To achieve global access to health care requires the participation of a range of actors including patients, well-organized NGOs and governments that are held accountable. This specific symposium covered a range of issues that are critical to providing access to health care for all. It also outlined the civil and social roles, such as that of the People's Health Movement (PHM).
Equity in Health
Across countries in sub-Saharan Africa, though socioeconomic inequalities in stunting do exist in both urban and rural areas, they are significantly larger in urban areas. Intra-urban differences in child malnutrition are larger than overall urban-rural differentials in child malnutrition, and there seem to be no visible relationships between within-urban inequities in child health on the one hand, and urban population growth, urban malnutrition, or overall rural-urban differentials in malnutrition, on the other
This session of the August 2006 Geneva Forum on health explored equity in health, including equity of access to essential drugs. Speakers identified constraints to equity, and suggested that equitable access to health care can only be achieved through reformation of the health sector. Measures proposed included a focus on poor geographic areas; the indirect measurement of the recipient's economic status; payments to poor service recipients; mass campaigns; contracting with NGOs and the active involvement of the poor. Inequity is not only due to social determinants and also demands scaling up financing of health systems.
Hon Minister Salih Meky, Minister of Health of Eritrea, spoke with interviewers at the August 2006 Geneva Forum for Health about achievements and challenges in the field of health in Eritrea and in Africa more generally. In Eritrea, health care is free of charge at point of care. The country has managed to keep under control a number of infectious diseases, but faces the increasing challenge of chronic illnesses, such as diabetes, hypertension and cancer. Hospital costs are a major issue. Minister Meky questioned whether there was a simple solution to the brain drain, and urged that it be addressed by the South and by the wealthy countries in the North. He observed that one priority was to improve living conditions and opportunities in the south and another for developed countries to help to train people. He felt that while there ought to be free movement of people, the brain-drain must be solved.
Six years ago, leaders from every country agreed on a vision for the future - a world with less poverty, hunger and disease, greater survival prospects for mothers and their infants, better educated children, equal opportunities for women, and a healthier environment; a world in which developed and developing countries work in partnership for the betterment of all. This report shows where we stand in 2006 toward achieving these goals. The challenges involved in reaching the MDGs are staggering, but there are clear signs of hope.
Mary Robinson, the first woman President of Ireland (1990-1997) and more recently United Nations High Commissioner for Human Rights (1997-2002) shared with the conference team some of the main challenges at hand when it comes to access to health for all: accountability, financing, the brain drain and the responsibility of those who have the means to make a difference, such as the private sector. She pointed out that the high turnout at the Forum was an indicator of the need for it and the urgency of discussing access to health. Access for all is the concern of all.
What we today term "health disparities" launched the modern public health movement in the nineteenth century. Yet only in the past two decades have governments begun to focus explicitly on the deep-rooted social determinants of health and disease. What are governments' responsibilities to reduce these disparities? The last of the three symposia included input from a southern African country in examining how official statistics can shed light on modern health inequities.
PHM has released its yearly update one year after PHA II, held in Ecuador a year ago where the Cuenca Declaration was approved unanimously by 1,400 participants. This update discusses progress in the five year plan adopted in the Cuenca Declaration.
Twenty-six years after the formation of the Southern Africa Development Community (SADC), it is estimated that 80% of the people in the region are living below the poverty datum line. What is the level of commitment within SADC towards improving the people’s livelihoods? Is SADC a true representation of African solidarity? Has SADC pursued a neoliberal agenda to the cost of people's wellbeing? As the SADC heads of State met on 14 to 18 August 2006, in Maseru, Lesotho the poor peoples of the region gathered at the Cooperative College in Maseru in order to seek answers to the above questions; as well as to examine the impact of privatisation, market reforms and debt on peoples access to health services, education and other social amenities.
Using the most recent data sets available from the Demographic and Health Surveys (DHS) of 15 countries in sub-Saharan Africa (SSA), this paper concludes that to successfully monitor the gaps between urban poor and non-poor, existing data collection programs such as the DHS and other nationally representative surveys should be re-designed to capture the changing patterns of the spatial distribution of population.