In 2011, there was important progress in a number of areas, according to the World Helath Organisation, with reports on AIDS, tuberculosis and malaria all indicating fewer deaths – and fewer new infections. The UN General Assembly met to agree a global agenda for noncommunicable diseases – only the second time (after HIV/AIDS) that a health-related theme was selected as the topic for a UN high-level meeting. Natural disasters and conflict took their toll. The year was marked by the earthquake, tsunami and nuclear power plant damage in Japan. Conflicts disrupted health services and added to health demands in a number of countries, notably in Libya, where WHO contributed to the health response, providing expertise and supplies. 2011 also continued to be marked by the world's financial crisis. This photo feature presents a selection of some of the major health issues in 2011.
Equity in Health
Despite successes in global health to combat specific diseases, progress remains slow particularly in sub-Saharan Africa. In this paper, researchers discuss two challenges in the global health landscape currently: the changes in global health governance and the recurrent pendulum swing between horizontal (health systems focused) to vertical (single-disease focused) programming by external funders and agencies. Using Ethiopia as a case study, their analysis highlights leadership actions that promoted both vertical and horizontal objectives. These included: clarity and country ownership of purpose, authentic engagement with diverse partners, appropriately focused objectives, and the leveraging of management to mediate policy decisions and front-line action. The authors conclude that effective leadership in global health can reconcile vertical and horizontal objectives.
This report presents the findings of a study on “Mainstreaming health equity into the development agenda in Africa”. A steep gradient in health outcomes between rural and urban areas, between better-off households and the less better-off are due in part to inequities in health. Reducing inequities in health is integral to success in reaching the targets of the three health-related MDGs and the other MDGs where health is an important component. The Report shows that policy makes a difference and that success requires that health equity is clearly mainstreamed in the national development plan because it provides the overall strategic direction to ensuring that development is more inclusive; it can infuse the multi-sectoral linkages required in addressing health inequities; and can strengthen the case for increased resources to health. In only a few countries are there identified health equity-focused strategies to
be implemented. Most of the plans outline strategies that are aimed at universal coverage of health services and take the goal of equity as given.
Studies on the burden of ill-health in South Africa have shown consistently that, relative to the wealthy, the poor suffer more from more disease and violence. However, these studies are based on selected disease conditions and only consider a single point in time. Trend analyses have yet to be produced. This paper specifically investigates socio-economic related health inequality in South Africa and seeks to understand how the burden of self-reported illness and disability is distributed and whether this has changed since the early 2000s. This study demonstrates the existence of socio-economic gradients in self-reported ill-health in South Africa. The burden of the major categories of ill-health and disability is greater among lower than higher socio-economic groups. Even non-communicable diseases, which are frequently seen as diseases of affluence, are increasingly being reported by lower socio-economic groups. The current burden and distribution of ill-health indicates how critical it is for the South African health system to strive for access to and use of health services that is in line with need for such care. Concerted government efforts, within both the health sector and other social and economic sectors are therefore needed to address the significant health inequalities in South Africa.
All too often what has been counted falls back into a traditional paradigm of economic inequity – measuring poorest and richest quintiles – not for lack of interest but for lack of agreement on an appropriate measure, let alone what priority measures should be. While we all recognize the need to go further, tested and validated measures bringing attention to geographic, ethnic, age and gender disparities are few, let alone those which truly measure inequities and inequalities in health and the related availability, accessibility, acceptability and quality of services as mandated under the right to health. But this panel argues that this must be the goal, with important implications for the health and well-being of children. Christopher Garimoi Orach from Makerere University School of Public Health, Kampala, gives an insight into research on the unmet needs of new and expectant mothers in displaced populations in Uganda, and Gavin Mooney from the University of Cape Town discusses research on the impact of health care payments on families, and in particular on the well-being of children.
In this report, the World Bank argues that closing persistent gender gaps is important for development, as gender equality is a core development objective in its own right. But it is also smart economics, as greater gender equality can enhance productivity, improve development outcomes for the next generation, and make institutions more representative. Building on a growing body of knowledge on the economics of gender equality and development, the Bank identifies the areas where gender gaps are most significant-both intrinsically and in terms of their potential development payoff-and where growth alone cannot solve the issues. It then sets forth four priorities for public action: Reducing excess female mortality and closing education gaps where they remain; improving access to economic opportunities for women; increasing women's voice and agency in the household and in society; and limiting the reproduction of gender inequality across generations.
Nearly two decades after the United Nations Conference on Environment and Development (the Rio Summit), the world still needs to alleviate poverty and improve human lives through more equitable access and use of resources and healthier environments. Understanding that human health depends on ecosystems, researchers are cutting a new path toward a more sustainable future. An ecosystem approach to health, integrating research and practice from such fields as environmental management, public health, biodiversity, and economic development, is based on an understanding that people are part of complex socio-ecological systems. Featuring case studies from around the world, Ecohealth Research in Practice demonstrates innovative practices in agriculture, natural resource management, community building, and disease prevention, reflecting the state of the art in research, application, and policymaking in the field. The book demonstrates how ecohealth research works and how it has led to lasting changes for the betterment of peoples’ lives and the ecosystems that support them.
A new High-Level Taskforce on Women, Girls, Gender Equality and HIV for Eastern and Southern Africa was launched at the 16th International Conference on AIDS and STIs in Africa (ICASA). The Taskforce will engage in high-level political advocacy in support of accelerated country actions and monitoring the implementation of the draft Windhoek Declaration for Women, Girls, Gender Equality and HIV, which calls for action in seven key thematic areas including sexual and reproductive health, adopting a multi-stakeholder approach to address violence against women and HIV and the law, gender and HIV. Young women are particularly vulnerable to HIV, accounting for about 70% of young people living with HIV in sub-Saharan Africa. The Taskforce members outlined the directions the group will follow to empower women as well as to hold governments accountable to ensure positive policy development and implementation of legal environments to protect women and girls. Participants outlined the need to engage political leadership to challenge harmful cultural norms and laws such as early marriage and wife inheritance. They argued that the involvement of men and boys in the gender equality equation was equally important.
What have the Millennium Development Goals (MDGs) achieved? And what might their achievements mean for any second generation of MDGs or MDGs 2.0? The authors of this paper argue that the MDGs may have played a role in increasing aid and that beyond aid, development policies have seen some limited improvement in high income countries, but with more limited evidence of policy change in low income countries. There is some evidence of faster-than-expected progress improving quality of life in low income countries since the Millennium Declaration, but the contribution of the MDGs themselves in speeding that progress is difficult to demonstrate, even assuming the MDGs induced policy changes after 2002. The authors reflect on what the global goal setting experience of the MDGs has taught us and how things might be done differently if there is a new round of MDGs after 2015. They conclude that any MDGs 2.0 need targets that are set realistically and directly link external funding flows to social policy change and to results.
Economic indicators suggest that there are adequate global resources to guarantee the essential needs of all of the world's seven billion inhabitants. Nevertheless more than 850 million people in the world are undernourished, according to this new report by Social Watch. To monitor trends in global deprivation, Social Watch developed a basic capabilities index (BCI), which combines infant mortality rates, the number of births attended by trained personnel and enrolment rates in primary school. These indicators are considered as a ‘minimum social floor’. Nevertheless the report notes that the world is far from achieving these basic targets. The BCI rose only seven points between 1990 and 2010, and progress was faster in the first decade than the second. This trend is the opposite for trade and income, both of which grew faster after the year 2000 than in the decade before. The authors warn that the global financial crisis is likely to worsen this inverse trend. The reason for the divergence between the trends in economic and social indicators is posited to be the growing inequality within and between countries.