This report measures progress on the health Millennium Development Goals (MDGs) to 2015 and beyond. The authors gathered data from a combination of literature reviews, interviews with key stakeholders in the health field, and a roundtable discussion. They found that the past decades have seen a gradual shift from a focus on a single disease to a more systemic approach by including a variety of health (and non-health) inputs which have to be integrated at the national, district and local levels. Although the authors predict that achievement of the health MDGs will almost surely be uneven, the available evidence suggests that the health MDGs have been effective in accelerating progress on target indicators, in stimulating global political support in the creation of significant global institutions dedicated to helping countries achieve the MDGs and in stimulating research and debate on systemic approaches to improving health outcomes. The authors argue that the current health MDGs will need continued focus beyond 2015 and must be included in some form in the post-2015 goals. The new goals should be simple enough to be politically intelligible and acceptable, and meaningful to politicians and laypeople. The report recommends that a mechanism be set up to ensure decision-makers and external funders are held accountable and to help countries get back on track.
Equity in Health
In this study, researchers quantified and compared education- and wealth-based inequalities in the prevalence of five non-communicable diseases in low- and middle-income country groups: angina, arthritis, asthma, depression and diabetes. Using 2002-04 World Health Survey data from 41 low- and middle-income countries, the prevalence estimates of angina, arthritis, asthma, depression, diabetes and comorbidity in adults aged 18 years or above was analysed by wealth quintile, education level, sex and country income group. Results indicated that wealth and education inequalities were more pronounced in the low-income country group than the middle-income country group. Both wealth and education were inversely associated with angina, arthritis, asthma, depression and comorbidity prevalence, with strongest inequalities reported for angina, asthma and comorbidity. Diabetes prevalence was positively associated with wealth and, to a lesser extent, education. Adjustments for confounding variables tended to decrease the magnitude of the inequality.
South Africa fares worse on health than the residents of any other BRICS country, according to the country’s Health Minister Aaron Motsoaledi. In a speech delivered on 29 July 2012, the Minister presented standard health indicators for life expectancy, with the average South African expected to live until 54, far behind the Chinese at 74, Brazilians at 73, Russians at 68 and Indians at 65. He quoted South Africa’s maternal mortality rates at 410 per 100,000 births, almost double India’s rate of 230, which lags behind Brazil (58), Russia (39) and China (38).
The United Nations (UN) has named the 26 members of its new High-level Panel to advise on the global development agenda beyond 2015, the target date for the Millennium Development Goals (MDGs). Three co-chairs have been appointed, including President Ellen Johnson Sirleaf of Liberia. The Panel is expected to prepare its development vision to present to UN Member States in 2013, with sustainable development and eradicating poverty at its core. The Panel is part of the Secretary-General’s post-2015 initiative mandated by the 2010 MDG Summit. It intends to take an open, inclusive approach, with consultations involving civil society, the private sector, academia and research institutions from all regions, in addition to the UN system, to advance the development agenda beyond 2015. The work of the Panel will reflect new development challenges while also drawing on experience gained in implementing the MDGs, both in terms of results achieved and areas for improvement.
he Africa Progress Report 2012 is the Africa Progress Panel’s flagship publication. Its purpose is to provide an overview of the progress Africa has made over the previous year. The report draws on the best research and analysis available on Africa and compiles it in a refreshing and provocative manner. Through the report, the Panel recommends a series of policy choices and actions for African policy makers who have primary responsibility for Africa’s progress, as well as vested international partners and civil society organisations. The report warns that Africa’s strong economic growth trajectory – which will see the region increase the pace of growth well beyond 5 per cent over the next two years – is at risk because of rising inequality and the marginalisation of whole sections of society. The report calls for a “relentless focus” by policymakers on jobs, justice and equity to ensure sustainable, shared growth that benefits all Africans. Failure to generate equitable growth could result in “a demographic disaster marked by rising levels of youth unemployment, social dislocation and hunger.” Africa’s governments and development partners must urgently draw up plans for a big push towards the 2015 Millennium Development Goals, the report says.
