This report from Population Action International examines progress made towards achieving the goal of reproductive health and rights for all by 2015, agreed at the 1994 International Conference on Population and Development (ICPD). Key achievements include a significant increase in contraceptive use, and higher secondary school enrolment rates among girls. However, significant challenges remain, notably: high unmet need for effective contraception and protection from HIV/AIDS and other sexually transmitted infections (STIs); continuing high levels of maternal mortality; high rates of unsafe abortion; and an acute and growing resource shortfall, with many clinics experiencing stockouts (zero supplies) of contraceptives, safe motherhood kits and other reproductive health essentials.
Equity in Health
A leading development group has welcomed EU proposals to allow export of cheap medicines to poor countries fighting HIV/AIDS and other killer diseases. Under a system to be known as 'compulsory licensing', poor countries facing public health crises will be able to override patents on expensive drugs and order cheaper copies from generic manufacturers in other countries.
Africa is facing a public health disaster in the form of multi-drug resistant malaria. People infected with malaria in eastern, central and southern Africa are rapidly becoming resistant to one of the most affordable and commonly used anti-malaria drugs, sulphadoxine-pyrimethamine (SP). Previously, a number of safe and cheap drugs including SP have kept down the number of deaths and people suffering from severe ill health caused by malaria. But there are ominous predictions that disaster looms – unless governments are willing to reconsider their treatment regime.
Developing countries are falling short of a United Nations goal of reducing child mortality rates by 2015 because of doctor shortages, failure to improve health- care services, and inconsistent funding, the World Bank said. No country in sub-Saharan Africa has made progress in cutting the number of deaths of children under the age of five from preventable illness since the UN issued its 2002 mandate to reduce mortality by two-thirds. More than 11 million young children died that year, with 42 percent in sub-Saharan Africa.
Along with millions of others, health workers celebrated South Africa's first democratic elections in 1994 as the first step in rolling back the devastating inequity of an apartheid era health system. At last the health needs of the whole population would be addressed with the advent of representative government and the anticipated “peoples” health system. An impressive array of health policies and plans were designed to reduce inequities and improve the health of all South Africans. Health activists and struggle veterans were in consensus that a single, unified National Health Service based on a comprehensive Primary Health Care approach would be the key to this transformation. Despite one of the most progressive constitutions on the planet and a strong rhetorical commitment to addressing the health needs of the poor, implementation has been slow. The huge effort put into reshaping the “architecture” of the health system has not translated into real health gain for all South Africans. Many of the poorest still find themselves marginalized and neglected, just as they were in pre-democratic South Africa.
The third meeting of the African Reproductive Health Task Force was opened in Harare, Zimbabwe, with a call on African countries and the international community at large to allocate more resources to reproductive health programmes with a view to stemming the tide of maternal and child deaths. "African health policies, including global health policies, have for a long time overlooked the need to allocate adequate resources to reproductive health programmes…and this has contributed to the massive numbers of maternal and newborn deaths", Zimbabwe's Minister of Health and Child Welfare, Dr David Parirenyatwa, told the meeting.
Health systems are consistently inequitable, providing more and higher quality services to the well-off who need them less than the poor who are unable to obtain them. In the absence of a concerted effort to ensure that health systems reach disadvantaged groups more effectively, such inequities are likely to continue. Yet these inequities need not be accepted as inevitable, for there are many promising measures that can be pursued, says this Lancet article.
Mozambique plans to have 8,000 people living with AIDS on free triple-therapy antiretroviral (ARV) treatment through its public health system by the end of the year. Although this is only a small proportion of the estimated 200,000 people in need of treatment, it is seen as a breakthrough for one of the world's poorest countries, where in the past ARVs were regarded as a luxury for Western countries only.
Eighty-five countries last month signed a statement reaffirming commitment to reproductive health- and HIV/AIDS-related population and health goals agreed to 10 years ago at the 1994 International Conference on Population and Development in Cairo, Egypt, the AP/Philadelphia Inquirer reports. More than 250 world leaders - including presidents, prime ministers and Nobel Prize winners - endorsed the goals of ensuring a woman's right to education, health care and reproductive choices. Despite endorsement by the entire European Union, China, Japan, Indonesia, Pakistan and more than 12 African nations, the Bush administration refused to support the statement because it mentioned upholding "sexual rights" - a term that the administration says has no "agreed definition" in the international community.
The U.S. Agency for International Development plans to give Zambia $24 million to combat AIDS and malaria and improve the quality of drinking water, the U.S. embassy in Lusaka, Zambia, said last Tuesday in a statement, the Associated Press reports. The money will be used to fund health education programs - coordinated by the government and the Society for Family Health - over the next six years. Zambia on Tuesday banned free condom distribution in schools just as USAID announced its funding for HIV/AIDS programs, with condom distribution a "key part of the strategy," Reuters reports.