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.
Equity in Health
Sixty-second World Health Assembly: Agenda for action
World Health Organization: 2009
Social determinants of health and health inequities in Nakuru, Kenya
Muchukuri E and Grenier FR: International Journal for Equity in Health, 14 May 2009
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.
WHA Resolution on Primary health care, including health systems strengthening
62nd World Health Assembly May 2009
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.
World Health Assembly 2009: People’s Health Movement’s statements on key health issues
People’s Health Movement: 2009
The People’s Health Movement has warned that the current global economic recession is a threat to the world’s health. It demands immediate measures by the international community and individual governments to ensure adequate resources to revitalise public health systems, pay urgent attention to the needs of the poor rather than reviving failed big commercial banks, allocate funds for the restoration of jobs and livelihood opportunities in low-income communities and strengthen social welfare programmes in developing countries. It urges those in power not to use the economic crisis downturn as an excuse to cut funds for welfare-related programmes and calls upon the World Health Assembly to adopt the final recommendations of the Commission on Social Determinants of Health immediately.
After Accra: Delivering on the Agenda for Action
Gutman J: World Bank, 2009
Developing countries need to deepen their ownership of the development process by engaging local governments, civil society, and parliaments – what could be called 'the basic body of democratic responsibility'. If they identify areas where their capacity is weak, they can develop plans to address those areas. Leadership is required in managing the development process, working out a sensible division of labour among the donors that are active in their countries. They need to improve their ability to gather and use statistical information, so that they know – and can report to their citizens – what results they are achieving. Donors should also make sure that the aid they give is properly managed and that it reaches those who need it most, namely the poor and underserved.
Millennium Development Goals: Progress and prospects for meeting child survival targets in South Africa
Sanders D, Reynolds L, Westwood T, Eley B, Kroon M, Zar H, Davies M, Nongena P, van Heerden T and Swingler G: Critical Health Perspectives 1, 2009
This paper takes a critical look at South Africa's prospects for meeting the Millennium Development targets for child survival. It asks the question: is a return to comprehensive primary health care (PHC) needed right now, as many have been saying? The time is long overdue for energetically translating the rhetorically rich promises of the PHC approach to reality, turning dormant policies into action. The main actions should centre around the development of comprehensive, well-managed programmes involving the health sector, other sectors and communities. The process needs to be structured into functioning district systems. In most countries these need to be considerably strengthened, particularly at the household, community and primary care levels.
Situational Analysis of Children in South Africa 2007–2008 UNICEF: 17 April 2009
UNICEF: April 2009
A bleak picture has been painted in the Situational Analysis of Children in South Africa 2007–2008, a report compiled by the UN Children’s Fund that looks at the standard of living of children in South Africa. It shows that poverty and crime continue to wreak havoc in the lives of this country’s children. It confirmed the view that South Africa will most likely not reach its Global Millennium Goal of reducing child mortality by two-thirds by 2015. Of every 1,000 children born in KwaZulu-Natal, 99 die before they reach the age of five. Gauteng’s mortality rate is still at about 63 deaths per 1,000 births; in Western Cape the ratio is 40 per 1,000.
The Millennium Development Goals Fail Poor Children: The Case for Equity-Adjusted Measures
Reidpath D, Morel C, Mecaskey J, Allotey P PLoS Med 6(4): e1000062. doi:10.1371/journal.pmed.1000062 - April 28, 2009
The Millennium Declaration is a statement of principles about the kind of future that world governments seek; a future that they envisage to be more equitable and more responsive to the socially most vulnerable. The Millennium Development Goals represent the operational targets by which we may judge their actions. The reduction of the U5MR by two-thirds by 2015 is one of the Millennium Development Goals (MDG4). The reduction in U5MR can, however, be achieved through a diversity of policy interventions, some of which could leave the children of the poor worse off. A celebrated MDG4 success can, thus, be a Millennium Declaration failure. Health policy informed by composite outcome measures that take account of both the U5MR and the distribution of the burden of mortality across social groups would help to overcome this.
Well-being: A new development concept
Vaitilingam R: The Broker, 30 January 2009
Leading aid models focus on economic growth and poverty reduction, but the well-being approach aims for more comprehensive change, said a new group studying the problem. Well-being requires us to go beyond the macro statistics on growth, poverty and inequality and get a more fine-grained understanding of the distributions of resources and relationships that constitute the barriers to successful development in particular contexts. This is what development policy must engage in. The work of the group brought together four major bodies of thinking about development, each of which has been adopted with some success by developing countries and development agencies: theories of human need, Nobel laureate Amartya Sen’s ‘development as freedom’, the ‘participation’ and ‘livelihoods’ frameworks, and the work of social psychology on subjective well-being.
Primary health care as a route to health security
Chan M: The Lancet, Early Online Publication, 15 January 2009
Health security must be addressed with great urgency, and health-system strengthening is one of the surest routes to health security. We are not secure when the difference in life expectancy between the poorest and the richest countries exceeds 40 years, or when annual governmental expenditure on health ranges from US$20 per person to well over $6000. We are not secure when more than 40% of the population in sub-Saharan Africa is living on less than a dollar a day. Medicine has never before possessed such sophisticated treatments and procedures for curing disease and prolonging life. Yet, each year, nearly 10 million young children and pregnant women have their lives cut short, largely by preventable causes. Economic development will not automatically protect people who are poor or guarantee universal access to health care. Health systems will not automatically gravitate toward greater fairness and efficiency. International trade and economic agreements will not automatically consider effects on health. Deliberate policy decisions are needed in all these areas.