According to this report, steady economic growth and improvements in poverty reduction on the continent are reported to have had a positive impact on MDG progress, with sustained progress toward several MDGs. Africa is on track to achieve the targets of: universal primary education; gender parity at all levels of education; lower HIV/AIDS prevalence among 15-24 year olds; increased proportion of the population with access to antiretroviral drugs; and increased proportion of seats held by women in national parliament by 2015. However, the report acknowledges that more needs to be done to address inequalities, including between women and men. It highlights the need to address the sub-standard quality and unequal distribution of social services between rural and urban areas. It suggests active steps to ensure that economic growth translates into new and adequate employment opportunities for Africa’s youthful and rapidly growing population, and supports social protection systems. The report urges policymakers to put greater emphasis on improving the quality of social services and ensuring that investments yield improved outcomes for the poor for MDG progress.
The World Federation of Public Health Associations honooured the author with the Leavell Lectureship Award and this paper is the speech given by the awardee on “Health Equity, from the African Perspective” at the Congress. He raises that addressing equity calls for African countries to break the vicious cycle of poverty and ill-health; to urgently address the water, sanitation and hygiene crisis; to mobilize adequate budget allocation to the health sector and provide social protection for poor people; to strengthen the capacity of health systems to provide effective and equitable quality health care services; to stabilise health personnel; to generate evidence and build transparency and accountability in the use of domestic and externally generated resources allocated for health. All these issues he noted need to be backed by political commitment to make health equity a priority.
Noncommunicable diseases are an increasing health concern worldwide, but particularly in low- and middle-income countries. This study quantified and compared education- and wealth-based inequalities in the prevalence of five noncommunicable diseases (angina, arthritis, asthma, depression and diabetes) and comorbidity in low- and middle-income country groups, using 2002-04 World Health Survey data from 41 low- and middle-income countries. Wealth and education inequalities were more pronounced in the low-income country group than the middle-income country group. Both wealth and education were inversely associated with angina, arthritis, asthma, depression and comorbidity prevalence, with strongest inequalities reported for angina, asthma and comorbidity. Diabetes prevalence was positively associated with wealth and, to a lesser extent, education. Adjustments for confounding variables tended to decrease the magnitude of the inequality.
Human-induced climate change will have the greatest, and generally earliest, impact on the poorest and most disadvantaged populations, according to this paper. Climate change adaptation is receiving much attention given the inevitability of climate change and its effects, particularly in developing contexts, where the effects of climate change will be experienced most strongly and the response mechanisms are weakest. Financial support towards adaptation activities from various actors including the World Bank, the European Union and the United Nations is increasing substantially. With this new global impetus and funding for adaptation action come challenges such as the importance of developing adaptation activities on a sound understanding of baseline community needs and vulnerabilities, and how these may alter with changes in climate. The global health community is paying heed to the strengthening focus on adaptation, albeit in a slow and unstructured manner. The aim of this paper is to provide an overview of adaptation and its relevance to global health, and highlight the opportunities to improve health and reduce health inequities via the new and additional funding that is available for climate-change adaptation activities.
Considerable declines in malaria have accompanied increased funding for control since the year 2000, but historical failures to maintain gains against the disease underscore the fragility of these successes. In this study, researchers conducted a systematic review of the literature to identify historical malaria resurgence events. They identified 75 resurgence events in 61 countries, occurring from the 1930s through the 2000s. Almost all resurgence events (91%) were attributed at least in part to the weakening of malaria control programmes for a variety of reasons, of which resource constraints were the most common (57%). Over half of the events (59%) were attributed in part to increases in the intrinsic potential for malaria transmission, while only 32% were attributed to vector or drug resistance. Given that most malaria resurgences have been linked to weakening of control programmes, this study highlights the need to develop practical solutions to the financial and operational threats to effectively sustaining today's successful malaria control programmes.