2015. ‘The decline in the death toll of children under five illustrates what can be achieved by strengthening health systems and scaling up interventions,’ said Dr Ties Boerma, Director of WHO’s Department of Health Statistics and Informatics.
The 62nd session of the World Health Assembly took place in Geneva during 18-22 May 2009. At this session, the Health Assembly discussed a number of public health issues, including: pandemic influenza preparedness: sharing of influenza viruses and access to vaccines and other benefits;
implementation of the International Health Regulations; primary health care, including health system strengthening; social determinants of health; and monitoring the achievement of the health-related Millennium Development Goals. The Health Assembly also discussed the programme budget, administration and management matters of WHO. The proceeedings and resolutions can be found at the website provided.
The 62nd session of the World Health Assembly took place in Geneva during 18-22 May 2009. At this session, the Health Assembly discussed a number of public health issues, including pandemic influenza preparedness: sharing of influenza viruses and access to vaccines and other benefits, implementation of the International Health Regulations, primary health care (including health system strengthening), the social determinants of health and monitoring the achievement of the health-related Millennium Development Goals. The Health Assembly also discussed the programme budget, administration and management matters of the World Health Organization.
This paper examines the health status of residents in a major urban centre in Kenya and reviews the effects of selected social determinants on local health. Through field surveys, focus group discussions and a literature review, this study canvasses past and current initiatives and recommends priority actions. Areas identified that unevenly affect the health of the most vulnerable segments of the population were: water supply, sanitation, solid waste management, food environments, housing, the organisation of health care services and transportation. The use of a participatory method proved to be a useful approach that could benefit other urban centres in their analysis of social determinants of health.
The 62nd World Health Assembly in May 2009 adopted a resolution strongly reaffirming the values and principles of primary health care, including equity, solidarity, social justice, universal access to services, multisectoral action and community participation as the basis for strengthening health systems. It calls on WHO to reflect the values and principles of the Declaration of Alma-Ata in its work and that the overall organizational efforts across all levels contribute to the renewal of primary health care and to strengthen the Secretariat’s capacities to support this. Full text is found at the website provided.